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Stop the Real Criminalization of Mental Illness

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Whenever some horrible event like that at Newtown or the Clackamas Town Center happens the immediate assumption is the killer was mentally ill, even though more than half the time he wasn't.  Regardless of the killer's frame of mind, two never-implemented aspects of the never-implemented solution to prevent such a thing from happening again are: 
  • keeping guns out of the hands of the mentally ill
  • and the easier, yet less frequently discussed, to improve mental health care  
While I'm all for the second one, the first would be a very bad idea.

To register most, if not all of us, in the FBI's National Instant Criminal Background Check System (NICS) database when we have never harmed or threatened to harm another person is the same as convicting us, without the benefit of a trial, of being violent felons when our only crime is being born with a mental illness.  Including us and our medical records in the NICS means we would not be able to get a job, rent an apartment, or do anything else where a criminal background check is now, or quickly becoming, a standard part of the procedure.  I know the NICS is supposed to be confidential and not part of the routine background checks that have become part of our daily lives, but consider this: our Social Security numbers were never supposed to be used by anyone other than the SSA, especially as a means of identification.

This is not about guns.  I don't have much need for one and I don't care what kind of arsenal my neighbors have for hunting, self-defense, or preparation for various doomsday scenarios.  If privacy rights guaranteed by HIPAA no longer apply to us, and our names, addresses, phone numbers, Social Security numbers -- basically everything needed to steal our identities -- along with medical records for conditions that carry a greater stigma than any other are to be entered into a database that is going to become much easier to look at, how many people do you think are going to seek treatment for their mental illness?  Worse yet, how many people with a mental illness who are currently being treated are going to stop seeing their doctors?

In the wake of tragedies like those at Sandy Hook Elementary School and Aurora Colorado the American people cry out for a way to keep guns out of the hands of the mentally ill.  Sometimes there is a call to improve the access to and quality of mental health care.  It doesn't seem to matter that those of us who are mentally ill aren't that much more violent than the general population.  Or that on any given day more people are murdered by assailants who are not mentally ill, and who used anything as a weapon, than Seung-Hui Cho killed at Virginia Tech.

Has anyone bothered to look into the research already done on violent crime not related to other criminal activity?  I have.  Would you like to know who is really more likely to kill someone with a gun, knife, crowbar, etc., than anyone else?   
Improving the inclusion of people with multiple DUIs and other substance-related offenses in the NICS would probably reduce the number of individual people killed by guns significantly.  As for mass murder, improving the collection of domestic-violence data would certainly help prevent would-be family annihilators from obtaining guns and turning office parks into shooting galleries.

Yes, the mentally ill sometimes do commit acts of violence, but the motives behind these acts are not as random, and thus crazy, as people think.  Things like physical abuse, substance abuse, actual threats, recent divorce, unemployment, and real or perceived victimization, the same things that motivate normal people to go forth and commit mass murder.  Normal people like:

  • Major Nidal Hasan is a fratricidal traitor, but not mentally ill.  In spite of NPR's best efforts to prove otherwise.
  • Wade Page, who was a violent bigot, with a worldview reasonable people may have a hard time understanding, but was not mentally ill.
  • Anders Breivik's worldview is even more difficult to understand, but he is not mentally ill.
  • Ali Sayed may have played far too many violent video games, but he was not mentally ill.
  • Former LAPD officer Chris Dorner may have felt he had no other option in resolving the workplace problems he had, but he was not mentally ill.
  • Bruce Pardo, who dressed up like Santa and, on Christmas Eve 2008, killed his ex-wife and almost all of her family, nine people in all, with a homemade flamethrower, was acting upon the overwhelming rage many people feel when you combine a messy divorce with severe financial problems.  He had a plan to get to Canada, and he would have made it if he didn't end up burning himself with his homemade napalm.  He was a horrible person, but he was not mentally ill. 
  • The same can said for every family annihilator who kills a bunch of people he feels were responsible for getting him fired, his family, and himself.

Even though mental illness was not involved in the above incidents, or countless others, it is the only acceptable explanation because most people are afraid to confront the fact that humans are inherently violent creatures; that our hands evolved to use fists as weapons as well as to hold other tools. People are afraid to confront how easy it is for the veneer of civilization to slip away; that anger and alcohol disinhibit more effectively than an abnormal psyche or neurological architecture.  People are scared enough when one of the good guys, like ex-LAPD officer Chris Dorner, just snaps; they are utterly terrified to consider that a neighbor, coworker, family member, spouse, partner, or they themselves could be just a couple of drinks and one more bad performance review away from being the next person to go on a killing spree.   For most people it is far better for the mentally ill to be the sin eaters than to face such a possibility.

