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Dec 21 2012

A National Database of the Mentally Ill

Subtitled: Has Anyone Here Heard of Client/Patient Confidentiality? No? No.

Today, the National Rifle Association had a press conference.

Wayne LaPierre, the Executive Vice President spoke, and I, recently relocated back to Texas for the holidays, slept through it.

Then I saw the transcript, sat bolt upright in my bed, and got ranty on the internet.

The relevant bit (emphasis mine):

 The truth is, that our society is populated by an unknown number of genuine monsters. People that are so deranged, so evil, so possessed by voices and driven by demons, that no sane person can every possibly comprehend them. They walk among us every single day, and does anybody really believe that the next Adam Lanza isn’t planning his attack on a school, he’s already identified at this very moment?

How many more copycats are waiting in the wings for their moment of fame from a national media machine that rewards them with wall-to-wall attention and a sense of identity that they crave, while provoking others to try to make their mark.

A dozen more killers, a hundred more? How can we possibly even guess how many, given our nation’s refusal to create an active national database of the mentally ill? The fact is this: That wouldn’t even begin to address the much larger, more lethal criminal class — killers, robbers, rapists, gang members who have spread like cancer in every community across our nation.

So, since the NRA seems long on rhetoric and short on facts, I thought I’d clear some stuff up for them.

Patient confidentiality exists even if you have mental illness.

Funny how that works, where you have rights still, when you have mental illness. Psychiatrists still have to follow HIPPA rules. In fact, notes on psychotherapy that are kept separate from medical charts are given even more protection. Was the NRA suggesting that we trounce all over patient confidentiality and require all diagnoses to be reported? Just the “dangerous” ones? Would someone like to clarify for me which ones those are?

Therapists are already required to report anyone who makes a credible threat, and warn any possible targets.

This is largely based on the Tarasoff Rule, which came out of Tarasoff v. Regents of the University of California. In essence, when a psychologist or therapist hears a client threaten harm, they are obligated to warn those people who may be in danger. “Protected privilege ends where the public peril begins.” This is one of several exceptions to confidentiality, which can be summed up as confidentiality except in instances of harm to self or others. (Which includes reports of child abuse while another child is in the home, risk of suicide, elder abuse, and any threats or injury or death to another.)

So, say there was a high correlation between being mentally ill and being violent. (There’s not.) And then say the Connecticut shooter was mentally ill and in treatment (As far as we know, he wasn’t.) And then, say he’d confessed his plan… oh wait, there’s already methods in place to deal with that. So your database does what now, NRA?

Not everyone with mental illness is diagnosed. 

So would you be requiring everyone to be tested for mental illness then? I mean, I’d be all over that if you didn’t then require that  the mentally ill be registered in a database à la sex offenders. 

Mental illness isn’t exactly uncommon. 

Twenty six percent of American adults meet criteria for a diagnosable disorder in a given year. That, for those of you inclined towards fractions, is one quarter of the population. Since I’ve noticed that it’s somewhat less than a quarter of the population that’s having trouble committing violent crimes with guns, I’m going to posit the radical notion that having mental illness and being near weaponry does not a killer make. Of course, there are some mentally ill people who shouldn’t be near guns. I’ll agree to that easily. There’s also some mentally sound people that we’d rather not have near guns.

Discrimination against the mentally ill is actually a problem. 

Nifty research here. (Abstract only if you’re not at a university, sorry.) Basically, the neurodiverse are more likely to be discriminated against by their employers and coworkers, as well as facing disadvantages in competing for jobs. So maybe we could try to avoid making that worse? Like say, by avoiding the creation of a searchable database of those with mental illness?

Note: I’m fully aware that some people with mental illness are violent. So are some neurotypical people. I’d be all over a psychometrically sound test of impulse control/aggression/etc, that tested abilities related to using a gun responsibly. Using science to determine safe gun owners–great! Using a highly stigmatized population to avoid discussing gun control–jerk move.

54 comments

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  1. 1
    Nick Gotts

    I’m sure the NRA know perfectly well that the proposal is completely impractical, even setting aside the issue of patient confidentiality. Its only purpose is distraction.

  2. 2
    Kate Donovan

    I don’t disagree, but given that I’ve seen people say stuff like this since the shooting, I thought I’d lay out exactly how wrong this idea is.

