Monday, January 10, 2011

Crazy man with a gun

Our national laws prohibit gun ownership by the insane. That is, the laws prohibit adjudicated mental defectives and those committed involuntarily to mental institutions from possessing or receiving firearms. This was good enough in 1968, when that provision took its present form.

Something has since changed in the way society deals with the hopelessly out of touch. Institutionalizing the insane is now often seen as inhumane and it is seldom done. The lesser measure of having them declared mentally defective in a hearing is seen as intrusion on the patient's privacy. It is now rare for health professionals to suggest commitment proceedings or court hearings to establish mental state. What changed, exactly?

In a fit of social zeal, crusaders for the good cause du jour labeled mental institutions as "snake pits" and decried conditions there. Mental hospitals were portrayed as hell on earth. The do-gooder campaign against institutionalization was successful. Emphasis shifted away from identifying crazy people and putting them away, to letting them go, and leaving them alone, or medicating them and hoping for the best.

Our laws for keeping crazy people from getting guns were sensible enough, back when we knew who the crazy people were and where to find them. If the address on your yellow sheet was "Happy Acres State Home," you didn't get the gun.

Today, if someone is insane, it is less likely to be apparent from public records. I attribute this to the trend toward leaving the deranged person in society and not seeking a) adjudication of his mental state or b) commitment. These legal processes formerly established when someone was a) nuts or b) nuts and furthermore needed to be kept apart.

The assumption in back of the 1968 framing of the law was that mental health professionals would do their jobs and flag those who had some sort of dangerously debilitating problem. Doing so was routine practice; it isn't any more. It was a part of the profession's presumed role in society but they got away from doing it. Somehow they transcended the idea that one very important role of the mental health system is to identify nut cases and keep them off the street.

I'm sure the reasons were grounded in compassion. Showing someone to be mentally incompetent impacted his ability to form contracts, and to get credit. It harmed his job opportunities, and had other ramifications in addition to making him unable to get a gun. It was kinder, gentler psychology not to draw attention to the sufferer's problems--not to 'out' the patient, as it were. But by showing this supposed kindness and compassion to the deranged, the shrinks have let down the rest of us. The law of unintended consequences, which seems particularly apt to strike when do-gooders are involved, strikes again.

I do not know as yet just what involvement, if any, mental health professionals had in the life of Jared Lee Loughner, the fellow who did those shootings in Arizona the other day. Here, though, we have a clear case of someone who was certifiable but not certified. He should not have had a gun. That's obvious enough, in hindsight, but the dealer had no way of knowing it. Presumably, Loughner refrained from deranged and sinister behavior while he was in the gun store, but he had displayed a good deal of it previously.

John Hinckley, who shot Ronald Reagan, had a mental health history. So did Seung-Hui Cho, the Virginia Tech shooter. These high profile cases prompt the question, how often does it happen that some other crazy man with a gun does a shooting that does not get high profile coverage? The high profile cases may be only a part of the story.


I think it's time the mental health community reevaluated its present, hands-off stance on commitments and interventions. Hint: You had it right before. If you know someone is a danger to others, you owe it to your fellow citizens to act on that knowledge; this must be considered in parallel with your concern for compassion toward the mentally ill.

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