The Mistake of Removing Mental Illness From The Discussion

There are a couple of things in common in some mass killings. One is that a weapon is used. The other is that the person doing the killing suffers from mental illness.  The former is the “real problem” in some discussions. The latter is not. We aren’t allowed to talk about mental illness.

There are two reasons why mental illness is given special status when we address these extremely rare, but certainly real, tragedies.  First, raising mental illness deflects attention away from gun control, and gun control advocates refuse to allow anything to divert focus on their preferred solution.  Second, mental illness has become a sacred cow, and we’re not allowed to have real discussions that involve sacred cows.

Public health experts say ready access to firearms makes it easier for people to act on suicidal thoughts. And about 85 percent of suicide attempts that involve guns are successful, compared with less than 3 percent of those involving drug overdoses. Over all, guns were used in about half of the 41,000 suicides in 2013, the latest year for which there is data from the Centers for Disease Control and Prevention.

Fair enough. So there are a lot of mentally ill people who commit suicide, or at least try, and many use guns to do so.  Yet, the balance of the editorial is about what can be done about guns.  Guns don’t make people suicidal. Mental illness makes people suicidal.  And so the solution to suicide is guns.

Those who oppose expanded gun-control legislation frequently argue that instead of limiting access to guns, the country should focus on mental health problems.

Blaming mental health problems for gun violence in America gives the public the false impression that most people with mental illness are dangerous, when in fact a vast majority will never commit violence. Still, some legal changes should be made to reduce access to firearms among the small percentage of people with mental illness who are dangerous to themselves or others.

This is simplistic rhetoric, designed to safeguard the sacred cow of mental health and redirect attention to the hated issue of guns.  We should blame mental health problems for mental health problems. To the extent anyone might get the “false impression” that “most people with mental illness are dangerous,” then correct that impression. But to pretend that some people with mental illness are not dangerous is similarly false.

To take facts off the table of discussion because some people just don’t want them to be there is disingenuous and unhelpful. You really don’t care about the problem if you refuse to allow an honest factual discussion.  You make the problem secondary to your politics, and so you forfeit your right to cry sad tears when tragedy strikes and you’re complicit.

As you correctly point out in “Don’t Blame Mental Illness for Gun Violence” (editorial, Dec. 16), strictly associating mental illness with mass shootings is a misguided and uninformed tactic that oversimplifies the complex issue of gun violence. But more important, it further perpetuates the negative attitudes of the American public toward people with mental illness.

“Strictly”? Cute trick, but the key phrase is “further perpetuates the negative attitudes . . . toward people with mental illness.”  This comes from a hospital administrator.  The crux of the progressive view toward mental illness is that the most important concern is eliminating the stigma.

Therefore, it is critically important that we continue to direct our collective efforts toward educating the public on mental illness stigma reduction and elimination.

Tell that to the victims of the Aurora, Colorado movie theater mass murder.  James Holmes had a gun. James Holmes was also mentally ill.  Why is one “the real problem” and the other unmentionable because it “perpetuates negative attitudes”?

What’s simplistic is to wrap all mental illness up in a pretty pink bow, as if someone suffering from mental illness so as to have murderous delusions is no different from someone who suffers depression and anxiety.  What is simplistic is to take mental illness off the table of discussion.

I know. We all know. There are a great many people we like, we feel kindly toward, who suffer from some degree of mental illness. We want them to seek help. We want them to be able to get treatment without being characterized as batshit crazy and offered a supporting role in One Flew Over The Cukoo’s Nest.  But we also need to recognize that there is a spectrum of mental illness, and somewhere along that spectrum is violence, harm to themselves or others.

“But it’s an illness,” you cry.  “You wouldn’t stigmatize someone for having cancer, would you?”

Of course not, but then, having cancer isn’t a material factor in someone deciding to murder people.  It’s a false analogy.  Denying that it’s a false analogy doesn’t save a life. Pretending that some mentally ill people, the ones who suffer from violent delusions, aren’t a threat to others is a deadly fantasy.  Your empathy comes at the cost of someone else’s life.