  3. 3
    Jean

    The truth is, that our society is populated by an unknown number of genuine monsters.

    And some of them are NRA members and possibly high ranking members…

  4. 4
    evilDoug

    A national registry of persons with mental illness: a national catalog of potential victims for “more lethal criminal class — killers” like George Zimmerman.
    “I’ve been following that kid around every day for two weeks, and today he bought some fuel that’s supposed to be for model airplanes. I was terrified he was going to use it burn down my truck with me in it. He kept looking at me funny.” “OK, then, you were just standing your ground. You can go.”

    “more lethal criminal class — killers” – brought to your community by the NRA and ALEC

  5. 5
    Adam

    I wonder what he would have to say about someone suggesting a national database of all gun owners….

  6. 6
    timgueguen

    \yeah, it’s funny he leads an organisation opposed to any sort of gun registration, yet turns around and wants citizens who have certain types of medical problem registered.

  7. 7
    J Lawrence

    It’s a no brainer that people who have had current or prior episodes involving mental illness should never, ever, ever be able to purchase a gun in this country. Buying a gun should be a privilege for those who are mentally fit. We need to change the laws to create a national database, even if organizations like the ACLU will challenge this effort. I speak from experience having had bipolar disorder for my whole adult life. If I didn’t have the sense to not own a gun, I most certainly would have killed myself or someone else by now during one of my dysphoric manic episodes. I am not a bad person. I am not evil. I have a biologically-based problem, like someone who has asthma or diabedes. But my problem shouldn’t cause others to suffer if I were to somehow really go off the deep end.

    Once I was in an “open” hospital with other mentally ill people. At one point people were attempting suicide on a monthly basis. During my stay one girl purchased a gun online and blew her brains out. Another girl brought a gun to therapy. Whether it’s suicidal or homicidal acts, these acts are violent, and I don’t believe for a second that there isn’t a connection between mental illness and proclivity to violence.

  8. 8
    Recreant

    @#5 J Lawrence- One thing I come across commonly in debates is an inability to recognize that others are not exactly like you. Your problems are not those of everyone who is not neurotypical. While it may be true that you should not own a gun, that limitation does not extend to others.

    As i’ve said elsewhere, I grew up with the stigma that I was a serial/mass killer in waiting because I was different. Your insistence that I register my condition for the nation to see would open myself and my family to discrimination. In all likelihood, it would lead to both me and my brother losing our jobs because, despite the fact that we clear bi-annual backgrounds checks, my name appearing on such a registry would be cited as ‘potential securtiy risk.’

    No thank you. If you feel the need to isolate yourself, by all means do so, but don’t try and drag me down with you.

  9. 9
    Robert Bauer

    Not to mention, the first effect of this registry would be that anyone who was in, or interested in, a lot of important careers – law enforcement, education, anything requiring security clearance, etc. – would start actively avoiding treatment so they wouldn’t get registered. This would be true even if the mental illness was related to the job, such as soldiers and police officers with PTSD from combat etc.

    Some people may not like the idea of people with mental illness in these jobs. But that’s the world we live in right now, and it doesn’t get any worse just because we know about it. What would be worse, is those jobs being filled by people with untreated mental illness.

  10. 10
    J Lawrence

    The registry should be used only for people who want to buy a weapon or work around weapons. Not for any other purpose. There should be no reason you lose your current job. But there should be no reason for you to own a gun.

  11. 11
    J Lawrence

    Again, the clearance is only for people who would buy or directly work with weapons. The dispersion of information must remain secure and secret to the general public. I feel that idea is perfectly reasonable. It might not prevent every act of violence, but combined with significant reduction of gun volume, it should improve the situation tremendously.

  12. 12
    J Lawrence

    I should state I respect others opinion on this, and if a majority feel squeamish about security of such a registry, then we shouldn’t do it. Realize, however, that to make this country more secure from gun violence, we would have to make tradeoffs concerning the rights of people to own (or work with guns). Without these tradeoffs there’s no reason to assume the gun violence won’t continue as is.

  13. 13
    Recreant

    Nope, sorry. Both my job and my brother’s involve working either with or around weapons. So yes, I would likely lose my job as would he due to the level of security clearance required. Why should I find that acceptable?

    Further, the idea that the registry would only be for people who want to buy a weapon or work around weapons is untenable. The registry would ostensibly be used to check in those instances (and I disagree with that) yet the only way one would make the list is if they applied for said job/gun ownership. How do you expect that to work? A blanket request for medical records to every mental health service in the nation?

