Mass Shootings, Mental Illness, and Fear

The sense of unreality is palpable. It makes NO sense whatever, yet lately we've seen this sort of thing happen every few weeks.

Why does it happen? Who is responsible? What can be done to prevent this ever happening again?

I suspect that none of these questions will ever have adequate answers. Too often the perpetrator takes himself out (it is always men) of the picture and can never be asked "why did you do this." And if mental illness is involved and the shooter does survive the answer won't be satisfying anyway. Insanity, by it's very nature, does not make sense to the rest of us. Why would it?

So we may never have a suitable answer to the question "why does it happen." Let use set this question aside for now and concentrate instead on responsibility.

Who is responsible seems simple on it's face. The shooter of course, but if we have a case of mental health issues with a violent component even that is not certain. Did the medications stop working? Did the shooter stop taking them? Did the mental health worker miss something or decide not to report what they saw?

Truthfully a case of mass murder really cannot be categorized as anything other than insanity. Whether the person has a disconnect from reality or is operating from rage, sanity is not really a factor. Rather a lack of sanity is at play.

The effectiveness of medication can plateau and then decline. The human body will try to account for and work around foreign substances. Medication is a foreign substance.

Also, many times the person with issues will feel well enough to decide that they no longer need the medication. Of course this is a mistake, but this sort of thing happens more often than you'd expect. Part of the problem here is that the patient, due to his/her illness, is not aware when they start acting erratically days or weeks after stopping medication. This is part and parcel to many mental illnesses. And trying to talk them into taking the medication again can be an exercise in futility.

Did the mental health worker fail to notice something or, out of reluctance, decide not to report a problem? Because mood stabilizers and anti-psychotics are the preferred way to treat mental illness, interviews with mental health professionals are typically short and center around renewing the prescription. More often than not a long conversation about what is going on in the patients mind is not going to happen. Warning signs can be missed this way.

We have a treatment model that seems to work. It is drugs. Spending valuable time delving into someone's demons isn't worth-while in this model if drugs can take care of the problem. Or at least that seems to be current thinking. How much is missed when a fifteen minute interview is all the time allowed?

Reporting bizarre behavior can be fraught with its own risks, some problems go unreported or under-reported. Maybe the patient is just venting because they feel comfortable doing so with their health-care provider. Maybe there just needs to be an adjustment in dosages. Maybe the patient is just having a bad day.

Deciding to report a patient and quite possibly be responsible for their incarceration, even if it is for a few days, can cause irreparable damage to the provider/patient relationship. Reluctance to report is understandable. But is it also irresponsible?

Some simple changes to weapons sales would help. I don't think limiting the size of the magazine is all that helpful. Shooters may be mentally challenged, but that does not mean they are stupid. Got a small magazine? Carry more of them.

Part of the issue too is the weapon often involved. Yes, I've heard the argument that these are  "sporting guns," but when Eugene Stoner developed them they were designed specifically for military use. The only difference between a "sporting rifle" and an "assault rifle" is being able to select semi-automatic or automatic fire. Semi-automatic means you have to pull the trigger for each bullet fired; automatic means the rifle fires as long as you hold the trigger down.

Having been a soldier I can tell you we were discouraged from going "full auto" because it burned through ammunition. Once you run out of ammunition you are no longer an effective solider. We fired the M16/M4 much the same way "hunters" fire the "sporting rifle;" one shot at a time.

So truthfully there is no real difference between an M16/M4 military weapon and an AR-15 "sporting rifle." They are essentially the same. But in the interest of full disclosure I also need to point out that in the military only one type of ammunition is allowed. Metal jacketed. This ammunition can pierce armor, but typically passes through flesh without expanding.

Civilian versions of the ammunition are much more varied. Civilian bullets can expand, fragment, or deform. In a way civilian ammunition is deadlier than military ammunition.

Still, attempting to recall these military inspired "sporting rifles" would be difficult at best and most likely impossible in realty. That's not what's needed anyway.

There are too many ways to purchase weapons that do not require a background check. Gun shows for one, private sales for another. Part of the problem is many gun owners are convinced that registration is a way for an oppressive government to track them down and take their fire-arms. Let me be blindingly honest here, this is delusional thinking at best and full out paranoia at worst. As you may realize both of these states of thinking are associated with mental illness.

Registration could come with requirements. Weapons owners might be required to buy insurance. Weapon owners could be required to equip their firearms with gun-locks and stored in weapon safes. Weapons that are registered can be also traced. Traced weapons lead to criminals. Why would this be a difficult to understand requirement?

Requirements like this could potentially keep these fire-arms out of the hands of anyone but the owner. Requiring locks, gun safes, insurance can only help.

But perhaps the most important factor that is lacking, in light of the shootings of the last few years, is how someone with known mental health issues can get their hands on weapons. The answer of course is that the gun lobby, in it's zeal to make sure anyone can buy a fire-arm, is solidly against any restrictions whatever. This is unrealistic.

True some states automatically require anyone detained for violent behavior to submit to psychological testing and surrender their fire-arms, at least temporally, until a determination is made. There's a problem here too. A judge may order an alleged offender to surrender their fire-arms, but the courts trust the person to voluntarily turn them in. Why? Better to issue a warrant and make sure they really are turned in. But some states is not all states; this should be a national requirement.

How about this. Anyone prescribed and taking mood stabilizers or anti-psychotic drugs be restricted from possessing fire-arms as long as they are on the drugs. This should apply to driving a truck or car as well. After all, the very label on the prescription typically prohibits the user from operating machinery. Guns and cars are most certainly machinery.

Reopen mental health institutions and stop relying so much on drugs. Prison is for people who understand right from wrong. This doesn't apply to some mental health patients.

Pay mental health workers to provide real services; not just drugs, but in depth counseling as well. Along with that reduce the likely-hood that a mental health professional will be penalized for reporting a patient. Our joint safety is at stake. We have to balance what is good for the patient against what is good for the rest of us.

Let us institute a national fire-arm and ammunition tax. To heck with trying to restrict the sale of firearms beyond the common sense approaches suggested above. The tax will be used solely to reimburse victims for injury and permanent disability along with loss of income due to death. It is simply wrong for the entire population to have to pay for permanent injury and disability when such a large swath of the population do not own guns.

To date second amendment rights proponents have gotten off light on the true costs of fire-arm ownership. We all have to pay for this whether we have weapons or not. How is that fair?

Finally, we have social media at our disposal. It can be used for good or ill. Let's use it to tell the NRA and other gun "rights" groups it's time for them to compromise, it's time to close the gun-show and private transfer loopholes, it's time to enact some common sense legislation about gun ownership and responsibility.

Let's use social media to tell the powers that be that pill pushing is not problem solving. And lets use it to tell the major news outlets that shock and sensationalist journalism is not responsible reporting.