Violence and Mental Health

The recent mass shooting at the Sandy Hook Elementary School in Newtown, Connecticut reinvigorated the national debate about gun control. While I believe that additional measures must be adopted to make it more difficult for criminals and the mentally ill to obtain firearms, it is equally important that Americans evaluate other areas in our society that may contribute to violent crime.

One major area where we need significant reform is mental health care. Because I am not a mental health professional, I am not qualified to give many specifics about improvements to mental health care; however, the recent mass shootings have clearly demonstrated significant failures in properly identifying and treating mental illness. Rather than just prescribing psychotropic drugs for people who are mentally ill, sending them home and calling it a day, we need to ensure that individuals who pose a danger to themselves or others are promptly committed, even against their will, to secure mental health facilities where they can receive appropriate treatment.

A family in my hometown LDS ward had a son with a serious mental illness, possibly some form of psychosis. A few years ago, when this young man was in his early 20s, his mother tried to have him committed involuntarily to a local mental hospital, but for a reason unknown to me, he was turned down. The young man killed his mother the next night because he perceived he had been told to do so in a psychotic hallucination. Unfortunately this kind of tragedy is hardly unique in America.

Paul Steinberg, a clinical psychiatrist, observed in a recent New York Times op-ed that our society has "too much concern about privacy, labeling, and stereotyping, [and] about the civil liberties of people who have horrifically distorted thinking. In our concern for the rights of people with mental illness, we have come to neglect the rights of ordinary Americans to be safe from the fear of being shot — at home and at schools, in movie theaters, houses of worship and shopping malls."

Mr. Steinberg pointed out that over the last 50 years, there has been a huge "swing in mental health care…: too little institutionalizing of teenagers and young adults (particularly men, generally more prone to violence) who have had a recent onset of schizophrenia; too little education about the public health impact of untreated mental illness; too few psychiatrists to talk about and treat severe mental disorders."

Jared Loughner, who shot and killed 6 people and injured 12 others (including a Congresswoman) in Tucson, Arizona in January 2011, had been suspended from Pima Community College the previous September because of bizarre behavior that caused college officials to believe he posed a danger to others. If Loughner's behavior prompted school officials to worry about the safety of those around him, why wasn't he committed to a mental institution for psychiatric evaluation? After the shooting, Loughner was diagnosed as a paranoid schizophrenic. The perpetrators of the Aurora and Virginia Tech mass shootings had also been flagged as a possible danger to others prior to the shootings. If they had been forcibly committed for complete psychiatric evaluation and treatment, those shootings may not have occurred.

Mr. Steinberg also noted, "severely ill people… fall through the cracks, in part because school counselors are more familiar with anxiety and depression than with psychosis. Hospitalizations for acute onset of schizophrenia have been shortened to the point of absurdity. Insurance companies and families try to get patients out of hospitals as quickly as possible because of the prohibitively high cost of care."

Mr. Steinberg calls for improved insurance coverage, expanded hospital capacity, and lengthier care for patients with schizophrenia, as well as intense public education regarding how we treat schizophrenia. Perhaps Americans must be more willing to forcefully commit people with severe mental illness who may pose a threat to themselves or others. We also may need legislation that will make involuntary commitment easier. Furthermore, in the interest of public safety, taxpayers must be willing to help shoulder the burden of providing comprehensive treatment to psychotic patients. Unfortunately, it's worth noting that Republicans, especially at the state level, have been systematically cutting public funding of mental health care.

While there might be merit to the notion that ineffective and inattentive parents and ever-eroding societal morals play a role in America's gun violence problem, government cannot force parents to be responsible or coerce individuals to be moral citizens. We should look for constructive ways in all pertinent areas, including mental health care and gun laws, to minimize the likelihood of these events occurring, even while recognizing that sometimes, despite our best efforts, bad things will occasionally happen.