    No, obviously the only way the registry would work is by reporting before the affected instances. As soon as that happens, the registry becomes a tool for discrimination.

    Once again, if you feel the need to isolate yourself, you’re welcome to do so, but kindly do not drag the rest of us down with you.

  14. 14
    Recreant

    I’m not really miffed about restricting gun access or gun ownership; it’s the way in which you intend to do it that concerns me. A national registry of aneurotypical individuals is an ineffective means to do so with massive potential for discriminatory abuse.

  15. 15
    Recreant

    That still doesn’t address the issue that was raised, namely people avoiding treatment in order to obtain said job/weapon.

  16. 16
    J Lawrence

    Of course the affected instances should be reported to the government. That’s the only way it would work. I work with secure information (people’s personal records) all the time from the NIH, and the information transfer protocol is extremely reliable and safe. It could be done with the information never getting out when it’s not needed, and if it get’s out, you would have a hell of a class-action lawsuit.

    Don’t forget insurance companies handle mental health information all the time, and the info remains secure by law (i.e., your workplace isn’t going to know your condition if you choose to use insurance). Of course the registry is different in that it would be involuntary.

    I find your repeated assertion that I’m “dragging you down” to be quite extraordinary. Owning a gun and working with guns shouldn’t be a right but a privilege for those who are of age and of healthy mind.

  17. 17
    J Lawrence

    We really don’t know how much of an impact this will have statistically (i.e., in a population). Sure we can fantasize about all the hypotheticals, but there is no data suggesting this would be a large-scale problem, particularly if the registry is used only to prevent the mentally ill from having access to guns (all other use of the information would be illegal).

  18. 18
    J Lawrence

    I did say that the registry won’t be perfect. That’s why we need to make multiple tradeoffs (please note the plural) to reduce gun violence, including banning assault rifles. Only a multi-factorial approach, in my opinion, will work. Both conservatives and liberals are going to have to compromise some on their ideology.

  19. 19
    J Lawrence

    By the way it’s preferable that you use the term “neuroatypical” to “aneurotypical,” FYI.

  20. 20
    robertbaden

    SS number originally was not supposed to be for any other use besides the social security system.

  21. 21
    Recreant

    And I find your inability to fathom that your problems might not be my problems quite extraordinary. Far too common, but extraordinary nonetheless. You are equating any/all aneurotypical individuals with violence/self harm, which is decidedly false, and insisting that we be punished for it.

    You have failed to explain why I should be excluded from holding my job because of my disorder. Your entire argument rests on the assertion that I, despite all other indications to the contrary, am homicidally violent simply because I am not neurotypical. I didn’t appreciate that stigma growing up and I certainly don’t like people promoting it as an effective means of combatting gun crime.

  22. 22
    Recreant

    You still have yet to provide a justification for barring all non-neurotypical (sorry, but no matter how correct it may be neuroatypical sounds displeasing to me-a consequence of my disorder) from owning or working around guns simply because some small subset may be prone to violence.

  23. 23
    J Lawrence

    Recreant, you make a good point, however, that perhaps not all mentally ill people should be included in the registry — perhaps only those who have exhibited behavior or extended fantasies that include self-harm or violence towards others. Realize, however, it’s a tradeoff; by being less inclusive you will less likely prevent suicides and homicides.

  24. 24
    Recreant

    J- I have to believe that there are better means of preventing suicide/homicde that also lack the potential for abuse that this type of registry inherently possesses. Further, no matter how broad such a registry might be, it wouldn’t eliminate suicides and homicides committed by neurotypicals.

    I’m simply not an “ends justify the means person.”

  25. 25
    Anne C. Hanna

    Kate, thanks for writing this. I agree with you 100%. This is a horrific proposal (seriously Nazi-esque, and I don’t care if that’s a Godwin). I don’t understand why the NRA hasn’t already been shamed into firing this LaPierre scumbag with extreme prejudice.

  26. 26
    Robert Bauer

    Trigger warning for discussion of the practicalities of suicide.