Has anyone considered how counterproductive the constant equating of mass murder with mental illness is?   How many people who are already skittish about seeking help for a mental-health problem because of the social stigma will want to seek help if there is a chance, real or perceived, that their name, address, phone number, and Social Security number, along with the indication that they are crazy enough to kill their family and coworkers, are all going into an FBI databaseOne recent survey of the mentally ill found that 38% of us who didn't bother to seek treatment cited structural reasons: lack of money, availability, or the inability to get to where the services are; while 21% said it was due to the stigma and 26% because they thought the available services weren't good enough.  Of those who started treatment and then quit within a year, 30% dropped out within a year due to structural reasons, 36% dropped out due to stigma, and 35% quit because the available services were not worth going to.  So, yes, improving the mental-health system will benefit a lot of people, a very small percentage of whom are occasionally more violent than everyone else, and all of whom are also ten times more likely to be the victims of violent crime than normal people!  But loudly using the prevention of gun-related violence as the reason to expand access to improved mental-health services will probably scare off more people who would have otherwise sought treatment!

I run a website for the mentally interesting -- people with mental illnesses and/or neurological conditions such as epilepsy or migraines that receives over 15,000 daily visitors.  It has a forum with over 4,000 active members.  Many are talking about how they will stop getting treatment if being treated means being in the NICS database for no reason other than seeking help for a mental illness.

Here is a comment on my letter published by the Missoulian on this subject:
Everything, these days, seems to be an illness. Lets boil it down. You're either worth a hoot or you're not. The cost factor of mental 'problem' treatment is a bottomless pit, and taxes are already way too high. There is no cure. Cull the herd. Historically, the T-4 program was very effective, reliable, and cost effective.

It takes a special kind of person to admit, albeit as an anonymous coward, that they admire Hitler and want to systematically round up people with epilepsy, like David Axelrod's daughter, autism, epilepsy and autism like my daughter, Down syndrome, and assorted other physical and mental disabilities, systematically kill us, and throw us in the ovens.  He is not the only person spewing such frightening rhetoric.  Look at the comments section on the websites of any publication or news organization that has written something on the issue of guns and mental illness, regardless of their political leanings, and you'll find similar comments.  Those who advocate something along the lines of Action T4 are in a not-small-enough minority; far more popular is the suggestion of warehousing all of us in psychiatric hospitals, whether we need it or not.  Wayne LaPierre, president of the NRA, advocates getting the ball rolling with "an active national database of the mentally ill."

Since the mentally interesting are lower than undocumented terrorists who illegally enter this country in order to steal the jobs of domestic terrorists, those of us who never have and never will commit an act of violence will probably wind up being made the scapegoats no matter what. If so, there is a way to disqualify the mentally ill with a propensity for violence without violating the privacy rights of those of us who never have and never will harm anyone.  Figuring out who will be a mass murderer is difficult. Doctors have a better chance of determining if someone is not going to be violent than if they are; although, as stated in that study, doing that first could make it easier to determine if someone might become violent using subsequent tests.  The existing tests confirm what I've written, substance abusers and people with a history of violence are more likely to commit homicide.  Just like people who are not mentally ill.  Has anyone considered a return to Prohibition?  One strike and you're out for domestic violence?

No matter what is done to determine if someone cannot own a firearm due to mental impairment, we need to remove the Category of Prohibited Persons (PCA) code, and other codes that would be deprecated by its removal (reporting agency, relationship to victim, and any I've overlooked), from the part of the NICS database that can be accessed by licensed firearms dealers and whoever else you decide can look at it regarding firearms transactions.  Our medical records, even a summary like our diagnosis, cannot be included.  The only people who should have access to the PCA and reporting agency are individuals requesting their own records.  I assume someone with a domestic-violence disqualification can't see things like  reporting person and their relationship, otherwise that's a huge problem along completely different lines.  Law-enforcement officials are the only people who have anything close to a legitimate reason to know the entire reason why someone is not allowed to own a gun.  While I don't particularly like that either, I can learn to live with it. 

If HIPAA no longer applies to us and the already vague definition of "mental defective" is expanded to be based upon nothing more than our diagnoses, then we will be identified to the world as criminals for no crime other than being born mentally ill.  If that happens, thousands of us will stop being treated, and tens of thousands more will never seek treatment in the first place.  Some of us might take heed of something attributed to Mr. LaPierre, among others, when they spoke of the time the Jewish people lived in Germany under NSDAP rule (1933-1945) arming themselves to prevent the Holocaust.  As we were the first victims of the Holocaust under Action T4, well, that's no crazier than registering all those who seek treatment as violent criminals, thus forcing us to live in the ghettos of run-down motels and t railer-park meth factories, and survive for as long as possible on whatever sort of job we can get, but more likely living on SSI or SSDI and relying on Medicaid or Medicare and relying on frequently inadequate workplace insurance, medications imported from Canada, overworked medical professionals, and understaffed volunteer organizations for our mental-health needs; instead of holding down real jobs with decent health insurance and living in a nice apartment or even owning a home.  If it becomes a crime to be mentally ill, far more people will die than do today, the overwhelming majority from the usual causes when the mentally ill don't seek treatment: suicide, being the victims of violent crime, exposure and other hazards of being homeless, and miscellaneous crazy behavior, such as whatever it was that killed my brother-in-law.  And, yes, there will be more mass murders that would have otherwise been prevented.

Talk about shooting yourself in the foot.

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I'm the founder, owner, and Chief Citizen Medical Expert of Crazymeds. Marketing researchers working for the pharmaceutical industry called me the first "Citizen Medical Expert." I liked the name so much I've been using it ever since. You'll (more...)
 

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