By Robert B Young, MD
I wrote the following reply to an article by Liza Gold, MD, “Gun Violence and Mental Illness: It’s Time to Change the Status Quo” (8/29/19). Psychiatric News editor Cathy Brown referred my response to their executive editor, Jeffrey Borenstein, MD, who has declined DRGO’s input in the past and did again, without comment.
However, it’s always worth responding. Occasionally one gets published, which is a win. If not, publish the exchange elsewhere so the biases are recognized.
To the Editor, Psychiatric News
I read with interest Dr. Gold’s August 28 Psychiatric News article “Gun Violence and Mental Illness: It’s Time to Change the Status Quo”. Last week, I had the great pleasure of meeting her when she gave a talk to the Genesee Valley Psychiatric Association here in Rochester, New York, about her other area of expertise, sexual abuse.
Dr. Gold’s main points are extremely well taken about how shocking and unacceptable are any violent deaths, and even more, mass murder; and that people with psychiatric problems are inaccurately and unfairly stigmatized as responsible, when only about 4% of all violent crime perpetrators had identified, treatable mental illnesses. We have a major responsibility as psychiatrists, along with our patients, to combat that stigmatization every chance we get.
Other matters are not so cut and dried. In fact, on a per capita basis, whether measured against population, the number of gun owners, or the number of firearms legally possessed by civilians here, the United States is one of the safest countries in the world. The idea that the presence of firearms in a household dramatically raises the risk of harm to family members is a canard dating back to Dr. Arthur Kellerman three decades ago.1 In fact, any such “risk” to others can be eliminated by owners’ wise decisions about storage and access.
National Instant Background Checks (NICS) have long been required for all commercial gun sales, along with state checks in many places. Many states also require them at gun shows (as does mine, New York). Requiring background checks for all purchases at all gun shows would be doable, but requiring them for private, 1:1 individual transactions is impossible and would highly complicate personal life for those who complied. Dr. Garen Wintemute found that California’s long-time universal background check requirement has had no impact on “gun deaths”, 2 nor did repeal of those in Indiana and Tennessee3, or establishing them in Colorado, Delaware and Washington.4 Too many jurisdictions inconsistently report prohibiting conditions to the NICS, allowing too many purchases by otherwise ineligible buyers. At the same time, most NICS’ denials may be false positives, wrongly denying legal purchasers.5
There would be almost nothing gained by banning “military-style assault weapons”. Retrospective analyses by the Department of Justice of the 1994-2004 ban could not “clearly credit the ban with any of the nation’s recent drop in gun violence.”6 Less than 2% of shootings employ any rifle (not just this subset)—that’s less impact than mental illness. And “assault weapon” is a made-up misnomer—these are simply semi-automatic firearms with features that make them easier to use, not more dangerous. They have become the most popular rifles of all since their appearance in the 1950’s).
Critically, overwhelming non-compliance with any bans must be assumed: in New York, Connecticut and California ((MSRs); Vermont and New Jersey (“bump stocks”); no more than 15% (and mostly less than 5%) of estimated pre-ban supplies were turned in or registered.7 These only criminalize erstwhile legal, responsible gun owners while not touching criminals at all, who obtain their firearms via theft or straw purchases and from each other.
Finally, Extreme Risk Protective Orders are a hot topic, being used or considered in many states already, with some Congressional interest in promoting them. They may have utility in forestalling some suicides,8 although their value, beyond anecdotes, in preventing murder (mass or otherwise) is uncertain. It is known that police killed one man because of the ERPO they attempted to serve on a man surprised and angered him.9
As thus far constituted, ERPO’s have many serious, inherent deficits: they deny initial due process for the uninformed subject; any action permitted to reverse the ERPO comes at the convenience of the court and at the cost of the accused, who is considered guilty unless he proves his own innocence; and like domestic abuse allegations, ERPO’s are easily abused by angry acquaintances.
We may well learn from court challenges that ERPO’s constructed in these ways are illegal and unconstitutional. Doctors for Responsible Gun Ownership wrote a position paper10 detailing what is necessary for fair, effective ERPOs, and is working with lawyers in the public interest toward promoting legislation that addresses these and other problems with them.
Overall, laws restricting legal ownership and bearing of firearms come up short. The very best recent nationwide study of trends in homicides and violent crime versus relative stringency of state gun laws shows no correlation between them.11
Plenty needs to and can be done to reduce the toll of violent deaths and injuries in the United States without barking up these wrong trees. What we can do and why would require another article, so I’ll limit this communication only to responding to these aspects of Dr. Gold’s excellent article.