    I am an “ends justify the means” person, in that I think it’s a false distinction – there’s not “ends” and “means”, there’s just all the consequences to what you do, all of which you are responsible for. I just think that the downsides of such a registry, even the milder version J Lawrence proposes, vastly outweigh the benefits. A person with suicidal ideation is more likely to harm hirself if you take away hir therapy and medication (by discouraging them from seeking treatment) than if you take away hir gun. Alternate ways of committing suicide – knives and overdoses and so on – are almost as effective as guns, but alternate ways of improving your serotonin levels – vitamin D, tryptophan, talking things out with friends and family – are not nearly as effective as medical treatment.

    Also, mentally ill people are more likely to be victimized, which makes it dangerous to publish their identity to anyone (and it’s not like the US government has a good track record of being just in how it uses information it has about citizens.) For one thing, every gun merchant in the country would at least have to be able to query it for background checks. And I estimate it would take about five seconds for the FBI to get the same access for background checks. Ten seconds later, public school principals would be able to check up on potential hires.

  27. 27
    Anne C. Hanna

    Absolutely agreed, Robert. And I can’t help noting that this same logic of a registry discouraging people from seeking treatment also suggests that a mental illness registry would be likely to increase the number and deadliness of mental-illness-related spree killings rather than decreasing them, just as with suicides. The disincentive to revealing oneself as mentally ill would mean that not only would we still have an unknown number of unidentified dangerously mentally ill people wandering around, an even larger percentage of those people would be *completely untreated* for their dangerous mental illnesses, compared to the current situation that this registry is supposed to fix. And thanks to the NRA’s insistence that we can’t impose any restrictions on guns whatsoever, all of those unidentified, untreated, dangerously mentally ill people would have easy access to the shiniest, highest-powered weaponry that money can buy.

    So, from the ends-justify-the-means perspective, the end is that we get more and worse spree killings, by the means of making the lives of the mentally ill even harder than they are now while failing to deal with the actual sources of gun violence in any way. Machiavelli must be spinning in his grave.

  28. 28
    Anne C. Hanna

    …I don’t believe for a second that there isn’t a connection between mental illness and proclivity to violence.

    I just want to note here that the issue of links between violence and mental illness is far muddier than you might like to believe:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525086/

    Your anecdotes are not data.

    But you know what *is* really strongly linked to violence? Being male. There are almost no female spree killers, and violence in almost all other contexts is massively disproportionately a male thing. I propose that all men should be required to be entered into a registry (hey, it’s only 49% of the population, not that much more than the fraction with mental illness, so big whoop, right?), and be prohibited from ever, ever, ever owning or working around guns, or anything more dangerous than a cotton ball. That oughta solve our problem right quick.

  29. 29
    Robert Bauer

    Though, to be fair, in this conversation we’re responding not just to the NRA, but also to J Lawrence, who has been arguing for stricter gun control and a mental health registry.

  30. 30
    Anne C. Hanna

    True, Robert, but even in J Lawrence’s scenario, the mental health registry would still be counterproductive to the goal of reducing spree killings and other gun violence rather than synergistic with it.

  31. 31
    Ibis3, Let's burn some bridges

    I know it’s only tangentially related to the registry idea (on which I agree with you 100%), but there’s another thing about the NRA’s “all people who kill other people with guns are mentally ill” premise that I doubt they’ve considered. If the justice system works as it is supposed to, mentally ill people who commit violent acts due to their illness are not criminally responsible, and therefore belong in hospitals for treatment rather than prison. Suggest to LaPierre that, by his own logic, any mass murderer using guns should not be incarcerated and let’s see how fast he backtracks.

  32. 32
    bubba707

    This is a highly complex problem and I tend to believe that if Government is the answer it’s a stupid question. To look at the prsctical side, the very first thing that needs doing is wipe out ALL existing gun laws as they stand and replace the nightmarish mish-mash with a truely national, uniform and coherent set of gun laws that make rational sense. So far that has never been even seriously considered. As for a database of the mentally ill, given the Governments track record I can’t imagine such a thing NOT being abused or any laws regarding it not being violated in a routine manner.

  33. 33
    evilisgood

    Thanks for this, Kate. That part of the speech scared the bejeezus out of me.

  34. 34
    raymoscow

    OK, my knowledge on this subject is very limited, but I’ll make two comments anyway:

    1. As far as I know, the incident of mental illness is not significantly higher in the USA than in other industrialised countries, and so it is not likely to be the underlying cause of US gun violence.

