Stop Throwing Mental Illness Under the Bus
A frank discussion about mental illness and gun reform
Hello and welcome to the Trauma-Informed Take! Today’s newsletter covers topics of mental illness and gun control. Content warnings for mental illness, suicide, and violence. There’s also a lot of stats in the first half of the newsletter, which I think are important, but if stats aren’t your thing, keep reading to the second half where I talk about the state of the mental health industry.
Whenever there’s a mass shooting, we hear from the same group of politicians and others who like to avoid the idea of gun regulation: it’s a mental health issue.
I’m a mental health therapist, so hopefully it’s obvious I’m pro-mental health.
But please, please, please stop pivoting to talk about mental illness every time there is a mass shooting.
The Senate recently reached an agreement about a bill that would be the first gun reform bill in 30 years (if it is passed). It’s a small step in the right direction, and as I mentioned in my last newsletter, I’d be happy with small steps, though in my view we have a long way to go. Part of the funding is for mental health services, which is great. And yet...
When politicians point immediately to mental health, it’s not only a distraction from meaningful gun reform, but it throws the many people who struggle with mental illness under the bus.
Blaming Mental Illness
First, "mental illness” is a broad term, ranging from depression and anxiety that afflicts many people to more serious mental illnesses like schizophrenia and bipolar 1 disorder. Only 3-5% of violent acts are attributed to people living with serious mental illness (SMI)1. Furthermore, people with SMI are 10x more likely to be victims of violence than be the perpetrators2!
According to this informative article from the American Psychological Association3, psychological traits associated with higher rates of violence include these three:
hallucinations (e.g. voices commanding the person to do something)
grandiosity or mania (an overinflated view of self and what you can do)
antisocial traits (a disregard for the needs or well-being of others)
We’re going to revisit a couple of those traits later. But another a major finding from a study? It’s environmental factors that make the biggest difference in violence: poverty, high crime, and unsafe neighborhoods increase the risk of further violence. NOT a person’s mental health status alone.
Additionally, in mass shootings (the type that make the news), it is often a suicidal mission: the person goes into the shooting with the knowledge he is unlikely to make it out alive or have a non-incarcerated life afterwards. 59% of shooters die during the attack. The Violence Project4 categorizes these actions with the increasing trend of deaths of despair, such as overdose deaths and rising suicides.
Mental illness is distinguishable from “being in crisis,” and The Violence Project points out that over 80% of shooters were in noticeable crisis before the event, with the most common sign being increased agitation.
Psychosis sometimes contributes to shootings, but nearly 70% of mass shootings occur with no psychosis, with an additional 10% having a minor role of psychosis.
There’s too many fascinating findings to name them all, but I’ll leave you with one more: mass shootings motivated by hate or fame have increased rapidly since 2015 (motivations by domestic / relationship issues are sharply on the rise, too). More on this below…
The state of the mental health field
It’s important that we provide quality mental health services to people in need. But as a person in the behavior health field, let me fill you in on how things are going...
We have high rates of turnover (especially in community-based, agency work, where people often start out with very little experience and for little pay. Community-based agencies are often where the people most in need receive their services.). The job is hard! We’re usually stretched too thin – expected to do too much for clients with too little time for both them and ourselves. We have high rates of burnout because of this and because of the overwhelming need in our field, especially in the last couple of years since COVID, as everyone’s mental health seems to have gone in the tanker.
Also, I don’t know if you’ve ever tried to help someone who doesn’t want to be helped, but not-spoiler alert: IT DOESN’T WORK. At least not very well. I remember when I was a school-based therapist and had various kids on my caseload who were made to see me either by a parent or school official. I had some loooong-feeling sessions in my office filled with a lot of silence. I don’t think it’s useless – I think letting a kid know that someone cares about them is always important – but it’s also really, really hard to work with someone who has no interest in changing.
And side note, a lot of these kids are coming from trauma backgrounds, from abusive or neglectful homes, or poverty, or exposure to violence or parental incarceration or substance abuse or on and on. You know: the things we mentioned above that are stronger contributors to violent behavior than mental illness. My one hour a week with them was not going to change their entire life trajectory (again, I hope it made a tiny difference, but realistically, we were fighting quite an uphill battle).
And another side note, antisocial (lack of empathy/compassion) traits and narcissism (grandiosity, mentioned above, is part of narcissism) are extremely hard to treat. These folks don’t just waltz into a therapist’s office because they’re feeling reflective and want to change their lives. They usually don’t waltz in at all unless they have outside pressure from someone close to them in their lives, or because they’re mandated to come. I’d prefer not to chance it with them having easy access to military-grade weapons, personally.
So what are we to do?
The people who like to talk the most about mental illness when a shooting occurs tend to be the least likely to fund it, since that often involves collecting taxes to be used on the common good (which they sometimes call “socialism,” and I call “the social good.”). So if you’re going to talk about mental illness, first let’s fund mental health measures.
Second, it’s hard to miss the fact that almost all shootings are done by males, and a concerning number are domestic / relationship related (30% as of 20195). The gun rights advocates often like to talk about improving family values, by which they generally mean increasing the patriarchy and reducing the expression of those who don’t believe like them. But it looks to me like there’s something pretty toxic going on with notions of masculinity in our American culture.
Third, we must trust there ARE things we can do. Shooters often give signs that they’re planning something. The student in Oxford, Michigan was essentially pleading for mental health help but his parents had given him access to guns anyway. Partners know when their boyfriend / spouse is dangerous (and may be afraid to leave because he has threatened violence if they do leave). Red flag laws exist in some places, but 2A supporters tend to think that making it a little harder to access weapons is restricting their God-given right to kill people to defend themselves (*said with much sarcasm*).
Mental illness is a real, serious issue to address. But we’re not going to fix it in one fell swoop, and unfortunately, we’re probably not even going to get close. Our ways of addressing gun violence are going to have to rely more on measures to slow down / restrict access to guns to people who can handle them responsibly, and much less on “thoughts and prayers,” “good guys with guns,” and throwing all mentally ill people under the bus.
https://www.apa.org/monitor/2021/04/ce-mental-illness
https://www.mentalhealth.gov/basics/mental-health-myths-facts
see 1
https://www.theviolenceproject.org/mass-shooter-database-3/key-findings/ (I HIGHLY recommend exploring this website. They have tons of engaging graphics and really great information. I also now want to read their book!)
https://www.theviolenceproject.org/mass-shooter-database-3/key-findings/
As a teacher of teenagers, I try to look closely at all of my students, especially the “quiet” ones who often get overlooked. We try hard in our district to meet as a team to discuss all students who concern us, but without help from home or tighter laws for the types of guns used in these shootings, it’s a struggle.
When a shooting occurs I go through a cycle of feeling angry and not wanting to teach anymore, realizing that my own kids would still be in the fray, mourning and praying for those poor parents who lost their children, and then numbly putting it behind me only to repeat the cycle with the next dreaded news report.
Why must this be so difficult?