While an improvement in the United States’ mental health care system would be “amazing, ... we should be frank about what (reductions in violence) we’re going to see,” said Richard Friedman, Cornell professor of clinical psychiatry, director of the psychopharmacology clinic at Weill Cornell Medical College and regular New York Times contributor, during a Janus Forum panel about mental health in relation to gun violence last night.
On the panel, Friedman joined Jeffrey Swanson, professor in psychiatry and behavioral sciences at Duke University School of Medicine, and Doris Fuller, executive director of the Treatment Advocacy Center, an organization committed to reforming how courts order an individual to receive mental health care.
The event was the third talk in the “Guns in America” series, a Janus Forum event co-sponsored by the Political Theory Project and the Office of the President. The first event featured speakers discussing the role of gun control in the reduction of gun violence. The second focused on society’s cultural relationship to guns.
In the wake of the massacre at Newtown Elementary School last year, when Adam Lanza murdered 26 students and teachers, his mother and himself, President Christina Paxson called for a campus dialogue on gun violence and its causes.
Haakim Nainar ’14, an executive director of the Janus Forum, said the organization worked with Paxson to design panels that looked at every facet of gun violence in America.
Friedman began the panel by pointing out that only 4 percent of gun deaths annually in the United States can be attributed to individuals with mental illnesses — far lower than most people think, he said. If America could hypothetically solve the problem of mental health issues leading to violence, “you’re likely to see a reduction in suicides, not homicides,” he said.
Every year in the United States, firearms kill 30,000 people — 17,000 by suicide and 13,000 by homicide, Friedman said. While only a small percentage of the homicides are due to mental health issues, the majority of people who commit suicide have an illness like depression, he said.
Disproportionate media coverage of mass killings “creates distorted perception of the risk” of mental illness in influencing gun violence, Friedman said. Mass killings “represent 0.13 percent of all homicides in the United States,” he said.
Focusing on mental illnesses as a major cause of gun violence can lead lawmakers to implement policies that cast too wide a net, Friedman said. For example, the New York state government just passed a law that requires mental health professionals “to report any patient they think is at risk of hurting themselves or anyone else,” he said. “Clinicians now fear they have to meet this very ill-defined threshold, (so) the system will be filled with false positives, (and) it might discourage patients from seeking treatment.”
Swanson argued that the federal guidelines preventing individuals with mental illnesses from obtaining firearms are ineffective at preventing violent behavior, particularly mass killings.
Americans believe all people with mental illnesses look like the mass murderers in Newtown, Virginia Tech and Aurora, CO, while in reality everybody from “your grandmother to your neighbor’s intoxicated boyfriend” is at risk, he said.
The selective federal prohibition on gun ownership fails to curb violence because “the criteria we have are both over-inclusive and under-inclusive,” Swanson said.
He cited a study that looked at the mental health of perpetrators of mass killings. The research found that 88 percent of killers had not been taking antipsychotic medication at the time of the homicide, 74 percent were not in contact with any mental health specialist and 62 percent had never been admitted to a psychiatric hospital.
Though studies have found that individuals with a gun-disqualifying illness — or history of illness — “were more likely to commit a violent crime … prohibited categories correlate poorly with violence risk, especially over time,” Swanson had written on slides he displayed.
Swanson added that proper mental health care could have saved the lives of about 100,000 of the 300,000 people who have died from gun violence over the past decade by reducing the number of suicides.
Fuller spoke of the need to strengthen laws allowing judges to order people who are a threat to themselves or others into psychiatric hospitals.
She referenced her own daughter’s battle with mental illness as she discussed the limits of current mental health care policy. During a psychotic break, her daughter was involuntarily treated at a psychiatric hospital. She spent two months with an attendant never more than a few feet away because she continually tried to pluck her eyes out. She believed it would save the world.
“She could imagine killing someone,” Fuller said her daughter has told her, if the voices in her head command her to do it. “When the commands are coming at her, she believes they are real,” she said. “People like her do need to get treatment.”
Americans place a premium on civil liberties, she said, but everybody loses when people who could have been saved by a court order kill themselves or others.
“People will find a way to hurt themselves if they are not treated,” she said. About 10 to 15 percent “of people with schizophrenia will eventually die of suicide.”
Paxson told The Herald that she thought the quality of the panels was “amazing” and that she “learned a lot.” She cited Tuesday’s discussion of mental health as the panel she found most informative.
Following the panel, students, professors and speakers went to Paxson’s house for a dinner and discussion.
Rhode Island Attorney General Peter Kilmartin, who attended the panel, spoke briefly about the nine pieces of gun control legislation — which he helped draft — that were introduced into the General Assembly yesterday. One bill would guarantee that Rhode Island begin to provide mental health and substance abuse records to the FBI’s National Instant Criminal Background Check System, a move the state has long resisted, the Providence Journal reported Tuesday.
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