GUN CONTROL OR PEOPLE CONTROL? Part Two: Psych Beds and Psych Meds–Faster Than a Speeding Bullet?

As we pass the 13.5-month anniversary of the Newtown school shooting, and approach the 15-year anniversary of the Columbine school shooting (or, hell, pick a school shooting and do the chrono-math) we find ourselves struggling with the idea of stigmatizing people with mental illness in order to support easy access to guns and ammo—okay, not so much struggling as having to have a really stupid argument with people who love guns and people who know better than to engage in such a dangerous form of Objektophilie at the expense of fellow citizens, and while demeaning a particular group of citizens.

In an opinion piece that was posted on the Fox News web site just before the one-year anniversary of the Newtown school shooting, “Medical A-Team Member” Dr. Keith Ablow once again lends his severely-compromised credibility to the issue of gun control versus mental-health-system-blaming in order to craft an argument where fewer people would die if only there was increased access to psych beds and other psych services, and just as much, if not more, access to guns.

You can read the piece (all puns intended) here… http://www.foxnews.com/opinion/2013/12/12/on-newtown-anniversary-america-mental-health-system-still-mess/

Dr. Ablow fires out a random assortment of gun- and mental-health-related ideas with the precision and deadly accuracy of a single blast of #9 shot, aimed to take down the elephant in the room—that no meaningful action has been taken to reduce access to unnecessarily powerful weapons and massive amounts of ammunition.  Of course, as with trying to take down an elephant with a single blast of #9 shot, all that Ablow does is irritate the elephant—or exacerbate the problem—by claiming that it is mental illness that is the real problem.

Ablow starts off by listing five mass shooters from recent years, and remarks that we “now know” that they were all severely mentally ill.  Ablow then abruptly shifts to talk about Virginia State Senator Creigh Deeds, whose adult son, Austin (aka Gus), slashed/stabbed the Senator (with a knife) and then committed suicide (with a gun) in November.  (Note: this crime did not involve mass killing).

Prior to the stabbing and suicide, Austin was under an emergency custody order for a psychiatric evaluation, which expired before a psychiatric bed was secured for him.  Multiple hospital officials in Virginia later stated that they had open psychiatric beds at the time Austin was turned away.  It’s unclear exactly how things fell apart in this case, but it wouldn’t be impossible for a six-hour hold to expire while an overwhelmed staff at one facility needed to present the case for, and secure a bed for, hospitalization at another facility.  It is also possible that Austin did not meet grounds for (mental health) detention.

Dr. Ablow states that Austin was “discharged from an emergency room where he complained of severe psychiatric symptoms.”  But there are a number of problems with this statement.  For one, it comes in the context of one of Dr. Ablow’s “We know” statements—and “we” do NOT “know” what Austin may or may not have said or “complained” about.  Also, given that Austin was under an emergency custody order, chances are that he wasn’t voluntarily seeking help.  If Austin was willingly seeking help, and considered competent to do so, then the order wouldn’t have been necessary.

Unfortunately, if a client is not a clear threat to self or others, or in danger of harm due to being incapable of caring for him/herself, the client (generally speaking) cannot be detained.  Senator Deeds stated, after the incident, that while he expected conflict with his son, he did not expect his son to turn violent.  And in Virginia (mental health evaluation and detention procedures differ from state to state) a person cannot be detained if the emergency custody order expires before a psychiatric “bed” is found.  By contrast, in a number of other states, if a person is viewed as detainable for mental health reasons, they can be held (for example, in an emergency room) until a psychiatric bed becomes available or the client is stabilized.

At any rate, Dr. Ablow devotes a one-sentence paragraph to greatly simplifying what happened in the Deeds case, and ensuring that nobody who reads his column would understand anything about how laws related to mental health treatment operate, or what is required of patients and evaluators in detaining a person for mental health reasons.

