Address gun violence, beyond mental health rhetoric

The harrowing mass shooting in Lewiston, Maine, has again thrust the U.S. back into the all-too-familiar and increasingly frustrating cycle of grief, rage and legislative stagnation. A predictable pattern ensues: gun violence, assault weapons blamed, redirection of focus to mental illness as the scapegoat and heads back into the sand. As a psychiatric-mental health nurse practitioner, I feel compelled to express my concern and frustration about the ongoing redirection of the conversation and ultimate inaction. First, a reality check. While the trauma of Maine will continue to haunt its citizens for years, the gun violence experienced is unparalleled elsewhere in the world. Developed allies such as Australia, the U.K., Canada and Switzerland report comparable prevalence of mental illness. However, they have significantly lower rates of gun violence. Why? They have stricter gun laws.

So, why does it come back to mental illness? The myth of mental illness as a predisposition to violence reigns in the U.S., even though research has shown for decades that those with severe mental illnesses are more likely to be victims of violence than perpetrators of violent acts themselves. Let’s face it: If someone kills another, then there is arguably a de facto element of disconnect from morals, laws or reality. We can’t ignore that the Maine gunman struggled with paranoia and hallucinations. Here again, a spotlight on our military’s mental health, suicide and gun violence remains insignificantly addressed. But pointing a finger at mental illness alone, thereby restricting background checks for firearms to those within this population, is shortsighted and potentially dangerous.

Consider these logical points. Individuals may avoid mental health care in order to not be labeled. The Maine shooter purchased his guns prior to visiting a professional for mental health care. Patient privacy, provider-patient confidentiality ethics and health care data security would be at risk. These are issues likely to hold up new policies in the courts for years. Implementing the necessary database to track this information would be monumental, necessitate interstate cooperation and networks and would be open to immense human error. Psychiatric conditions may change, fall into remission and/or be cured. And we haven’t even begun to crack the surface of arguments about whether there are distinctions between mental illnesses — insomnia vs. paranoia vs. grief. The point is that targeted background checks based on mental illness diagnosis will clearly not be a panacea, if even tenable.

We have another option. Let’s align our policies with public opinion. Americans, including gun owners, overwhelmingly support universal and stricter background checks for all. Political leaders should revisit motions for nationwide mandatory waiting periods between applying for and purchasing a firearm, required firearm safety classes before licensing, a ban on assault rifles and other firearms designed for military combat and yellow/red flag laws that could apply to acute episodes of psychosis, mania or other mental illnesses linked to impulsivity. These policies uniformly will lessen gun violence without simply blaming mental illness as the single causative factor.

How do we know? These measures already have been effective in other countries.

Beyond background checks, combating gun violence necessitates a thorough and multidimensional approach. It is critical to improve mental health services and make sure that everyone in America, especially veterans, has access to care. We can better address the nascent seeds of violence and promote a culture of support and resilience by strengthening community resources, improving crisis intervention services and removing obstacles to mental health care, starting with reducing the stigma perpetuated by false claims of violent potential. The killings in Maine are yet another reminder of the complexity and urgency with which the public health epidemic of gun violence in America must be addressed. Frankly, we are failing miserably. The people of America deserve better than the non-action rhetoric of “thoughts and prayers” and are smarter than to accept continued political deflection. We can pay tribute to the victims of gun violence by supporting comprehensive gun control, investing in mental health services and creating a culture that values safety and well-being. The time for inaction has passed, and we are reminded too often that the cost of remaining passive is immeasurable.