To make matters worse, the scope of mental illness has devolved to the point of its being disconnected from serious pathology.  We’re inundated with conflated claims of students who suffer from self-proclaimed and self-diagnosed PTSD and demand safe spaces, trigger warnings. Post-traumatic stress disorder is a serious diagnosis, and they don’t suffer from it.

Instead, they’ve watered it down to become an excuse for needing solace from every unpleasant twinge, and by doing so, created a mass of faux mental illness entitled to dignity and recognition. We’re close to, if not at, the point where suffering from pseudo-mental illness is the next cool victimhood. As a result, the victims are entitled to whatever they claim is necessary to remove their stigma and eliminate their unhappiness. That’s just nuts.

Trading off the lives of people who are harmed, killed, by those who are mentally ill, and whose mental illness manifests itself in violence, for those who feel entitled to not feel anything unpleasant is the by-product of making mental illness a sacred cow that cannot be part of the discussion. It exists. It’s part of the problem. It needs to be addressed. Your simplistic politics won’t make death at the hands of a mentally ill person any less tragic.

14 thoughts on “The Mistake of Removing Mental Illness From The Discussion

  1. Levi

    Your first quote is a good example of how people uncritically conflate data even while citing it. At the beginning they are talking about suicide attempts and by the end they are talking about successful suicides, and the conclusion they draw is that suicides are grossly inflated by guns. But from the same data, because guns are significantly more effective in successful suicide attempts, they represent a relatively small amount of attempted suicides. According to that Harvard study cited, firearms are used in only 5-10% of attempted suicides even though (from fresher data) they represent some 50% of successful suicides. At the same time, about 30% of people in the country have a gun in the house, suggesting either that gun owners are less likely to attempt suicide or (more likely) guns are not even the first choice of suicide attempt for gun owners.

    I can’t think of any other thing that people advocate barring many/most people from obtaining on the off chance that mentally ill people might get their hands on it. On the other hand, I can see where if there were some official mental health registry that blocked gun purchases that it would discourage some unstable people from seeking treatment because they knew it might lead to giving up a right. And since most people who attempt suicide once do not attempt it again, the clearest flag that would lead someone to be placed on a “dangerous to self” mental health restriction is the least likely to actually prevent a significant number of firearm suicides.

    1. SHG Post author

      It’s one or many pieces of advocacy for the cause of gun control. And they’re allowed to make their arguments, even if subject to being discredited. Just not to the exclusion of all other material arguments for the sake of winning the gun control fight at the expense of lives.

  2. mb

    If a focus on safer treatment for mental health “stigmatizes” mentally ill people, it seems to me to be much less effective in doing so than gun control advocates have been in “stigmatizing” their neighbors who lawfully exercise their rights to own guns. I’ve never heard anyone compare the mentally ill or those who advocate on their behalf to Nazis, pigeonhole them as privileged on the basis of their race or sex, accuse them of backward, irrational, or malicious thinking, or question the size of their penises. Meanwhile, almost every single person I’ve encountered who supports strict gun control laws says every one of those things about gun owners and manufacturers, and lobbying groups, and the authors of the Second Amendment every time the issue is brought up within earshot of them.

    This is beyond simplistic rhetoric. This is a lack of self awareness so extreme that I’m forced to question the sanity of the person who wrote it. Of course, even if they are a flaming narcissist, I still think that their life has the same value as anyone else’s, and I would only want whatever was best for them, with full respect for their rights as an individual.

    1. SHG Post author

      Don’t be as harsh as your adversaries. It’s unnecessary and unbecoming. Nor does it further your point to denigrate their point. We had a terrific discussion here, without much rancor, about gun control. We can rise above the ad hominems.

      1. mb

        I was being serious. (at least in a way) I don’t think they would claim to be unaware of the rhetoric on their side or dispute my argument that the national conversation on mental health fails to demonstrate any equivalent stigmatization. I think that they would argue that lawful gun owners aren’t harmed by the awful things gun control advocates say about them. This is the absolute height of irony. This argument can only come from someone who has internalized the stigmatization of their ideological opponents. My dog has a greater capacity for introspection than that.

        1. SHG Post author

          I do get your point, and I also realize how some of the otherwise very smart and thoughtful people turn blind on this extremely emotional and controversial subject. What I’m suggesting is to end the blindness rather than point fingers at it. Someone has to be the grownup, and if they won’t do it, we’re all that’s left.