    2. If we are just looking for a list of irrational, dangerous people, why not just use the NRA membership list?

  35. 35
    bubba707

    Ray, add every politician to that list.

  36. 36
    Crunchy Renee

    I am all for trade offs!
    Let’s trade easy access to guns for a national registry and limits on what people own, for safety!

    I seriously cannot believe a peraon with bipolar actually thinks this is a good idea, instead of just restricting guns. Mentally ill people actually commit FEW crimes. If you want a registry of dangerous people, gun owners are a much better, and more fair, target. Why should the MI have their freedoms limited so that any e can own assault rifles with huge clips? Seriously? thats just about as dumb as armed guards in schools.

  37. 37
    J Lawrence

    I’ve given up arguing my point, as (mostly) everyone else who posts on this blog apparently belongs to one mindset. Realize however, just like you want to hold on to your precious beliefs, and that’s ultimately what they are in my opinion, the conservatives and NRA will want to hold on to theirs. And we’ll likely end up with the same old story — nothing getting done in Washington.

    It’s only when different groups make practical compromises on multiple fronts will the mass shooting problem be significantly diminished.

  38. 38
    J Lawrence

    And the single review article you point to has very muddy data because the author lumps all mental illness and all acts of violence together. It also doesn’t mention suicides once in the paper; I don’t think you can have an accurate analysis without addressing this. I’d take my years of experience over the paper you present.

    I find your analysis about males mildly offensive. If you ask statistically what variables have led to success in business, being male is probably highly overrepresented. I assume you don’t believe that we should hire only males to be CEO’s.

  39. 39
    Anne C. Hanna

    The lumping of all mental illnesses together is kind of my point. In part, I picked something that lumps them all together because that’s what Wayne LaPierre did in his nasty little proposal, and that proposal is what Kate was writing about here. But it’s also reasonable to look at statistics from all people with mental illnesses together because of the fact that in reality it’s very very hard to reliably separate out the tiny handful of mentally ill people who are serious dangers to themselves and those around them from the vast majority who are perfectly harmless.

    This issue is similar to the problems we have in terrorism prevention. Let’s say we’re worried about Islamist terrorists hijacking airplanes. The problem that it’s very difficult is to separate out the tiny handful of Islamists who want to crash airplanes into things from the harmless majority of people whom our poorly-trained airport screeners think look like scary Muslims. Because the genuinely dangerous ones are so rare, you tend to get such a nastily high false positive rate that you waste far too many resources harassing innocent people and impose far too much of a burden on those innocents for the system to be workable. And in addition, you get a bunch of false negatives (failing to detect terrorists who actually do damage) because you were so busy focusing on the one group you decided to demonize that you missed all the other malefactors who either never fit that profile in the first place, or who knew you were narrowly focused on that profile and just disguised themselves a bit. (See Bruce Schneier for more discussion of these kinds of issues.)

    And please note that this analysis applies to both homicides and suicides. Plenty of suicidal folks would never have made it onto the database (I have an uncle who killed himself who probably would’ve escaped detection by this system), and plenty of people who were never suicide risks could easily end up on it (I experienced a pretty serious depression about a decade back that could’ve easily landed me there even though I was never even remotely suicidal).

    ———

    Your years of experience with your own mental health issues, and with the mental health issues of people you have incidentally encountered, are still anecdote, not data, and should not be “taken over” sound data collection and analysis. I could point you to plenty of racists who could claim from their “years of experience” that dark-skinned people are just straight-up inferior to whites, and sexists who will claim from their “years of experience” that men are from Mars and women are from Venus, and you (hopefully) wouldn’t buy that crap, so why do you expect me to accept it from you on this issue?

    ———

    I’m glad you find my suggestions about banning men from having weapons offensive, because it was supposed to be offensive, in a way that would make you think about the offensiveness of your own proposals. The linkage between Y-chromosomes and violence is much stronger than the linkage between mental illness and violence, yet you’re prepared to put something pretty damn draconian in place based on the weak mental illness link while being offended by the notion of a similar constraint based on a much stronger gender link. Maybe you should think about why you’re doing that.

  40. 40
    Anne C. Hanna

    I’m not gonna “compromise” my fundamental civil liberties and my right to privacy just because you enjoy spouting platitudes about how both sides are equally wrong and we all just have to give a little. I’d rather “nothing” get done on this than “something” get done that actually makes things objectively worse for a lot of vulnerable people while not even coming close to addressing the problem it’s supposed to “solve”. Sometimes gridlock really is the lesser of the two evils.

