December 18, 2012

Mental health services needed

It’s Easier For Americans To Access Guns Than Mental Health Services

By Sy MukherjeeDetails about Friday’s horrific shooting spree at a Connecticut elementary school are still emerging, and it remains unknown whether the suspected shooter suffered from underlying mental health issues. But the fact remains: in America, it’s currently easier for a poor person to get a gun than it is for them to get treatment for mental health issues.

Most murders committed in the United States involve a firearm—particularly handguns. A quick search shows that a typical handgun can be purchased for anywhere between $250 and $500. A .223-caliber semi-automatic rifle—which some reports indicate was the type of firearm used in today’s attack—costs between $700 and $2000. And contrary to the gun lobby’s most ardent hysteria about Barack Obama, gun ownership has actually been rising over the past four years, as has the use of guns in violent crimes.

By comparison, access to mental health services remains spotty, its funding and beneficiary requirements subject to the whims of governments attempting to balance their bloated budgets. People often do not know when they are entitled to preventative care services for mental health, and the people who do often forgo care due to the stigma associated with receiving such care.

And then there’s the cost of more extensive care. According to the National Survey on Drug Use and Health (NSDUH), a mere 7.1 percent of all American adults receive mental health services.

Most of these Americans’ care is covered by private insurance, with children, poorer, and more elderly Americans being covered through public insurance programs such as Medicare and Medicaid. An additional ten percent are uninsured. But out-of-pocket costs for both inpatient and outpatient mental health services remain staggeringly high.

In Gun Debate, a Misguided Focus on Mental Illness

By Richard A. FriedmanEven if clinicians could predict violence perfectly, keeping guns from people with mental illness is easier said than done. Nearly five years after Congress enacted the National Instant Criminal Background Check System, only about half of the states have submitted more than a tiny proportion of their mental health records.

How effective are laws that prohibit people with mental illness from obtaining guns? According to Dr. Swanson’s recent research, these measures may prevent some violent crime. But, he added, “there are a lot of people who are undeterred by these laws.”

Adam Lanza was prohibited from purchasing a gun, because he was too young. Yet he managed to get his hands on guns—his mother’s—anyway. If we really want to stop young men like him from becoming mass murderers, and prevent the small amount of violence attributable to mental illness, we should invest our resources in better screening for, and treatment of, psychiatric illness in young people.

All the focus on the small number of people with mental illness who are violent serves to make us feel safer by displacing and limiting the threat of violence to a small, well-defined group. But the sad and frightening truth is that the vast majority of homicides are carried out by outwardly normal people in the grip of all too ordinary human aggression to whom we provide nearly unfettered access to deadly force.
Comment:  Better treatment of mental illness is a good idea whether or not it would stop future shooters.

Comment:  For more on gun control, see NRA Enables Mass Murderers and The "More Guns" Fallacy.

1 comment:

Anonymous said...

One slight nitpick about the cartoon: Most psychiatrists don't really follow psychoanalysis any more, so Freud is more often mentioned in Woody Allen movies than in modern-day practice.

But if you expect a perfect prediction of violence, you won't get it. First off, anyone can lie to a psychiatrist. You can lie yourself into sanity, and lie yourself into insanity if for some reason you so desire.

That said, better access to medical care would benefit us all.