Here We Are Again: Guns and Mental Illness

It’s an ordinary school day. Kids and teachers go in and out of the office, phones ring. Then a young man with an assault weapon walks in.

That’s how “DeKalb Elementary,” an Oscar nominee based on a 2013 Georgia incident, begins. As I watched, I thought what a wonderful counselor the office worker would make at the crisis hotline where I consult. Remaining calm and empathetic to the gunman throughout, she defuses a dangerous situation without anyone being harmed.

The day after I saw the film, a young man with an AR-15 walked into a Florida high school and killed 17 people.

We cannot rely on words to stop guns any more than we can rely on armed “good guys.” I juxtapose the two events and my work with at-risk people not to apportion credit or blame, but to illustrate different facets of the debate about mental illness that invariably arises whenever these tragedies occur.

We absolutely need more funding for mental health. Yet what’s often proposed after mass shootings is counterproductive. Donald Trump suggests bringing back institutions to contain the threat. Less inflammatory mental health “solutions” aim to identify and remove “monstrous” people—not their guns–from circulation. Mental health professionals already must report those at imminent risk of hurting themselves or others. Stigmatizing mental illness and enlisting clinicians as wide-net detainers makes people less, not more, likely to seek treatment. Blaming gun violence on the mentally ill overlooks the fact that they account for a tiny fraction of gun homicides and are far more likely to be the victims rather than the perpetrators of violence. It also ignores the biggest threat: guns.

Two days after seeing “DeKalb Elementary,” and the day after the Parkland massacre, I consulted at the crisis hotline. I told the staff how much the film reminded me of them and the unsung, heroic work they do. Counselors listen, assess for risk, and, like the office worker in the film, connect calmly and empathetically to enlist that aspect of the person’s ambivalence that leans toward safety rather than destruction. Outside resources are utilized when there is imminent danger, but usually the internal resources of human connection and compassion are enough to defuse a volatile situation.

Mass shootings and the fear they evoke can cloud assessment and intervention.  Callers are often hostile, distraught, vaguely menacing. Violence is notoriously difficult to predict; thoughts, feelings, and fantasies are not the same as action. Parkland illustrates not only the importance of being vigilant about danger, but the vigilance of making sure we are not overreacting from anxiety to enact ineffectual preventive detention.

Mental health interventions are most effective early on. Guns in the picture indicate that the window for optimal engagement has already closed. A culture that promotes more guns as the solution, not the problem, suggests collective, not individual, pathology.

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This piece originally appeared in “Impulse,” an online publication of the Northern California Society for Psychoanalytic Psychotherapy

 

Enough

It’s surprising how affecting a pair of shoes can be. Particularly when they’re empty, and when they’re one of 17 pairs representing the students and faculty killed at Marjory Stoneman Douglas High School in Parkland, Florida, on Valentine’s Day.

These empty shoes, bereft of those who normally wore them, were on the steps of my town’s high school as part of a student-led nationwide walkout to protest Congress’s failure to do anything to stop gun violence.

There have been 17 shootings on school grounds in the United States so far in 2018, 208 since Columbine. Including that initial 1999 rampage, which shocked the nation and defined the country today’s teenagers know, more than 200 have been killed. This does not count the additional 29 assailants who died, all but two of whom turned their guns on themselves. Far more have been injured and traumatized.

A dispassionate account of these incidents, most of which never rise to the level of national attention, makes for sobering reading. Most of the victims are young, but so are most of the attackers—too young to even be called gunmen (almost all are male). One six-year-old boy fatally shot his six-year-old classmate. So many of the incidents arise out of arguments, and have nothing to do with the usual false narratives of lone nuts, terrorists, and other bad guys. It’s easily accessible guns—not mental illness or monsters–that turn mundane hot-headedness deadly.