  41. 41
    J Lawrence

    Read your paper again. It specifically mentions it ignores suicides. Suicides are much more common than homicides among the mentally ill. Furthermore, it doesn’t attempt to make distinctions among different acts of violence, perhaps because of low statistical power. Therefore, I think they overreach in their conclusions, as scientists (particularly in the “soft” sciences) tend to do. Papers can come to the wrong conclusions based on insufficient data. I rather trust my own instincts based on years of experience than one single unknown source you have given with questionable analysis. You don’t have to believe me. I don’t really care. It’s all opinion anyway, and skepticism is good. Good instincts and anecdotal data (yes, it’s still data) are the building blocks to eventually generate testable hypotheses.

    “Maybe you should think about why you’re doing that”
    Maybe you should stop telling me what I should be thinking about; learn to be less rude when you make your point.

  42. 42
    J Lawrence

    You don’t know it won’t address the problem. You think it won’t based on your ideology and not hard scientific fact. The paper you presented is terribly flawed. We don’t have any hard data (that I am aware of) to make any conclusions. You really can argue fairly only from a legalistic point of view. So if you want to “stick to you guns” and “screw” compromise, God, you sound like that person from the NRA! Call me a little nuts, but there seems to be no difference!

  43. 43
    changerofbits

    I don’t mean to derail from the NRA’s attempt to further pollute our culture’s understanding of mental illness, but:

    “How can we possibly even guess how many, given our nation’s refusal to create an active national database of the mentally illgun owners?”

    “How can we possibly even guess how many, given our nation’s refusal to create an active national database of the mentally illGOP super-PAC donors?”

    “How can we possibly even guess how many, given our nation’s refusal to create an active national database of the mentally illRomney voters?”

  44. 44
    jesse

    J Lawrence, let’s think this through for a second.

    How would you define mental illness for purposes of such a registry? If you came up with this idea in 1970 every gay person would be on it. Mental illness is a tricky subject because it isn’t like having the flu. What is considered mentally ill varies a lot over time and between cultures.

    Then there’s what other people have brought up — there’s a huge disincentive to seeking treatment under the scenario you propose. It just doesn’t account for any possible unintended consequences.

    Those are two pretty hard facts, and by themselves they are enough to make me want to deep-six the idea. Saying that others are too worried about hypothetical problems or that we don’t know if it would work misses the point — the odds of it working, given all the other problems it raises, aren’t big enough and it means you have to go back to the drawing board.

    As for stricter gun controls, there are lots of things we could collectively do to make it harder to be a mass murderer, as you suggest. (Microstamping, giving guns to those with licenses only, banning concealed carry are three I can think of).

  45. 45
    Anne C. Hanna

    I don’t have any guns, figurative or literal, and I don’t want any. But I have plenty of other civil rights that I’d like to hang on to.

    I don’t even know what you’re on about with this stuff about a “legalistic perspective”.

    The paper I linked to is one example of the evidence on the subject, but not the only one, and you’re welcome to come up with countervailing *evidence* rather than anecdote if you don’t like its findings.

  46. 46
    Anne C. Hanna

    The conclusion that I’m suggesting you should draw from that paper is not that it’s impossible that there might be any links between mental illness and violence, it’s that the links are unclear and muddy, which is a perfectly legit conclusion to draw from the data they present. And, in particular, the data in that paper makes it reasonable to conclude that the link between mental illness and violence is much weaker than the link between Y chromosomes and violence, the latter being a link which you persistently refuse to justify ignoring in preference to the mental illness link. But the relative strength of those two links does not change just because you don’t like the way I pointed it out, or because the gender link makes you uncomfortable while the mental illness link fits nicely into your worldview.

    If you don’t trust the data in that paper (not to mention all the other data and arguments I’ve mentioned), then go find better data and arguments. It’s not okay to just go with your “instincts” when you’re pushing for a law that has the potential to severely harm to an awful lot of people. Your “instincts” are not a valid basis for a legal code.

    In addition, if you would like me to use a nicer tone in talking to you, then it would behoove you to stop trying to abrogate my and others’ human rights. Tit for tat, Clarice.

