Attacking Gun Violence from Both Sides

Tuesday, February 19th, 2013

“They deserve a vote.” This was President Obama’s refrain during last week’s State of the Union, and he referred to the countless individuals who have lost lives and loved ones in recent (and not-so-recent) tragic shootings across the United States. I know I wasn’t the only viewer moved by Obama’s speech and by the dozens of gun violence victims who were present. The nation listened, teary-eyed, as the President ticked off the names of individuals and towns whose identities will be forever linked to tragedy: Gabrielle Giffords, Newtown, Aurora…the list goes on, and it’s clear that something needs to change.

But where do we start? It seems obvious, but the first thing our nation needs to do is to make it more difficult for people to buy firearms in the first place. We need gun law parity, not different gun laws from state to state as we currently have. And it might sound strange, but we should be looking at gun violence in largely the same way we look at prescription drug abuse—by tackling supply and demand. This means better background checks and regulation of firearm purchases. It also means addressing the debilitating mental health problems that often lurk at the root of gun violence.

There has been some buzz here in New York about a tougher gun law that would require therapists and psychiatrists to report a patient if they believe him or her to be dangerous—which could, in turn, lead to the revoking of that patient’s gun permit. I wholeheartedly support this law, despite concerns that it might deter gun owners from seeking treatment. Think about it: if there’s a significant risk that someone may be harmed, it’s our duty as mental health professionals to protect that person. It’s no different than our existing requirement to report a patient who is making suicide threats.

Of course, reporting requirements are a moot point if people aren’t in treatment in the first place. Eight of the nine killers in last year’s mass shootings had histories of mental illness, and few were receiving treatment or even community support. This is unconscionable, and it’s proof of what we in the treatment industry have long known: that mental health services need to become more mainstream, accessible, and affordable in order to reach those who truly need them. Providing these services within treatment programs like Phoenix House isn’t enough; services must also be available in schools, at doctor’s offices, and at the ER.

Too many mental health issues go unnoticed until there’s a serious problem. Americans are good at situational management – treating someone when they get sick – but we have a long way to go in terms of prevention. If you go to the doctor for a check-up, for example, you should get a mental health “check-up” at the same time. We need to implement sustainable methods like this so people can be assessed and get help before their problems spiral out of control. We need to address violence like we address addiction, pinpointing both the dangerous instruments involved (drugs or guns) and the underlying causes that spark their use. Most importantly, we need increased funding and resources to make mental healthcare accessible to all—because far too often, the folks who receive the least need mental healthcare the most. They, too, deserve a vote.

Steven Margolies, M.D.
Medical Director
Phoenix Houses of New York

If you or a loved one needs help for substance abuse, call us today at 1 888 671 9392 or send us an email.

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  • Mike McIntosh

    The National Institute of Mental Health’s Epidemiologic Catchment Area study, which followed nearly 18,000 subjects, found that the lifetime prevalence of violence among people with serious mental illness — like schizophrenia and bipolar disorder — was 16 percent, compared with 7 percent among people without any mental disorder. Anxiety disorders, in contrast, do not seem to increase the risk at all.

    Alcohol and drug abuse are far more likely to result in violent behavior than mental illness by itself. In the National Institute of Mental Health’s E.C.A. study, for example, people with no mental disorder who abused alcohol or drugs were nearly seven times as likely as those without substance abuse to commit violent acts.

    Calls to make counselors the “violence police” are not supported by facts, not conducive to reducing stigma, and run counter to your own argument that treatment should be more available.

  • J.D.

    What part of “shall NOT be infringed” in the 2nd Amendment do you not understand? Stick with subjects that you know about, such as illness, and spend less time talking about things you obviously know NOTHING about (ie: firearms laws).

  • Shauntrice

    I responded every strongly to the part where you discussed the reactionary nature in this country towards important issues. The president has often discussed at length the flawed theory that healthcare can occur solely in the emergency room. You brought up some great points. As someone who plans to work in mental health for a long time, I see more and more how imperative it is that we push for education and prevention rather than reaction.

    The African proverb that says “it takes a village to raise a child” should be applied here. In the second to last paragraph, you point out that most of the shooters in recent years have not been in treatment of any kind…this is a sad fact. Had others been more active in their lives, maybe some key indicators would have been reported. That statement is in no way meant to blame anyone, it simply suggests that as a society, we lack the care and understanding to recognize and report early warning signs in mental health. Maybe there should be a stronger nation-wide push for prevention/intervention education.

  • Steve Margolies

    In response to Mike’s comment above: To clarify, I certainly don’t believe that clinicians should add to the stigma of mental illness or substance abuse by becoming the ‘violence police.’ However, I think that when there’s a significant risk of harm, we have the duty to speak up. The new law gives clinicians an avenue to help people find safety. But this is definitely a complex issue, and we must work to reduce stigma if we want to expand treatment.