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Gun violence and the straw dog of mental illness

December 18, 2012
By Steven Sonnenberg, M.D.

It has become a pattern. With each episode of senseless violence, "keeping guns out of the hands of the mentally ill" becomes a rallying cry that all sides, from the National Rifle Association to Mayor Bloomberg, can agree upon. It sends chills up my spine as a psychiatrist, as a friend and as a neighbor, bells of alarm as a citizen who values my freedom.

To start with, the association between mental illness and violence is extremely low. In fact, people suffering from serious mental illness are far more likely to be the victims of violence than the perpetrators. Responsible research consistently shows that the stereotype of the violent psychopath promoted by the news and entertainment industry, by politicians and the gun lobby is a patently false and self-serving one, good for ratings and, more importantly, good for diverting attention away from the true causes of gun violence and the need for change.

Think for a moment. What would it mean to restrict gun access for those with mental illness? It would require a national database containing the names of every American with a mental illness. If you went to your primary care provider and were prescribed an antidepressant, would your doctor be required to enter you into the registry? If, in order to work and support your family, you required an anti-anxiety medicine to treat your social anxiety, would your pharmacist be mandated to report this? Would your teenager with attention-deficit disorder be prohibited from deer hunting with you next season?

I have worked as a psychiatrist in rural New York state for more than 27 years. The people I treat are ordinary people with commonplace illnesses. Most of them work. Most of them have families. I have never, and I emphasize never, treated a person with mental illness who was the perpetrator of gun violence. My patients are ordinary people with commonplace illnesses, many of whom are responsible gun owners.

So why the outcry to restrict access to guns for the mentally ill? Mental illness is a scapegoat, a straw dog upon which we displace the incomprehensible evil of our society, externalizing blame and putting the responsibility for change outside ourselves. More importantly, it is a straw dog that serves the interest of the National Rifle Association and the politicians, Republican and Democrat, in their pockets, a pretense that allows them to escape accountability.

Gun violence is a national tragedy and an enormous public health problem. The gun lobby says, "Guns don't kill people; people kill people." But they kill with guns. They acquire them far too easily. They kill with them far too quickly and far too efficiently.

As a physician, the state controls my ability to prescribe medications. If you need to take a medicine that is a controlled substance, whether it be for pain, for anxiety or for sleep, the state restricts the prescription to a 30-day supply. It restricts how many pills the pharmacist may dispense. These restrictions serve a public health purpose, to prevent the illegal diversion of potentially addictive medications into the community. And yet, there are no restrictions on how many guns an individual may purchase in a month, no restrictions on how many rounds of ammunition may be contained in a magazine and no equivalent to a physician or pharmacist to monitor the potential for diversion of the guns into criminal hands.

Where is the sense in this? An American dies from gun violence every 17 minutes, eight of them each day under 20 years old. If this isn't a national health crisis, I don't know what is. It is time for Americans to insist politicians give their 30 pieces of silver back to the NRA and do what is needed to protect the lives of the people they are elected to represent. It is time for responsible gun owners in the Adirondacks to withhold their dues from the NRA until the interest of their families are put before those of gun manufacturers. Time for a 30-day waiting period for a gun purchase and limits on how many guns one person may purchase. It is time for the licensing and monitoring of every venue in which a gun may be purchased. It is time for a ban on the sale of assault weapons, time to make it illegal to own an assault weapon and time for a national assault weapon buy-back program.

It is not time to put your family and friends, employees and neighbors, on a registry that stigmatizes mental illness and penalizes those who seek the help they need.

We live in a violent society, the most violent of all industrial nations. Many of our children are killing video-game zombies at the age of 6, terrorists at the age of 12 and enemy soldiers at 15, transitioning smoothly forward to the video games used to train Marines and Army infantry. Torture has become a staple of our international police efforts and is quickly becoming a staple of the entertainment industry. American citizens, without trial or due process, are assassinated by unmanned drones. Afghan women and children, brides and grooms at wedding parties, mourners at funerals have become acceptable collateral damage. And now a young man kills 20 first-graders with his mother's automatic weapons. We can hope somehow, through prayer and self-examination, to change our society. In the meantime, we can limit access to our own weapons of mass destruction.


Steven Sonnenberg, M.D., lives in Saranac Lake.



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