          1. mb

            I will say it more nicely:

            Anyone making the argument above, you lack the moral high ground from which to lecture others on our attitudes towards the mentally ill, as long as you and your friends are using the tactics I described above. Condescension on your part is not a substitute for mutual dialogue. No intelligent, educated person wants to harm the mentally ill or deprive them of their rights. Your concern for them is laudable, and I am glad to listen to your specific recommendations. I’m sure that the best policy will be one that addresses your concerns as well as the safety of the mentally ill and those around them. Gun control policy is a separate issue, one on which there can be no rational discussion until you disabuse yourself of the wrong headed beliefs which lead you and your friends to use the rhetorical tactics I described above, and which allow you to make this argument without realizing how hypocritical it makes you look.

            Better?

  3. Marc R

    Gun-blamers and brain-blamers miss the point. Neither criminals nor mentally ill (easily defined here, operationally, as those sick enough to murder people) will abide by laws mandating gun penalties and/or government medicaid/medicare mental health professionals. Also, since most guns used in murders were legally purchased, many gun owners won’t try to obtain guns if they’re illegal, and access to guns will go to some degree each year, then it follows gun deaths will go down. Likewise, if mental health access was easier for those suffering, then mental illness rates will decline to some degree each year, and thus less gun deaths will occur by those mentally ill. Neither have been seriously mandated and enacted so we will never know to what degree.

    Of course, some would argue both are above solutions are fine. Obviously some will never get health care and some will always have easy access to most weapons, but all laws our most important laws have restrictions; 1A – fire in a theatre, fighting words, obscenity, 3A – martial law and eminent domain, 4A – exclusionary clauses, 5A – trial tax, missing PDs, non enforcement of Brady and immunity versus due process, civil forfeiture and Nebbiah hearings before any guilt, etc. etc. the 2nd’s restrictions will soon be defined…Scalia never explains how to define the framer’s thoughts on arms (chemical weapons/smallpox blankets, catapult/artillery, Greek fire imitations/napalm,radioactive rounds, tall people with rocks/F17s) and his originalism will go the way of daytime savings before 2025.

  4. OEH

    I can’t not think of my good friend NI, who I loved so much.

    She suffered from schizophrenia, for decades. The social attitudes toward her illness were not just an occasional awkwardness; they were a constant drain on her life. All her relationships were infected by how people saw her, what they did and did not know about her illness.

    She told me that where she grew up, people with mental illnesses are shunned and isolated. She asked if it was better in America. I didn’t have the heart to tell her that we were just as bad.

    1. SHG Post author

      That’s a sad and unfortunate story. The families of people killed in mass murders have sad and unfortunate stories too. Should this be a Queen for a Day contest, of whose story is the saddest and most unfortunate?

  5. dm

    As there is already a standard which enables the homicidal/suicidal mentally ill to be denied access to firearms via legal purchase, had it been properly applied it might have caught up James Holmes (Aurora theater). Unfortunately, the mental health professional who had the power to institutionalize Holmes and seek a judicial determination of Holmes’ severe mental instability (homicidal and suicidal ideation) opted not to pursue that path despite deeming it serious enough to inform the campus police (U of Colorado)(the campus police also opting not to follow up on the matter despite them also being empowered to seek a judicial determination of somebody’s severe homicidal/suicidal ideation).
    This is, I think, another instance where new laws aren’t necessarily needed. Rather, there needs to be an emphasis placed on following through with laws presently on the books in most or all states. in those narrow spectrum of mentally ill who would seem to present a bona fide danger to the public.

    1. SHG Post author

      Had Holmes’ homicidal ideations been reported, it would have been stigmatizing as he would have never shot up the theater and therefore never proven violent. This would have exposed the therapist and school to criticism for their lack of enlightenment and concern for the welfare of the mentally ill. providing the incentive that allowed Holmes to get a weapon.

      They can’t have it both ways. Mental illness looks a lot more clear cut on the other side of a murder, as there are lots of people with homicidal and suicidal ideation, and never act upon it. It’s impossible to determine how narrow that spectrum is until after they act or not.

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