Both mental health and guns deserve our attention

The Newtown school shooting. It’s a tragedy that a mass shooting requires a qualifier, but this is America so we need to be specific as not to be confused with Aurora, Columbine, Arizona, or Virginia Tech. Colorado massacres require a site specific qualifier.

There are 2 common elements with all these massacres: mental illness and guns (not hunting rifles, but firearms designed to cause maximin human carnage in the shortest amount of time).

And both deserve our attention.

Mental illness, because people who commit mass murder have some mental health condition found in a psychiatric textbook. They are either schizophrenic, psychotic, or sociopaths. The 1st two have treatment the last one, not so much.

Most people can spot someone who is psychotic or a schizophrenic who is decompensating. Odd stares, strange behavior, paranoia. Come walk with me in San Francisco, for many sleep on the streets and during the day they wave at bugs that don’t exist, rock back and forth to sooth unseen demons, and have shouting matches with invisible adversaries. They are desperately in need of mental health care, but for some reason can’t get it. Lack of insurance, marginalization, stigma, drugs, fear of the system, homelessness, lack of money to pay for treatment as many psychiatrists don’t accept insurance, paranoia, or the fact that they have to be an immediate danger to themselves or others to be forcibly treated.

Not everyone can spot a sociopath. They blend and ooze among humanity. Chameleons of destruction that look like the guy next door. On a small scale they cause contained mayhem, but if they are so inclined they could become the next Ted Bundy or Jim Jones. There is no treatment for sociopaths, although who knows if we had a better way to identify them early and start behavioral therapy?

While it is true that almost anything can be weaponized, Jones used poisoned Kool-Aid, modern day massacres on American soil involve guns. We don’t know whether the killer in Newton was schizophrenic, psychotic for some reason (there are several causes) or a sociopath, but we do know he had access to weapons of carnage. Had he been armed with a kitchen knife and an axe he would have not breached the security system, but even if he had he would have been stopped with far less loss of life.

Ask yourself, do you want someone descending into mental illness who is rapidly loosing their grip on reality or a sociopath careening out of control to have access to a semi-automatic weapon?

We need to fix the way we treat mental illness in America. We must remove the stigma and the barriers to care as well as research better treatment options. We also need to eradicate weapons that have the sole purpose of killing people with efficiency. These are not mutually exclusive discussions.

If we don’t do something, we’ll just keep asking ourselves, “How could this happen,” when we all know the answer. This happens because as a society we choose to let it happen and until we do something about it we will all continue to pay the price, some more than others.

Jennifer Gunter is an obstetrician-gynecologist and author of The Preemie Primer. She blogs at her self-titled site, Dr. Jen Gunter.

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