Gun control and mental health

By Jim Killebrew

[May 29, 2014]  "Don't call me and tell me you're sorry about my son's death. I don't want to hear it from you. I don't want to hear that you're sorry about my son's death. I don't care you're sorry about my son's death. You go back to Congress and you do something and you come back to me and tell me you've done something, then I'd be interested in talking to you." (Quote from Richard Martinez, father of Santa Barbara shooting victim Christopher Martinez)

This is the emotional, agonizing cry of a father who has just lost his son. He is grieving for his son and wanting to know what is going to be done about the conditions in culture and our society to help mitigate the loss of his son, Christopher Martinez. His alleged killer, Elliott Rodger apparently was a troubled youth. He allegedly stabbed three victims in his room before he randomly shot others in the college town of Santa Barbara, California. Subsequently the authorities discovered there had been issues that created suspicion the young man had a mental health issue. After his self-video describing what he was going to do to those he perceived to have snubbed him, he allegedly killed at least three more and injured at least thirteen others, which ultimately ended in a shoot-out with police and his own death by initially suspected self-infliction.

The agony of Christopher's father was felt by all who heard him. He lashed out in remorse and grief just having experienced the death of his son. His challenge was directed at the lawmakers and the National Rifle Association (NRA) as being blatantly negligent in providing safety to citizens by doing something about controlling the guns in America. Without a doubt there is something askew in society with the instances of killings in instances of workplace violence, schools and random shootings, stabbings, bombings and other acts of terror.
 

As with this case, in the aftermath the law enforcement agencies almost always find the perpetrator is suffering from some sort of mental illness. They have created "manifestos" or diaries, journals and articles about themselves and what they plan to do, or have demonstrated other signs of instability prior to the incident. In many ways the neighbors or family are able to look back with a renewed interpretation of certain behaviors that have amounted to cries for help. In many cases there have been indicators that would have indicated a need for treatment even to the point of institutionalization.

During the past two or three decades, however, there has been a national movement against people being institutionalized or taken even to private mental health hospitals or clinics. Laws have been passed that initiated and processed the flow of "de-institutionalization" for people who had received mental health treatments. Most states have receded from the business of residential care for the mentally ill person. Admission to such facilities are difficult to maneuver by families, and always rely on the person with a mental illness to "voluntarily" submit to admission even during the height of a manifested mental illness; with much difficulty being successful in reasoning with a person with paranoia or delusional behaviors to assist in a voluntary admission to a mental health facility. This is true even when the person is writing materials or making videos that forecast future harmful behavior that is known by close family members and friends. Most family are unable to predict on the basis of what they might consider "bizarre" behaviors what might happen in the future; and they rarely begin to reasonably think in terms of their family member engaging in such mass killings or suicide connected with the person's ramblings or behaviors that have never produced a danger to self or others.

Yet the criteria established for admission in most mental health hospitals requires the evidence of harm to self or others as the primary reason for admission in the hospital. Even that usually requires the evaluation or assessment of a mental health professional or a medical doctor. It usually requires even more than that for an involuntary admission. When the courts get involved the bar is raised to include evidence from at least two physicians or at least a clinical psychologist and a physician to provide recent evidence to the court to compel the person to submit to an evaluation as an in-patient hospital. That evaluation is usually set for a time period from three to thirty days; once the person is "lucid" and wants to leave the hospital there is no longer enough "evidence" for the court to keep the person in treatment. When the person is discharged on medication it is the individual's responsibility to continue with the medication to keep the mental health symptoms under control. If the individual becomes non-compliant with the medication it could be weeks, months or years before anyone in the medical mental profession finds out about it. During that time the symptoms break through and re-emerge with a greater degree of loss of reality, especially in cases of various types of schizophrenia.

This cycle of reduced or non-existent treatment and lack of access has through the years, especially in California, has caused a mass exodus from the mental health hospitals to create a national endemic of homelessness in the streets of America. With the lack of aftercare and follow-up for the masses of homeless people to determine who might suffer from mental illnesses exacerbate the issue of those with mental illnesses acting violently toward themselves or others. This condition remains a dangerous situation since there is little, or no, statistical information and specific, targeted clinical information about where they are and who may be violent. Obviously, the young man in Sana Barbara, California was not in this homeless situation. However, he was trapped in the mass of laws and regulations that prevented him from being discovered as a candidate who might have needed mental health treatment even outside of his parental consent or his voluntary consent.

It would be much more worthwhile for the politicians to step back from their liberal versus conservative stands regarding the issue of controlling the guns as the ultimate answer to these kinds of issues, and more constructively set down in a bi-partisan manner with the federal and state law-makers and fix the mental health system in the fifty states to help those who need mental health treatment to receive it in the most effective treatment environment. It needs to have active follow-up oversight and related to other activities such as continued compliance to treatment. I would be surprised if our founding fathers thought it would be acceptable when they wrote the Second Amendment that it should apply in full force to those people who suffered from mental illnesses that created within them a propensity to kill themselves or others.

[By JIM KILLEBREW]