New York’s New Gun Law Conflates Violence, Mental Illness

Huzzah and hallelujah, that’s what I should be saying in response to New York Gov. Andrew Cuomo’s tough gun control law that he signed with lightening speed as of yesterday. The New York Secure Ammunition and Firearms Enforcement (SAFE) Act—the first piece of legislation to come out of the Newtown shooting—increases the kind and number of banned weapons, enhances background checks and refines rules for gun storage.

But it also has a section titled “Provisions Related to Persons with Mental Illness,” which “will require mental health professionals, in the exercise of reasonable professional judgment, to report if an individual they are treating is likely to engage in conduct that will cause serious harm to him- or herself or others.” That’s a serious problem. I’ll tell you this: If the same language is enacted in Pennsylvania, I’m not going to have much confidence in doctor-patient confidentiality. I sure as hell wouldn’t talk about feeling suicidal, a crucially important and potentially lifesaving part of a therapeutic conversation.

This is just one bill in one state, but it’s a sign of things to come. From pundit to politician, if they say “guns” in one breath, you can be sure they’ll say, “mental health” in the next. That’s a spurious connection, and one we have to guard against. Richard A. Friedman M.D., in a New York Times piece called “In Gun Debate, a Misguided Focus on Mental Health,” wrote:

But there is overwhelming epidemiological evidence that the vast majority of people with psychiatric disorders do not commit violent acts. Only about 4 percent of violence in the United States can be attributed to people with mental illness.

Consider that between 2001 and 2010, there were nearly 120,000 gun-related homicides, according to the National Center for Health Statistics. Few were perpetrated by people with mental illness.

Statistics show that the majority of people who are violent do not have mental illnesses, and that risk factors for violent behavior are more likely to be substance abuse; a history of physical abuse or juvenile detention; recent stressors like family troubles or losing a job; and a family history of violence or abuse.

And when it comes to mass shooting in America, it helps to be an angry white male.

So why are we writing mental healthcare law at the same time we’re legislating guns? Because we’re legislating in response to a tragedy and to try to prevent that tragedy from happening again. Since 1982 there have been 62 mass murders in the U.S. In many of these cases—but not all—the perpetrators have had mental health issues. They’ve also been white males without much social interaction. Should we legislate sock hops? Classes in not being so white? In our grief and fear, we imagine that if we do something about “crazy people,” we won’t have any more mass murders to contend with in the future.

But that’s not realistic, as Friedman points out:

Jeffrey Swanson, a professor of psychiatry at Duke University and a leading expert in the epidemiology of violence, said in an e-mail, “Can we reliably predict violence? ‘No’ is the short answer. Psychiatrists, using clinical judgment, are not much better than chance at predicting which individual patients will do something violent and which will not.” It would be even harder to predict a mass shooting, Dr. Swanson said.”

Sweeping bills like Gov. Cuomo’s may not have any impact on the two people per year who commit mass shootings, but it will have a negative effect on the 20 percent of Americans who deal with some kind of mental health issue, from anorexia and ADD to Seasonal Affective Disorder and Compulsive Gambling. There are 300-plus conditions in the DSM, the text that lists disorders identified by therapists when they see patients. What about the disorders that are exclusive to or more prevalent in females? What about women who seek counseling for domestic violence, and then worry they can’t tell the truth? Wrong target audience, if you will.

Additionally, when you talk about guns, it’s easy enough to cite a weapon’s make and model and quantify rounds of ammunition. But what does a politician mean by “mental health problem”? The terminology is frustratingly vague. Panic disorder? Tourette’s? Depression? What they really mean is, “I don’t want to just talk about guns because it’s too controversial and yeah, these guys seem off their rockers.”

But look, I’ve been diagnosed over the years with at least eight different disorders, half of them wrong. I’ve taken dozens of medications. I’ve been hospitalized and jolted with shock treatments. Yet there’s no chance I will commit a mass shooting. If i lived in New York, however, there’s every chance that I’d censor my conversation with my therapist if I felt a lack of trust. I’ll bet even those of you who just go to therapy to talk about your marriage would be wary too.

I like what Dr. Alan Heisterkamp, who works with kids, had to say about these mass shootings:

[O]ur country has a major problem associating guns with power and control, and associating power and control with being a man. Gender construction on what it means to be a real, authentic man must be the new curriculum. … If we’re really serious about preventing more tragedies like the one in Newtown, Conn., we should expect to see more men in positions of leadership and power dispelling the myths that it’s a sign of weakness to advocate for gun control, and to mentor young boys to appreciate and celebrate their entire, emotional self.

We may have to implement a new bill: All schools play Rosey Grier’s “It’s All Right to Cry” in the mornings. And then the boys hug. Write to Gov. Cuomo today.