Gun Control: Turning to Mental Health Instead of Hopelessness

President Obama speaks at a memorial service for the victims of the Washington Navy Yard shooting at Marine Barracks Washington on Sept. 22 Photograph by Charles Dharapak/AP Photo

President Obama sounds hopeless on the topic of gun violence. In his Sunday eulogy for the 12 victims of the Washington Navy Yard massacre, he mourned not just the innocent dead but what he called a “creeping resignation” in the U.S. about random mass shootings. Sounding frustrated, he said that changes in the nation’s gun laws “will not come from Washington, even when tragedy strikes Washington.”

At least one leading advocate for stricter gun control concurred with the president. In the wake of the Navy Yard atrocity, the New York Times editorial page opined:

The Senate had already failed miserably to approve modest new gun restrictions despite public outrage over the massacre of 20 schoolchildren and 6 educators in Connecticut last December. The tacit, cynical question now was whether 12 more victims could contribute anything new to the equation.

The answer to that question is: probably not. At least not unless we apply new, more disciplined thinking to the issue.

The Navy Yard bloodshed presents gun-control proponents with a dilemma. None of their main proposals of the moment—comprehensive criminal background checks, a ban on military-style semiautomatic rifles (“assault weapons”), and restriction of large-capacity ammunition magazines—would have had even the slightest bearing on the massacre. The shooter, Aaron Alexis, passed the federal background check and used an ordinary shotgun. The weapon, in fact, was the type of firearm that Vice President Joe Biden owns and earlier this year enthusiastically recommended for home defense.

Requiring universal background checks makes sense. Currently, sales by federally licensed gun dealers go through a computerized FBI screening system; “private” sales do not. Tightening the background check system might deter some crime. But it would not stop the determined mass shooter, or even the violent career criminal, from obtaining weapons on the black market. See this piece from just after the Newtown school shooting for more explanation.

This isn’t a reason for hopelessness.

Mass shooters, we learn after the carnage, are typically mentally disturbed young men. Like Alexis, they’ve often shown evidence of their disturbance. As was again tragically the case in the Navy Yard episode, that evidence receives too little official attention or none at all. Bloomberg View columnist Sally Satel, M.D., assess this sad reality in a vital piece entitled “We Have the Tools to Prevent Another Shooting Spree.” As a psychiatrist, Satel writes, she has

frequently seen psychotic patients brought into the emergency room by police, only to be released into the night because of a toxic combination of restrictive commitment laws and a desperate shortage of psychiatric beds. For the most part, such sad stories affect only the patients themselves and their families. On a few horrific occasions, they are a missed opportunity to prevent a larger, bloodier tragedy.

Satel outlines a commonsense agenda for tightening commitment laws and expanding the availability of in-patient psychiatric treatment. Washington Post columnist Charles Krauthammer, another physician-turned-pundit, sounds similar themes when recounting the cavalier police response in Newport, R.I., last month to Alexis’s floridly psychotic symptoms. “Had this happened 35 years ago in Boston,” he writes:

Alexis would have been brought to me as the psychiatrist on duty at the emergency room of the Massachusetts General Hospital. Were he as agitated and distressed as in the police report, I probably would have administered an immediate dose of Haldol, the most powerful fast-acting antipsychotic of the time.

This would generally have relieved the hallucinations and delusions, a blessing not only in itself, but also for the lucidity brought on that would have allowed him to give us important diagnostic details—psychiatric history, family history, social history, medical history, etc. If I had thought he could be sufficiently cared for by family or friends to receive regular oral medication, therapy and follow-up, I would have discharged him. Otherwise, I’d have admitted him. And if he refused, I’d have ordered a 14-day involuntary commitment.

Satel, Krauthammer, and other tough-minded medical experts have suggested a reform agenda that could lessen the danger of mass gun carnage. Their ideas, while not without complications of cost and inevitable privacy concerns, offer an alternative to hopelessness.

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