The horrific shooting in Lewiston, Maine, has once again thrown the US back into the all-too-familiar and increasingly frustrating cycle of grief, anger and legislative deadlock. A predictable pattern occurs: gun violence, assault weapons blamed, redirecting the focus to mental illness as the scapegoat and heads back in the sand. As a psychiatric-mental health nurse practitioner, I feel compelled to express my concern and frustration about the ongoing redirection of the conversation and the eventual lack of action.
First, a reality check. While the trauma in Maine will continue to haunt its citizens for years to come, the gun violence experienced is unmatched anywhere else in the world. Developed allies such as Australia, the UK, Canada and Switzerland report similar prevalence of mental illness. However, they have much lower rates of gun violence. Why? They have stricter gun laws.
So, why is it back to mental illness? The myth of mental illness as a predisposition to violence reigns in the US, even though research has shown for decades that those with severe mental illnesses are more likely to be victims of violence than those who commit violent acts in themselves. Undoubtedly, in very rare cases, serious mental disorders that are not well managed can increase the risk of violent behavior. Let’s face it: If someone kills another, then there is a de facto element of disconnection between morality, law or reality.
We cannot ignore that the Maine gunman struggled with paranoia and hallucinations. Here again, a spotlight on mental health in our military, suicide and gun violence remains irrelevant. But pointing a finger at mental illness alone, thereby restricting background checks for firearms to those within this population, is short-sighted and potentially dangerous. .
Furthermore, focusing on keeping guns out of the hands of the mentally ill is pointless. Consider these logical points. Individuals may avoid mental health care to avoid being labeled. The Maine shooter bought his guns before visiting a professional for mental health care. The ban would not have worked. Patient privacy, the practice of provider-patient confidentiality and the security of health care data can be at risk. These are issues that will likely keep new policies in the courts for years. Implementing the necessary database to track this information would be enormous, require interstate cooperation and networks and be open to great human error. Psychiatric conditions may change, go into remission and/or improve. And we haven’t even begun to crack the surface of the arguments about whether there are differences between mental illnesses – insomnia vs. paranoia vs. depression. The bottom line is that targeted background checks based on a diagnosis of mental illness are clearly not a panacea, if they even are.
We have another option. We will adapt our policies to public opinion. Americans, including gun owners, increasingly support universal and stricter background checks for everyone. Political leaders should revisit motions for nationwide mandatory waiting periods between applying for and purchasing a firearm, required pre-license firearm safety classes, bans of assault rifles and other weapons designed for military warfare and yellow/red flag laws that can be used in severe episodes of psychosis, mania or other mental disorders associated with impulsivity. These policies would collectively reduce gun violence without simply blaming mental illness as a contributing factor.
How do we know? These measures are already in effect in other countries.
The killings in Maine are yet another reminder of the complexity and urgency with which America’s public health epidemic of gun violence must be addressed. Frankly, we have failed miserably. We can honor the victims of gun violence by supporting comprehensive gun control, investing in mental health services and creating a culture that values safety and well-being. The era of inaction has passed, and we are reminded time and again that the cost of remaining passive is immeasurable.