The mental health scapegoat

Don't make the mistake of blaming the wrong thing

Yes, this substack is late. And with good reason.

I had intended this week’s substack to highlight a joint annual report by Well Being Trust and Trust for America’s Health about the many lives lost last year due to deaths of despair. Instead, I, like many of you have been floored over what’s happened the last 48 hours. I am heartbroken, angry, and devastated by the massacre in Texas. Nineteen children and two adults murdered ruthlessly days away from the summer break.

And what has added insult to such a major injury is that we are seeing people once again blame all that’s happened on mental illness. I had the chance to go on Morning Joe today to talk about this. While I was waiting to join the show live, I watched as Mika read out the names of the children. I watched the video play of the father talking to a reporter about how he found out about his child being a victim. It hit me hard and I had to pull myself together to go on television and disabuse people of the notion that mental health is not the culprit here.

I am tired of losing our children to guns and blaming it on mental illness. The United States isn’t the only country with mental illness. The difference is we’re the only country in the world who refuses to make hard choices and enact logical policies to prevent mass shootings and other forms of gun violence.

In 1996, a massacre at Dunblane Primary School in Scotland killed 16 students and one teacher. The UK enacted a number of gun control policies following the school shooting. These policies worked, and 23 years later, there have been zero school shootings in the UK.

In stark contrast, America has more guns and more guns per capita than any other nation. The U.S. has more than 390 million guns in circulation in 2018. With 120 civilian firearms for every 100 persons, the United States more than doubles the next country in line.

After tragic events such as Uvalde, mental illness will yet again find itself the scapegoat in the media and in political debates. Commentators, politicians, and those whose political ideologies it serves will write the massacre off as a lone wolf shooter with a mental illness. Yet, the innate reflex to associate every act of gun violence to mental illness only serves to further stigmatize mental health in daily life. And its wrong.

I am sickened by the continued inaction of those in positions of authority. So many gun deaths – by mass shooting and by suicide – are preventable. But our leaders are stuck in this cyclical pattern of mourning, advocating, and then moving on until the next preventable tragedy strikes.

Nearly half – 48% – of Americans see gun violence as a huge problem in their country today and more than half of them are in favor of stricter gun laws. Irrespective of public opinion, “the U.S. has the weakest gun laws and the most guns of any comparable nation.”

Should Congress and our state houses finally decide that they are tired of seeing innocent children and people senselessly murdered by individuals who should not have access to guns in the first place, implementing red flag laws nationwide and universal background checks would make for a decent start. Why shouldn’t we apply a public health approach to what’s obviously a public health problem?

We require people to go through all sorts of processes and checks for much more benign purchases. Why shouldn’t a gun purchase require a background check? Public health practitioners would see this as common sense - others see it as political. Currently, less than half of states require background checks. Closing this loophole would work to cut down on commerce across state lines and ensure everyone who purchases a gun is properly vetted. Another action worth taking immediately is issuing extreme risk protection orders, sometimes known as ‘red flag’ laws nationwide. Extreme risk protection orders would restrict gun access for individuals who appear to be a danger to themselves or to others. Oh, and they also work really well in helping prevent suicide.

Finally, communities can take action where government falters. Educational programs such as The Gun Shop Project that started in New Hampshire, is distributing materials in gun shops to inform gun owners about suicide reduction efforts and tactics. In the health care community, providers and professionals should be trained in lethal means safety and assist in educating those around them to prevent suicide by lethal means.

For me and likely for all of us, the last 48 hours have been heavy, sad, and disheartening. Gun violence is a tragic reality of everyday American life, but it doesn’t have to be. Hug your loved ones a little tighter today and then call your members of Congress to action to demand change – so this opportunity doesn’t pass us by, yet again.

If we want to talk about doing something for mental health - let’s do that - but do not conflate it with gun violence. There are different strategies and tactics for each, and I for one, hope we urgently pursue both.