As a bit of an aside, I routinely speak with people who think that all it takes for the state to send out an ambulance with a couple of guys and a straitjacket to cart away a loved one is three people who will pinky-swear that a relative or close friend needs to be “locked up.”  This is the kind of information that comes from old movies involving a group of people conspiring to get a relative “committed,” so they can usurp the family fortune.  As another bit of an aside, think of how much you agree with the idea that it should be legal for the state to lock a person up based on a consensus among three people that the person is “crazy.”

But Ablow’s interest is not in creating greater understanding, or making any kind of appeal to anybody based on, say, critical thinking skills.  It’s in telling us how guns are not a problem when it comes to people being shot.

Strangely enough, to make his pro-gun argument, Ablow then discusses Adam Lanza, the Newtown, Connecticut mass-shooter, in deeper detail.  Lanza, Ablow explains, was “allowed” to “learn how to shoot a firearm” by his mother, Nancy, who was the first victim of Adam’s shooting spree.  Dr. Ablow apparently hopes that readers don’t remember/can’t do an Internet search to find out that Lanza’s mother had numerous guns and a great deal of ammunition in her home (where Adam also lived), all purchased legally, and, shortly before the killings, had even written a check to Adam so he could go buy his own gun.

Also, as with the Deeds case, Lanza’s mother indicated that she did not fear violence from Adam, despite his statements and behavior to the contrary, and despite the large number of weapons she kept in her home.  Nancy Lanza’s sense of safety in opposition to all signs to the contrary is not unusual.  Most gun-rights advocates seem to suffer from some sort of collective delusion that they cannot be harmed with their own guns, although statistically speaking, gun owners and their family members are much more likely to be shot with those guns (accidentally, self-inflicted, or otherwise) than any bad-guys.

While ignoring Nancy Lanza’s love of guns, Dr. Ablow notes Adam’s obsession with mass murder, his playing of “violent video games (including one about school shootings)” and that Adam lived in the basement of his mother’s home, where he had covered the windows with trash bags and only communicated with his mother via e-mail during the three months before the shootings took place.  Dr. Ablow mentions Lanza’s Asperger’s Disorder diagnosis, and posits that he “may well have merited other diagnoses.”

Well, given that most people with Asperger’s Disorder don’t take up arms against grade-school children, I’d guess Dr. Ablow might be right about that diagnosis piece.  Lanza had also been diagnosed with an anxiety disorder, and with Obsessive Compulsive Disorder (neither of which tend to lead to mass killing), and had been prescribed medications related to his various diagnoses, but there was little follow-up by Lanza or his mother with regard to the psychiatric care.

This leads to another point regarding how pointless it is to claim that the “mental health system” is to blame for the problem of gun violence.  If the family members of someone like Adam Lanza did little or nothing to get him help, and actively encouraged his access to guns, it seems rather ridiculous to think a psychiatrist would be able to correct that situation with a few days in the hospital and some medications.

Strangely enough…whoops, I mean, “of course,” Dr. Ablow doesn’t mention where Lanza got any of the weapons and ammunition, but instead highlights just how weird (he assumes his readers will believe) it is that Lanza lived in his mother’s basement, and spent time on computers.  Remember, kids, video games kill.  Living in your mother’s basement kills.  Having a massive arsenal of weapons in the home is NOT the problem.

Getting all compassionate, Dr. Ablow goes on to say that “untreated or poorly treated mental illness is” a problem.  He even italicizes it.  Oh, wait, let me back up off of that statement a bit, so that we can see that what he actually says is that (and let this soak in), an “anti-gun agenda misses the point: Firearms aren’t the responsible variable in mass killings: untreated or poorly treated mental illness is.”  (His italics)

Well, I don’t know, Dr. Ablow…I’ve got a weird feeling that there are a lot of people out there with untreated or poorly treated mental illness who don’t commit mass killings, at least in part because they don’t have access to a bunch of guns and ammunition.  (My italics)

After his impassioned, italicized plea that guns don’t kill people, people with mental illness kill people, Dr. Ablow awkwardly segues to a brief mention of the 1927 Bath School disaster as the example of the “worst episode of school violence ever” and notes (italicized and underlined) that it “involved no gun.”  (Yes, his underlining and italicizing).

