Apologies for missing my last post. Two weeks ago today, my father died. The tragedies of the Washington Ship Yard caused me to think of the last long and serious conversation I had with him. This post was inspired by that conversation.
Time and time again we have seen insane and unstable individuals open fire. In recent memory alone we have the mass shootings of James Holmes in at a showing of Batman in Aurora, Colorado, Adam Lanza at Sandy Hook Elementary in Newtown, Connecticut, and now Aaron Alexis at the Washington Navy Yard in Washington D.C. In each of these cases the mental health of the perpetrator has been questioned publically, and in the former two cases has been shown to be abnormal. From this deadly marriage of an insane individual and a lethal weapon several questions and several proposed solutions arise. However, it is important to ask the right questions and to ask them in the right way in order to get solutions that are workable and realistic.
I would like to focus on one question in particular, a question that arose in the aftermath of the Sandy Hook shooting: “Why is it possible for the mentally ill to get weapons?”. The National Rifle Association was a big voice asking that question, with NRA chief executive Wayne LaPierre questioning the lack of an “active national database of the mentally ill.” The question and the NRA’s proposed solution is not a partisan one, demonstrated by Florida Democrats supporting legislation restricting gun access to the mentally ill.
Once I heard about the proposal of creating a national mentally ill persons database, I started asking questions about what the government would have to do in order to bring such a project to fruition, and what such a database might achieve. To wrap my head around these quandaries, I phoned up my late father, who was a psychiatrist for most of his professional career. I posed the following question to him: “What would happen if the government set up a database of the mentally ill.” His response was unequivocal: it would not be possible, and if any database of the mentally ill were possible, by some stroke of force, it would have disastrous consequences.
First, let’s look at the possibility of constructing such a database. To begin with, there is a fundamental problem with numbers, as there are a very large number of people who suffer from some form of mental illness throughout their life course. Given that many people afflicted with mental illness go undiagnosed, either because they do not have access to the proper health care or refuse to go even if they do, we can come to a reasonable conclusion that even if such a database were to exist, it would be incomplete.
A response to that limitation could be that some information is better than no information, so let’s make the database anyway, which is exactly what has been done in 38 states already. This brings us to our second concern: the potential effects of populating such a database. As my father immediately pointed out, the people who possess the information on who is of mentally ill are health care professionals who are currently bound by doctor-patient privilege. Such a database would destroy doctor-patient privilege as we know it, and, moreover, would have serious implications with regards to the reporting and diagnosis of the mentally ill. Indeed, we have no data on the how these databases effect the decision of individuals to seek help regarding mental health issues. It is a serious question that needs to be answered. If individuals concerned about their mental health refuse to seek help because of fear of government control or compromised privacy, then the number of unknown mentally ill people in our society will increase.
Such an end should not be surprising. People do not like to be put on lists that they have not signed up for, government or otherwise. The NRA rebuffs calls for a national gun database. Judicalis’ own David Brewster notes that the marijuana licensing efforts in the Netherlands have been widely unpopular. So what is to stop a group of already socially stigmatized people, the mentally ill, to reject or resist a measure that would further add to their social burden? Over time, as a new generation of mentally ill people become aware of the way that their medical information is stored and shared, it is not inconceivable that we could see fewer individuals agreeing to psychiatric evaluations, much less care. If that occurs, it would be a significant step towards provoking a mental health crisis, the likes of which would be incredibly costly to society as a whole.
A further question to ponder is the extent to which such a database would prevent a mentally ill person from acquiring a firearm. In brief, one would have to question the efficacy given the ease of getting a gun without having to go through a background check, which, presumably, would be the point that the information stored in a database of the mentally ill would affect the gun sale.
In short, the question: “Why is it possible for the mentally ill to get weapons?” is one that incorrectly imagines and restates the problem of the use of guns in mass shootings, and is one that has provoked a false solution (databases) that will only have damaging effects over time. It completely disregards the liberty of the mentally ill. Their continued stigmatization can be compared to the dystopian world portrayed in Philip K. Dick’s Minority Report (and the subsequent Spielberg film by the same title). Furthermore, the question, by casting the mentally ill as the likeliest violent offenders, fails to consider if mental illness is even a good predictor of gun violence. A study released this week in the American Journal of Medicine (fully available as an open source document) does just that, indicating that “[t]he number of guns per capita per country was a strong and independent predictor of ﬁrearm-related death in a given country, whereas the predictive power of the mental illness burden was of borderline signiﬁcance in a multivariable model.” Alas, in spite of that finding, it is unlikely that American politicians and the American public are ready to consider that possibility.
That is a shame because we need to ask good, relevant questions about guns in society. We need to have discussions where we understand the consequences of our choices. I suggest that the overarching question of liberty, what it is, and the lengths we must take for our security is one that needs to be rigorously and discussed publically and transparently. As Judicalis’ own Dan Alati pointed out recently, there is a delicate balancing act between these very two elements. The complexity of this balancing act should not undermine the dialogue necessary to inform the public and ask for feedback. Yet I fear such a discussion that is a long way from happening, especially if the newfound interest in unpacking those issues or funding studies to examine the consequences of guns is in name only.
What is more, databases of the mentally ill creates a hierarchical understanding of liberty where the liberty to own a weapon is placed above the liberty to keep your health issues private. As a whole the mentally ill are not criminals and should not be treated as such. What happened to Kennedy’s statement that “all men are created equal, and that the rights of every man are diminished when the rights of one man are threatened”? Does that statement hold no bearing on modern society? What do we mean by liberty? What are our obligations and responsibilities for having liberty? Do we even want all of those obligations and responsibilities, or are we happy to cede some liberty not to have to bear those pressures? These are just some of the many relevant questions that we need to ask and interrogate, because by jumping over them, we are setting ourselves up for disaster.