School shootings account for a tiny fraction of the 33,000+ (and rising) annual gun deaths in the United States, and schools remain among the safest places to be. Too many kids have more to fear in dangerous neighborhoods and volatile homes or, if they’re young men of color, from police. All mass shootings, including highly publicized tragedies in nightclubs, workplaces, churches, concerts, and Congressional ballgames and meet-and-greets, account for only two percent of firearm fatalities. Almost two-thirds of all gun deaths are suicides. Research by the Harvard School of Public Health and Everytown for Gun Safety consistently shows that guns in the home are far more likely to increase the risk of injury, especially but not exclusively when domestic abuse occurs. States that have more guns (and less restrictive gun laws) tend to have more gun injuries and deaths than states that don’t. Whether we’re talking about suicide, homicide, or accident, limiting access to guns saves lives,

When we widen the scope of gun violence beyond the school shootings that understandably horrify us, we see, if we care to, the grotesque number of casualties—38,658 gun deaths in 2016, the last year for which CDC data are available. That’s a lot of pairs of empty shoes.

But it is those kids in schools—the post-Columbine generation—whose grief and rage now galvanize a nation. They are not activists for arming teachers, turning schools into prisons, or rounding up the mentally ill. They want politicians to stop cowering before the NRA and commonsense gun safety regulations, and they won’t stop until they get them.

“We are only 24 percent of the population, but we are 100 percent of the future!” The girl leading the walkout I attended exclaimed through her tears.

Her fellow classmate urged everyone to vote. The students paid tribute to the lives that would never be lived, the contributions that will never be made by students just like them. Too many empty shoes. But the kids still here are stepping in and stepping up. It is our sacred duty to step, walk, march, run, speak out—and vote—alongside them.

The Illusion of Invincibility

safety_pin_crp1When my daughter was little, my husband and I tried to safeguard her against people who might do her harm. “It’s OK to kick and scream,” we told Emma. “You don’t have to be nice if someone tries to hurt you. Not everyone is a good person.”

“Those bad guys better watch out!” Emma replied. “I’m gonna have safety pins with me, and if they try to get me, I’m just gonna take out my pins and stab them!”

I loved my daughter’s confidence in her strength, her ability to quell her fears by standing up to danger. No matter that her plan for protection was childish folly.

We’re now seeing a similar impulse play out on a national scale.

The New York Times reports that in the wake of the latest mass shootings here and in Paris, Americans are rushing to arm themselves. When something frightening happens, people want to feel safe and in control. Their fear of becoming a victim is transformed by the illusion of invincibility.

The gun lobby and its political minions masterfully exploit this psychological dynamic by stoking fear, then offering a reassuring (though false) “solution” like the one promulgated after 20 six-year-olds were gunned down at Sandy Hook three years ago today. “The only thing that stops a bad guy with a gun is a good guy with a gun,” proclaimed NRA spokesman Wayne LaPierre in response to that horrific massacre.

This sentiment has been echoed by the Republican Presidential contenders in response to more recent mass shootings. The day after the San Bernardino massacre, Ted Cruz proclaimed at a gun rights rally, “you don’t stop bad guys by taking away our guns, you stop bad guys by using our guns.” A couple of months before, Ben Carson essentially blamed the victims of a heavily armed gunman at Umpqua Community College by saying, “I would not just stand there and let him shoot me.”

If only it were that easy!

Yet the research—not to mention law enforcement and military personnel–overwhelmingly contradict this simplistic notion. “Good guys” unloading their weapons against an active shooter in a public space would likely result in greater mayhem and casualties. Guns on alcohol-infused campuses are a recipe for disaster.  The risk of gun deaths from homicide, suicide, or accidental shootings is much higher when there’s a gun in the home. And guns, in the heat of the moment, can turn a “good guy” into a killer instantaneously. More guns mean more gun deaths.

Yet reason doesn’t seem to stand a chance against fear and its exploitation. In the three years since Sandy Hook, Congress has done nothing to enact gun-safety legislation. Although some states have tightened restrictions on guns, many more have actually made it easier to purchase and carry guns.

It’s one thing for my young daughter to fantasize about wielding her safety-pins for protection. But it’s quite another to arm ourselves to stay safe from gun violence. As adults, we should know better.