The Bath School disaster is one of those weird things that pro-gun folk like to cite as a reason why school shootings really aren’t all that bad.   Unfortunately, it kind of undermines their argument if you actually look at it—because the Bath School disaster was committed using dynamite and incendiary pyrotol—substances that are not generally sold in your local Walmart.  Those explosives in particular aren’t actually available much anymore, pyrotol having been banned for sale to farmers in 1928 (the year after the Bath School disaster—committed by a guy who owned a farm), and dynamite having largely gone off the market due to the availability of more stable explosives.

Another fun fact is that explosives tend to be rather heavily regulated by the government.  After that whole episode of Timothy McVeigh blowing up the Oklahoma City Federal Building, a whole lot of regulations got slapped on the seemingly innocuous components of his fertilizer-truck-bomb.  So, if you want to make a connection about the appropriate action to take after somebody uses a certain kind of “tool” to kill a lot of people, bringing up explosives isn’t really helping your case.  After all, we don’t encourage people to go buy more explosives to make sure the good exploders can explode the bad exploders.

Ablow also forgets to make any relevant connection between Andrew Kehoe, the man responsible for the Bath School disaster, and mental illness.  Certainly, given that Kehoe was homicidal and suicidal, he could have been detained by today’s standards if his intentions were at all known.  But from all accounts, he was a rather angry, vindictive individual, like a lot of people who commit gun crimes.  Ablow fails to delve into the possibility that Kehoe was constantly playing Grand Theft Auto XIV, eating Cheeto-and-kale sandwiches (on Dave’s Killer Bread), and drinking Baja-Blast Mountain Dew, while masturbating to animated monster porn.

In another odd turn that undermines his argument, Ablow then chooses to discuss untreated mental illness, saying (in relation to suicide of all things) that, “shooting victims don’t come close to the body count from untreated mental illness in the United States.”  Apparently, Dr. Ablow,  thinks that “shooting victims” who shoot themselves don’t count.  Because suicides make up about two-thirds of all gun-related deaths in the U.S.  And suicide by firearm makes up about half of all suicides.

To give some nice, round numbers, there are over 30,000 firearm deaths per year in the United States, with about 19,000 of those due to suicide.  There are about 38,000 suicides total.  The next-highest category of suicides is suffocation, which accounts for around 9,500 deaths.  But “suffocation” includes a variety of things such as hanging, cutting off one’s air with plastic bags over one’s head, and using one’s car exhaust to deprive an enclosed space (and, hence, oneself) of oxygen.

Along with failing to mention that suicides by gun account for the lion’s share (sorry lions) of suicides, Ablow also neglects to mention that a big piece in risk assessment and suicide prevention involves removing firearms from the homes of suicidal (and homicidal) people.  After all, why would anyone take the guns away from people who are suicidal or homicidal (or who are so paranoid as to think that the government is coming to take their guns away)?  Why would anyone take guns away as part of “fixing” the mental health system?

Dr. Ablow then makes the tragi-comedic statement that he wishes that in the year since the Newtown shootings the Surgeon General would have, “declared war on mental illness.”  I suppose Dr. Ablow means a declaration of war on mental illness—like where a lot of resources are committed to treating mental illness and maybe to getting rid of the stigma associated with mental illness—as opposed to declaring war on those with mental illness.  Because, in effect, blaming mental illness and the failures of the “mental health system” for mass shootings, instead of viewing easy access to the tools for killing (guns and ammo) is a rather shaky position to take.   As a general rule, “untreated mental illness,” which covers a huge range of possibilities, is not the vehicle by which metal projectiles end up penetrating children’s skulls.

