Missing the mark: gun control is not the cure for what ails the U.S. mental health system.

AuthorWolf, Carolyn Reinach
PositionSymposium on Guns in America

Recent gun control legislation aimed at removing guns from the hands of the mentally ill in order to reduce violence is misguided. In fact, this only contributes to the mistaken belief that there is a direct link between mental illness and violence. This Article suggests that instead, policymakers should be focusing on modifying existing restrictive mental health laws and increasing the funding needed to provide adequate mental health services in the community. Family members, the community, and the individuals themselves must have access to adequate resources and support systems to increase the individual's chance of recovery and stability. In light of recent tragedies, a better solution to reducing gun violence includes offering community programs and preventive training in educational and workplace environments to allow for early detection and intervention. The current system does not support those in need of treatment and only serves to exacerbate the stigma associated with mental illness.

TABLE OF CONTENTS INTRODUCTION I. UNDERSTANDING MENTAL ILLNESS II. GUN CONTROL LAWS AROUND THE UNITED STATES A. New York B. Illinois C. Other State Gun Control Policies III. CONCERNS OF MEDICAL AND MENTAL HEALTH PROFESSIONALS A. Barriers to Seeking Treatment B. Threatening the Duty of Confidentiality C. Alienating Those Who Need Treatment IV. IMPROVING THE FLAWED MENTAL HEALTH SYSTEM A. Allocating Resources and Increasing Access to Services for Mental Health Treatment at the State Level B. Preventative Training and Behavioral Intervention Teams in Educational and Workplace Communities C. Inconsistent Background Check Policies CONCLUSION INTRODUCTION

Recent mass shootings such as those at a grocery store in Tucson, Arizona, (1) an elementary school in Newtown, Connecticut (2) and the Navy Yard in Washington, D.C., (3) have motivated state governments across the country to draft policies that would more strictly limit the gun rights of those with mental illness. (4) These policies contribute to the belief that all individuals with mental illness are dangerous. These tragedies repeatedly renew the debate over gun regulations as the appropriate response to gun violence, (5) instead of raising awareness that these incidents may have been prevented if the perpetrator had received timely treatment. (6) Policymakers have not focused on treatment, modified existing restrictive mental health laws, or increased funding for mental health services. Instead, they have concentrated on gun control and taking guns out of the hands of people who suffer from mental illness or behavioral health issues, as well as requiring mental health professionals to report dangerous people to the authorities. (7)

The problem with tying mental illness to the gun control debate is that people assume those with mental illnesses are more prone to violence than those without these issues. (8) The truth is that individuals falling into the category of "mentally ill" only account for a small fraction of all violent conduct. (9) Simply having a mental illness is not a strong predictor of future violence. (10) Individuals who have exhibited dangerous behaviors in the past, have a criminal record, or have a history of drug abuse, for example, are much more likely to commit future violent crimes. (11) In fact, the risk of violence, if any, by a person suffering from a serious mental illness may increase when the proper treatment, support, and medication are not available. (12)

Many shootings, whether on a college campus or in a workplace setting, could be prevented not solely through stricter gun control laws, (13) but rather through a higher level of mental health awareness in these respective communities and increased funding for community and support services. Unfortunately, funding for mental health care has diminished significantly; over the past few years, states have cut approximately $4.35 billion from their mental health care budgets. (14) While it is important to control access to firearms by those who are prone to violence (not just those with mental illness), it is more important that we fix the flawed mental health system, starting with increasing the funding for, and availability of, mental health services.

This Article will examine the ways in which recent gun control laws in the United States do or do not address relevant mental health issues. Part I presents an overview of mental illness and the importance of ongoing treatment throughout an individual's lifetime. Part II discusses different current gun control laws across the United States and evaluates their impact on the mental health community. Part III explains the concerns of medical and mental health professionals, including the impact on doctor-patient relationships and confidentiality issues, among others. Part IV explores possible improvements to gun control laws and to the broken mental health system, such as the use of Behavioral Intervention Teams in educational and workplace environments. Finally, the Conclusion reinforces the argument that providing better mental health care resources for those with mental illness will do more in the long run to reduce violence than more stringent gun control laws.