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Had enough? One of the reasons we have failed to enact more common-sense gun-safety laws is that those who support such measures don’t speak out. You can bet gun- rights advocates don’t make that mistake. Contact your representatives. Rally. Sign petitions. Vote your principles. And check out these organizations that are working hard to make a difference:

Everytown for Gun Safety

Moms Demand Action for Gun Sense in America

Newtown Action Alliance

Suicide by Gun

Means Matter logo

Once again, America is transfixed by a mass shooting. No doubt the list of massacres will grow to encompass other shattered towns and families, evoking fear and horror every time.

Yet almost two-thirds of gun deaths do not make national headlines. These are the more than 21,000 people–many of them teenagers— who every year kill themselves with a gun.

As someone who has worked in the field of suicide prevention for decades, I know that the best way to prevent these tragedies is to restrict access to guns. Current research contradicts the commonly held but false belief that suicidal individuals will just find some other way to kill themselves. In fact, self-destructive feelings are often impulsive and fleeting, dissipating as the crisis passes. Ninety percent of those who survive an attempt never go on to die by suicide. But when guns are involved, the crisis can quickly escalate, precluding safe resolution. Fast and deadly equals no second chances.

According to the Harvard School of Public Health, those states with the highest rate of gun ownership also have the highest rates of suicide. Access to lethal means is a far greater risk factor than mental illness. Although some promote the fallacy that a gun in the home makes you safer, the opposite is true. The risk of suicide is two to five times greater for all household members in gun-owning homes. In one study, 82 percent of children 17 and under who shot themselves to death used a gun belonging to a family member. Homes without guns have the lowest suicide rates, but even in homes where firearms are present, risk decreases if they’re properly stored—unloaded and under lock and key.

When it comes to preventing suicide, means matter. We always ask why people kill themselves. But we’re better off focusing on how so many people die.

It’s the guns. If we really want to save lives, restricting easy access to such lethal means is our best approach.

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The statistics cited here are from these sources, which provide a wealth of additional information:

http://www.nytimes.com/2015/03/10/health/blocking-the-paths-to-suicide.html

http://www.hsph.harvard.edu/means-matter/

http://actionallianceforsuicideprevention.org/sites/actionallianceforsuicideprevention.org/files/Reducing%20a%20Suicidal%20Persons%20Access%20to%20Lethal.pdf

 

 

 

 

Insane

No gunsMy husband and I were hiking in the Alps with a group of Australians shortly after Dylann Roof murdered nine members of a Bible study group in Charleston, South Carolina. We felt like we were on a different planet trekking all day among towering peaks and wildflowers as at night we kept abreast of the horrific news on our smartphones.

The stark racism behind the Charleston shooting makes it almost beside the point to zero in on guns; a massacre so intertwined with America’s long and sorry history of racial oppression, particularly in the South, has understandably made this the prevailing focus. Nonetheless, although the why of Roof’s violent bigotry is deep-rooted and complex, the how is simple: easily obtained guns and ammunition.

Our Australian hiking companions were incredulous about America’s failure to do anything about gun violence. These were not our usual crowd of Bay Area liberals for whom guns arouse a knee-jerk suspicion. Our fellow trekkers were arrayed across the political spectrum. Several were ranchers; one talked about getting his first rifle as a kid. Yet Australia chose a different path from the United States after its own traumatic experience with a mass shooting.

In 1996, an Australian gunman killed 35 people in what came to be known as the Port Arthur massacre. Instead of sorrowful hand-wringing and inaction, John Howard, the newly elected conservative prime minister immediately passed with bipartisan support strict gun control laws throughout the country.  Private sales were banned, and only a narrow range of reasons were valid for ownership (self-defense, fear, and gun “rights” were not among them). Gun owners had to pass a safety class, could not carry their weapons around, and had to register and store them properly.

Some legislators paid a political price, but almost 90 percent of the population favored the new regulations. As our Australian friend who had grown up with guns explained, there were initial misgivings, but after a couple of years everyone saw that life continued to be fine, and the resistance disappeared.

The new laws were extremely effective. In the next decade, Australian gun homicides declined by 59 percent, the suicide rate by 65 percent. The rate of home invasions also declined. And there have been no mass shootings since Port Arthur.