Ablow goes on to compliment the Obama administration for providing additional funding for mental health care through the Mental Health Parity and Addiction Equity Act. No, really, a guy on Fox news said the Obama administration kinda-sorta did something good.  But he then condemns the Obama administration for undermining mental health care by trying to ensure access to mental health care via “Obamacare.”  He says that insurance companies do nothing but try to block access to mental health care, and because Obamacare tries to bring down costs, it sucks that people are going to have access to mental health care and the insurance companies that want to deny them care.

So, I think Ablow’s point is that Obama tried to do some good, but failed because he didn’t devote enough resources to it.  Increased access to mental healthcare is good, but failure to provide enough money for the highest levels of mental healthcare is bad?  What’s the remedy for that?  Dr. Ablow apparently thinks the remedy is mental health spending in whatever amount is necessary to put all people dealing with mental illness of any kind into the ongoing care of a psychiatrist…because we all know that what helps people diagnosed with a mental illness…any mental illness…is somebody who prescribes them the right medications.  Right?

Let’s do it, then, Dr. Ablow: provide unlimited funding for unfettered access to psychiatrists for all people who are diagnosed with a mental illness.  What does that entail?  Monthly check-ins with a psychiatrist?  Weekly check-ins?  Daily check-ins?  It’s hard to know what Dr. Ablow is talking about, because he states that MDs need to be in charge of the care of any person who needs mental health care.  But unless we increase spending on mental health care by billions, and find a gusher of a grad school, spewing psychiatrists, his ill-defined proposal isn’t going to work.

What Dr. Ablow (very vaguely) proposes is sheer fantasy.  And the reason he proposes fantasy to deal with a real world problem is that if a real world problem has a fantastical answer, then that real world problem never has to be solved.  We can keep saying, “Fix the mental health system,” or, “Make sure the mentally ill can’t get guns” all while we ignore the fact that we have no intention or way to fix the mental health system in the fashion proposed.

Maybe a better solution is to allow mental health professionals to evaluate people who want to buy guns.  If you meet certain diagnostic criteria, you are not allowed to own a gun.  If you own a gun, everybody in your house must undergo annual psychiatric testing.  But, then, wouldn’t the desire to own a gun be an indication of mental illness, since the intent to own a gun to protect oneself from bad guys would indicate an intention to shoot somebody?  Well, nevermind, it would all be rather expensive anyway.

Dr. Albow leans toward closing his piece out by claiming that “We haven’t done anything to meaningfully coordinate police departments and the courts with the gutted community mental health system.”  Aside from the idea that the mental health system has been “gutted,” I think those involved in dealing with the “mental health system” might find Dr. Ablow’s statements false and offensive.  Because, despite massive budget cuts, and childish blame-cops-judges-and-mental-health-providers arguments like Dr. Ablow’s, numerous police agencies, court systems, and mental health agencies have been doing their damnedest to coordinate care, and provide community education into how to navigate the complicated legal knots of the system. They’ve also been doing what they can to get guns out of the hands of people who are potentially suicidal and/or homicidal, despite the best efforts of the NRA to make sure that everyone, regardless of mental health status, has access to guns.

Dr. Ablow actually closes out his piece by claiming that the Newtown school massacre was “entirely preventable”—which I guess it was, but not by anything that would happen in Dr. Ablow’s fantasy world where psych beds and psych meds negate bullets.  He states that the real surprise in the year since the Newtown school massacre is that there wasn’t “another” Newtown massacre.  But I’m guessing that the parents of the children who were the victims of the 27 school-shooting deaths and 35 gunshot injuries committed in schools in the year following Newtown might disagree with the idea that there was not “another” Newtown.   Sure, there wasn’t a single incident where the same number of people were killed and injured. But what kind of world is Ablow living in where he is willing to excuse even one person being shot at a school in a given year, and to blame mass shootings on mental health providers and people with mental illness, while choosing to support the right of gun manufacturers to continue to provide just about anyone with access to firearms and ammunition designed specifically for killing people?

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