  47. 47
    J Lawrence

    Hanging on to one’s civil rights for the sake of hanging onto one civil rights is essentially arguing from a legal / “Bill of Rights” perspective . There is really no ability to argue against the proposal otherwise in my opinion, as I think it’s silly to just pull out paper after paper that have different conclusions. For example I could have pulled this out from an article from a book published by the APA (1994):

    “The relationship of mental illness and violence is an issue of longstanding clinical and policy importance, and recent research on this association has sparked renwed debate. The arthor formulates six statements on the association that seem warranted by recent investigations and reviews the research evidence. In general, contrary to findings of earlier research, an association does appear to exist between mental illness and the likelihood of being involved in volent incidents. A dual diagnosis of mental illness and substance abuse probably significantly increases the risk for violence, and the association between mental illness and violence is probably significant even when demographic characteristics are taken into account. Given the considerable limitations of current research, priorities for future research including attention to the strength of the association for individual subjects, inclusion of adequate comparison groups of non-mentally-ill persons and a board range of variables and intensive studies of repetitively violent individuals over time.”

    I have as much confidence in this paper as I have in yours.

    Your best argument is that since there is no definitive evidence on the subject, we shouldn’t be reducing people’s rights because it is morally wrong. I can sincerely appreciate that argument, but I disagree with it because I believe it’s even worse to continue to allow these mass shootings to occur. This is the lesser of two evils argument. However, the communications from this board have made me believe that there will be significant ideological resistance to the idea of creating a mental heath registry, regardless of it improving the situation or not (which we won’t know unless we try it). A counterproposal would be (as mentioned in the intro) giving a mental health examination (e.g. an interview by a clinical psychologist) to anyone who wants to own a gun. I still think the best indicator of violence is prior information, but at this point this would be my compromise. Good luck trying to get the NRA to go on board with that! In the end we’ll probably have a stalemate, and the mass shootings will continue like clockwork.

  48. 48
    J Lawrence

    By the way women do commit acts of violence. The two people who wielded guns in the hospital I was at were both women. One blew her brains out, the other brought the gun to therapy. My point: I have very little confidence in your examples and in your analysis.

  49. 49
    J Lawrence

    I consider the problem of mental illness and violence to go way beyond the mass shooting sprees we see sensationalized by the media. I also include the people who suffer silently and terribly until they attempt or commit suicide, and in this case, women appear to be just as violent as men. According to Science magazine, which is actually a top journal in science:

    Suicide vs. attempted suicide
    There are roughly 30,000 suicides in the United States each year, and three-fourths of those are men. But the number of attempted suicides is at least 10 times that, and even that estimate may be low because many suicide attempts are euphemistically classified as lacerations or accidental poisonings when patients receive treatment in hospital emergency rooms.
    Although suicide rates are lower among women, women lead men two to one in suicide attempts. So, Murphy says at least 200,000 women are involved in suicide attempts annually.

    I want to save lives. Really that’s it. And if I curtail people’s civil rights a little bit for doing so, so be it. Others stick to their ideological safety zone. And people will continue to suffer because of this.

  50. 50
    Nathair

    the incident of mental illness is not significantly higher in the USA than in other industrialised countries, and so it is not likely to be the underlying cause of US gun violence.

    We know that there is a significant link between access to a gun and, for example, suicide. We know that there are a lot of suicides among males aged 15-24 in the US, more than ten times more than in, say, Canada. Does that mean we can say that mental illness is therefore not the underlying cause of male teen suicide in the US? Of course not! Mental illness (especially in combination with substance abuse) remains the number one risk factor for suicide.

  51. 51
    Nick Gotts

    Sure, my comment wasn’t intended to be dismissive, but I see that it’s easily read that way. Sorry.

  52. 52
    gwen

    Please add that the seriously mentally ill are FAR more likely to be the victim of crime, than the perpetrators.

  53. 53
    Kate Donovan

    didn’t think you were being dismissive! :)

  54. 54
    nickmatzke

    Note: I’m fully aware that some people with mental illness are violent. So are some neurotypical people. I’d be all over a psychometrically sound test of impulse control/aggression/etc, that tested abilities related to using a gun responsibly. Using science to determine safe gun owners–great! Using a highly stigmatized population to avoid discussing gun control–jerk move.

    Good post! Why don’t we have this already? What would the NRA counterargument even be?

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    A Handy List of Everything Wrong with Creating a Database of People with Mental Illnesses » Brute Reason

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