As we listened to our hiking companions’ stories, they listened to ours:

  • About how even after 20 first-graders were shot to death in Sandy Hook in 2012, Congress could not summon the courage to mandate universal background checks supported by 90 percent of Americans.
  • About how the NRA’s response to gun violence is to advocate arming more people; “The only thing to stop a bad guy with a gun is a good guy with a gun,” an NRA spokesman said after Sandy Hook.
  • About how men armed to the teeth swagger around advocating open-carry laws.
  • About how restrictions on guns have loosened rather than tightened since Sandy Hook.

“You’re kidding! That’s insane,” one of the Australians exclaimed over and over.

Indeed.

We hear a lot about insanity in conjunction with America’s mass shootings, which now occur at the rate of about every other week. The mental instability of the killers is inarguable, as is the need for more effective mental health screening and treatment. Yet scapegoating the mentally ill (who are far more likely to be victims than perpetrators of violence) misses the point of a widespread cultural insanity. It also misses the point of doing something about the delivery system if not the root causes of our national pathology.  As Australian’s John Howard recalled about the Port Arthur massacre in an op-ed he wrote following Sandy Hook,  “The fundamental problem was the ready availability of high-powered weapons, which enabled people to convert their murderous impulses into mass killing. Certainly, shortcomings in treating mental illness and the harmful influence of violent video games and movies may have played a role. But nothing trumps easy access to a gun.”

We left the Alps much rejuvenated by the scenery and much enlightened by our Australian friends. Because we were on vacation, I didn’t write about it at the time. When we returned, we were gripped and heartened by the sea change that finally brought down the Confederate flag from South Carolina’s capitol in the aftermath of  Dylann Roof’s rampage. Guns, again understandably, took a back seat as we celebrated this important if symbolic milestone in tackling racial oppression.

But I knew it wouldn’t be long before gun violence was in the news again. Sure enough, this week Chattanooga and Lafayette were added to the roster of communities shattered by a gunman. More gun deaths will surely follow—those that make headlines and those that don’t. As glad as I am about the Confederate flag’s downfall, I wish we could take a page from the Australians, and see our gun insanity follow suit.

Trigger Alert

(AP Photo/Jae C. Hong)My daughter Ally’s been living in Spain following her graduation from UC Santa Barbara last year. Occasionally, I send her articles about her alma mater, including one about a recent UCSB student Senate resolution calling for mandatory trigger alerts–warnings about potentially upsetting lecture or reading material, such as rape, childhood abuse, or racism, that might inadvertently traumatize students.

Now it is Ally sending me urgent messages from Spain about UCSB. But it’s not words on campus that have upset her.

“Did u hear about what happened in Isla Vista????” read her text.

Of course I had heard—who hadn’t, as Isla Vista joined the long string of names where innocents were slaughtered by an angry and alienated young man with a gun. Columbine, Virginia Tech, Tucson, Aurora, Sandy Hook, street corners every day in our cities. And now again, on the streets where my daughter has spent the last several years riding her Cruiser to class, partying on Del Playa, buying snacks at the IV Deli whose plate glass windows are now riddled with bullet holes.

Skype is inadequate for the arms-around-soothing these incidents require, though I tried my best. At least Ally was safe in Spain, where the rate of firearm homicide is less than 1/10th  of this country’s. Toward the end of our conversation, Ally, who has traveled alone extensively abroad, said, “I’m afraid to come home to the United States.”

This breaks my heart. And makes me furious.

The real trigger alerts are the ones we apparently dare not issue—those having anything to do with curtailing the availability and lethality of guns. Almost twice as many gun laws have been loosened than have been tightened since 20 six-year-olds were massacred at Sandy Hook. There have been at least 74 school shootings since Newtown.

Open Carry aficionados wear their weaponry loud and proud. One such demonstration in Texas inspired a mild protest from an NRA member who wrote on an official site that such tactics, which he called “weird” and “scary,” could hurt the gun rights cause. Since his statement caused undue upset, perhaps it should have come with its own trigger alert. So outraged were the highly sensitive (though strangely insensitive) members of Texas Open Carry that the NRA apologized and distanced itself from the offending member by expunging his post.

We do not need protection from words. We need protection from guns, and from those who cherish them above all else.