As the horror of the Sandy Hook massacre and the Boston Marathon bombings begin to fade, the country and politicians are debating what they feel are the ?real? issues behind this tragedy.
Lip service has been given to the lack of mental-health funding, weak mental-health-commitment laws, and battles between liberals and conservatives over gun control vs. second-amendment rights.
Meanwhile, the fixable causes are ignored. All the gunmen in the recent shootings had active and untreated psychiatric disorders at the time they committed the acts. Lack of mental-health funding (conservatives) and weak commitment laws (liberals) prevent adequate care.
I prematurely released two psychotic, paranoid patients with access to weapons recently for this reason. I could, tragically, do nothing else. It is common sense that some of these people will commit violent crimes. Three decades ago, this would never have happened.
Here are four ways to deal with the societal risks:
? Stop the ?Guns vs. Mental Health? debate. One does not negate the other. More than 300 million firearms exist in the United States alone today, many in the hands of gang bangers, professional criminals and drug cartels. Assault weapons have been sold since the 1960s. It?s a fool?s errand to think you are going to control them now. This debate is a waste of time and resources.
? Take charge of your family. The best predictor of violence is past violence, except in young adult males with a serious psychotic illness. Newtown, Aurora and Arizona all involved such cases. Their families and mental-health professionals all knew of the risks.
If your child has such an illness, make sure you educate yourself about it and that he receives adequate care. None of these shooters could have bought guns without family financial support.
Learn the mental-health laws in your area and be willing to use them. You have a responsibility to your teenage and adult child and your community to do all you can.
? Identify those at risk. Sociopaths and hard drug users are traditional criminals and not hard to identify. Psychiatric patients present no greater risks to the general population, with the exception of young adult males with a paranoid psychotic illness. And often, teachers, friends and neighbors identified these kids as ?odd.?
These individuals must be assessed by a trained person, preferably a psychiatrist, to determine dangerousness. Of course, access to care and commitment laws are the impediment.
? Restore funding to treat psychiatric patients. Treating psychiatric patients is utilitarian in saving money now spent on police work and prisons, as well as being the decent path. It would likely prevent some, if not most, of these tragedies.
Perhaps it is time to put aside stigma and follow the known science in this field. Let?s hope the next White House summit will be on mental health! In the meantime, we can all wait for the next event.
Gary L. Malone is an associate clinical professor of psychiatry at the University of Texas South?western and a teaching analyst at the Dallas Psycho?analytic Insti?tute. He is a distinguished fellow in the American Psychia?tric Association with board certifications in general and addiction psychiatry.