  1. UNDERSTANDING MENTAL ILLNESS

    Mental illness refers to a diagnosed medical condition that "often result[s] in a diminished capacity for coping with the ordinary demands of life." (15) The significant behavioral or psychological symptoms of these illnesses result in the impaired ability to think, feel, and relate to others. (16) Early identification and access to treatment are extremely important when it comes to reducing symptoms and improving one's quality of life. (17) There is no "cure" for mental illness; (18) in order to experience relief from symptoms, treatment (i.e., psychiatric medication, psychotherapy, brain-stimulation treatments, hospitalizations, residential treatment programs, or substance abuse counseling and support groups) (19) must continue over the individual's lifetime. (20)

    The recovery or treatment process can span a lifetime, meaning that the individual participating needs individual strength, insight, supportive relationships, and community services in order to function in society. (21) There are two major aspects of recovery: first, stabilizing symptoms and restoring social function and, second, changing one's attitudes and feelings, and developing a new meaning or purpose in one's life. (22) The key to both aspects, however, is having a support system; a support group, therapist, friends, or family members are essential as the individual goes through the challenges of recovery. (23) Working with a mental health professional can help the individual achieve treatment goals. (24) The reality is that there are sometimes severe consequences for the individual if a mental illness goes untreated: unemployment, substance abuse, homelessness, incarceration, and suicide, among others. (25) Through the use of medications and therapeutic services, most individuals suffering from a mental illness can minimize the impact of that mental illness on their life and experience some level of recovery. (26)

    Despite the beneficial outcomes that individuals can experience from adequate mental health care, significant barriers exist, blocking access to that care. The high cost of mental health care, the shortage of mental health professionals around the country, and the public's negative attitudes about mental illness all prevent individuals from seeking help. (27) Additionally, and with harmful consequences, recent gun control legislation targets the mentally ill which exacerbates the stigma about violence and mental illness and may deter individuals from seeking the care they need.

  2. GUN CONTROL LAWS AROUND THE UNITED STATES

    The purpose of the federal and state gun reporting laws is to ensure that communities across the United States are safe from gun violence. In order to achieve this objective, those gun laws should be based on propensity or actual violence, not mental illness. "[Reactionary gun control legislation (28) fails to halt violent gun crime," however, "because [it] do[es] not address the root causes of gun crime." (29) Nevertheless, several states passed measures aimed specifically at keeping people who are mentally ill from accessing guns. (30) State legislatures must acknowledge that it is more effective to aim our efforts at preventative mental health measures than to engage in endless gun control debate. (31) This Part will discuss different gun control laws across the United States and explore their impact on the mental health system, highlighting two states that have recently targeted the mentally ill.

    1. NEW YORK

      After the shooting at Sandy Hook Elementary School, (32) the first gun control bill to become law was the New York Secure Ammunition and Firearms Enforcement Act of 2013 ("SAFE Act"). (33) The SAFE Act is a prime example of "reactionary gun control legislation" (34) as it was essentially passed overnight. (35) The intention behind passing the SAFE Act was to enhance public safety by preventing "criminals and the dangerously mentally ill" from purchasing a gun through the use of universal background checks. (36) This legislation significantly impacts all mental health professionals, but was created with "seemingly little input from [them]." (37)

      Certain mental health professionals in New York are now required to report patients they deem dangerous to themselves or others. (38) The SAFE Act establishes Section 9.46 of the New York Mental Hygiene Law, which requires "physician[s], psychologists], registered nurse[s,] [and] licensed clinical social worker[s]" (39) to report patients they believe are "likely to engage in conduct that would result in serious harm to self or others" to county authorities. (40) This standard, as defined in Section 9.01 of the Mental Hygiene Law, means "threats of or attempts at suicide or serious bodily harm" to...

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