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Hundredth verse, same as the first: Talking mental health after mass shootings

We’re now almost four weeks out from the shooting at an Oregon community college that killed nine people and injured ten more, and we know what that means: We can now stop “caring about mental health care” without guilt. Time heals all weaknesses in the mental health system, and while it becomes a subject under great scrutiny whenever a gunman commits a mass shooting — particularly when discussions start straying toward the subject of gun control — the passage of time, and the accompanying passage of fear, washes away those concerns pretty effectively. (Until the next shooting, of course.)

And the reason this happens isn’t because we manage to effectively address all of our problems in the interim. It happens because discussions purportedly focused on Improving Mental Health Care are actually all about Protecting The Good People From The Crazies. Not the same thing at all. The former comes from a place of compassion, and the latter comes from a place of fear, and we, as a society, don’t give two shits about acting compassionately when we’re afraid. (And then, when our immediate, acute fear of The Crazies has faded, we don’t give two shits about acting at all.)

“Improving mental health care,” for the purpose of ongoing discussions, means identifying the dangerous crazies and making sure they make it onto a national registry so no one will sell guns to them. Period. That’s the strategy. It doesn’t mean actually encouraging people to seek care when they need it — people may, in fact, be more likely to opt out of any activity that gets them added to a national registry of cray-crays that will follow them everywhere they go. It doesn’t mean removing the stigma surrounding mental illness — when we only ever discuss mental illness in the context of murderous rampages, it creates a pretty solid impression that all people with mental illnesses are rampaging murderers. And it doesn’t mean improving access to mental health care — training more mental health professionals, funding community and long-term care resources, and cracking down on illegal discrimination by insurance companies doesn’t keep guns out of the hands of crazies. Yes, that stuff saves lives, but not the lives that, like, matter or anything. No Guns For Crazies is about as far as we need to go.

And turning the entire focus to mental health is a fantastically handy diversion, because the subject is so complex and shrouded in so much stigma that, fuck the medical community, “mental health” can mean pretty much whatever we want it to mean. We’re a big fan of ex post facto diagnoses, the tautological proclamation that obviously this person was mentally ill, because a person would have to be mentally ill to do such a thing. We don’t want to accept that a person could be sane, “normal” and also really angry. Hateful. Greedy. Ignorant. Bigoted. Self-centered. Raised in an environment of fundamentalist absolutism. Raised in an environment of violence. Entitled — to personal success, to attention from women, to public affirmation. Not any one by itself, but rather deadly combinations and perfect storms of things at which we don’t bat an eye when they’re at the center of wars or terrorism, but which have to have some exotic explanation when they’re coming from someone who looks like us.

Dylann Roof, to the disappointment of many, didn’t have a history of mental illness — he was a white supremacist with substance abuse issues and access to guns. Timothy McVeigh, who of course killed with a bomb rather than a gun, was sane and paranoid and vengeful and angry and wanted to make a statement. George Sodini, who killed four people and injured nine more at an LA Fitness in 2009 — remember him? No? — wasn’t mentally ill, he was a loner and a misogynist and a textbook Nice GuyTM. (Would that we could screen for those.)

No one ever talks about screening for substance abuse or relationship stress or a history of violence, or assembling a National Victims of Bullying Registry, to make sure that none of those people has access to firearms — and those are much more reliable predictors of gun violence. There will never be a box marked “Yes, I’m an angry, paranoid white man” on an application for a firearm permit. Nor will there ever be widespread claims concern about better care to make them less dangerous to the public.

The statistics are so quoted so often that you’d think it would be accepted as common knowledge by now: People with mental illnesses are vastly more likely to be the victims of violence than perpetrators, and even those who are most prone to violence — people with schizophrenia, bipolar disorder, major depression — account for a minor percentage of overall gun violence (rarely directly related to symptoms of their disorder). A mentally ill person with a gun in his hand is far more likely to turn it on himself than anyone else. But suddenly people start caring (“caring”) about mental health when they fear for their own safety. And they care about it with solutions (“solutions”) that cause more problems than they’re solving.

I get it. I do. I’m not sitting here grinding my teeth about the subject because nothing is actually being done to improve mental health care in the U.S. — that’s certainly nothing new, and the teeth reserved for that particular grinding are pretty much nubs at this point. At this point, the only thing worth grinding teeth about is accuracy, saying you’re talking about one thing when really you’re talking about another — saying you’re concerned about mental health care when you’re really just worried about Protecting The Good People From The Crazies. So while ideally, we’d actually be discussing real, substantive change so that people can have access to, and can feel safe accessing, the mental health care that they need, at the very least let’s try to keep ourselves honest about when we aren’t discussing that. Which, when mass shootings are in the news, is pretty much always.

7 thoughts on Hundredth verse, same as the first: Talking mental health after mass shootings

  1. Yes, putting me onto the same list as convicted felons and people with restraining orders would push me to seeking alternative mental health treatment. (Or emigrating.) Interestingly, part of my self-help plan includes voluntarily staying away from firearms due to increased risk of self-harm.

  2. Whenever people talk to me about mental health, I maintain that diagnoses of mental illness have no meaning outside of their interaction with a specific course of treatment from a mental health professional. Psychiatrists know this, but the common person wants a mental health diagnoses to mean something absolute like other disease diagnoses.

    Mental health science has just not progressed to the point where you can image a brain and say “Your bipolar disorder is right here” the way they can with a tumor. It’s still about reported experience and reported difficulties with the world. It’s still diagnosed based on symptom, and the etiologies of mental health disorders are not known.

    That’s why the mental health industry has to keep updating their terms and methodologies. The general population keeps coopting medical terminology to apply to their peers as insults or essential characterizations of their nature, and doctors cannot label a patient with the same epithet that would be thrown at them as an insult.

  3. I am glad I found this article. I agree with your sentiment. Much change is needed in the treatment of the so-called mentally ill. But as long as we are calling it that, there should be one correction noted. You stated that one of perpetrators did not have have a history of mental illness, but was substance abuser. Substance Abuse is a mental illness as described in the current diagnostic manual (DSM V). Thanks 🙂

  4. —-the stigma surrounding mental illness

    Never offer validation to a claim of “stigma”. The Women’s Movement told us unequivocally to end the bullying mind game, rape/stigma. Re-directing it does not alter the game, only the intended victim.

  5. I heard that some countries have out lawed guns that can automatically shoot multiple bullets. I don’t know what excuse NRA will come up with for that.
    Maybe people won’t fight over spending money on mental health services. One can hope.

    1. Including the US, actually. There are a couple extremely narrow and expensive exceptions for antiques and museum pieces, but it’s effectively illegal to own any automatic or burst-fire weapon in the US (unless you’re you’re willing to spend $25,000 or more to purchase a pre-1986 weapon, the associated ATF stamp, go through a Federal background check, get your local police chief to sign off on the application, and then wait 6-12 months to hear back).

  6. I like your article. Hate, being angry at the world, misogyny, racism, the desire to punish people are not mental health problems, at least not in the medical sense. I dislike that I have to hide (rather than simply keep private) my bipolar because some people believe that makes me a threat.

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