Sincerely yours,
Robert B Young, MD
Associate Clinical Professor of Psychiatry, University of Rochester School of Medicine
Distinguished Life Fellow of the American Psychiatric Association
Executive Editor, Doctors for Responsible Gun Ownership
Footnotes:
1 https://guncite.com/gun-control-kellermann-3times.html
2 Annals of Epidemiology: https://www.sciencedirect.com/science/article/abs/pii/S1047279718306161?via%3Dihub
4 British Journal of Medicine: https://injuryprevention.bmj.com/content/24/6/431
5 Crime Prevention Research Center: https://johnrlott.blogspot.com/2011/06/problem-with-brady-background-checks.html
6 Koper, National Institute of Justice: https://web.archive.org/web/20130120051343/http://www.sas.upenn.edu/jerrylee/research/aw_exec2004.pdf
8 Law and Contemporary Problems: https://lcp.law.duke.edu/article/implementation-and-effectiveness-of-connecticuts-risk-based-gun-removal-law-swanson-vol80-iss2/
9 https://www.baltimoresun.com/news/crime/bs-md-aa-shooting-20181105-story.html
10 https://drgo.us/wp-content/uploads/2018/06/DRGO-on-Firearm-Confiscation-due-to-Dangerousness.pdf
11 Journal of the American College of Surgeons: https://www.journalacs.org/article/S1072-7515(18)32074-X/fulltext
Robert B. Young, MD is a psychiatrist practicing in Pittsford, NY, an associate clinical professor at the University of Rochester School of Medicine, and a Distinguished Life Fellow of the American Psychiatric Association.
This article originally appeared at drgo.us and is reprinted here with permission.
MOST, somewhere north of 95%, of ALL mass killers recently in the US were under the influence of psychoactive medications for depression, anxiety, or ADHD.
What more needs to be said?
Well, that really depends on whom you define as a “mass killer.” For some reason, the news on mass killers does not include gang and bar shootings, the most recent of which killed four or five and wounded nine in Cleveland. Inner city violence, for example drive by shootings that kill some and wound many, are never reported as “mass shootings,” nor are the shooters “stigmatized” with the mass shooter label. One gets the idea after a while that if you want to be a mass shooter, you have to, with rare exceptions, use an AR or AK. I suspect that although many gang members are under the influence of drugs at the times of the shootings, few are under the influence of medically prescribed anti-depressants. Moreover, a causational element between use of antidepressants and mass shootings is missing: 12.7% percent of the U.S. population over age 12 took antidepressant medication in the past month, but only a very small percentage of those people are out trying to become infamous. It would seem that other mental health risk factors are in play, not just the drug use.
If one defines “mass killer” arbitrarily & subjectively as seems to be the case, then why are the various leaders of countries who have killed millions over the past hundreds or thousands of years seemingly exempt from such definition? I submit that governments of any type reserve the exercise of the power of life and death to themselves; not because of any moral position, or some claimed wisdom, but only out of selfish concern for their power to rule.
In the US, “mass killer” is a 2010’s term the FBI came up with. Someone will come up with a new term.
In order to be a “mass killer” you must target some subset of the population that creates fear and terror in a larger subset that has the resources to have some affect on political outcomes. Whacking rival drug gang members in the ‘hood doesn’t scare Exurban Moms into haranguing their husbands into writing checks for lefty causes. Hard to exploit tragedy when it happens to “those people” and not your own.
100% of all fatal automobile crashes found that the person killed had previously consumed water! See how that works…
Smdh.
How would an automobile crash find something?
“MOST, somewhere north of 95%, of ALL mass killers recently in the US were under the influence of psychoactive medications for depression, anxiety, or ADHD.
What more needs to be said?”
Plenty more needs to be said. Let’s use reason and think about this critically. What do we know about these “mass killers”?
They have mental issues. They are troubled people in one way or another. So what are we told to do when we have issues like depression, anxiety, or ADD? Well you take medication of course! They’ll prescribe and sell you a daily pill for whatever bothers you.
So here’s an alternative hypothesis: What if the medication wasn’t the cause, as you imply. What if they were all just trying to treat their symptoms? Then this means that the medication didn’t work at all obviously!
I have extensive experience with a loved one taking various prescribed SSRIs. I can tell you that the medication does work, but perhaps not in the way intended. All of this persons negative tendencies are exacerbated. They are more negative, more aggressive or hostile, and more reactive to stimuli. It also severely disrupts their sleep, which can lead to all sorts of problems in and of itself. Fortunately this person had no violent tendencies, and has not displayed any violent behavior.
I have told this person that I could see how the same effects in someone who had preexisting violent tendencies could drive them to act on those violent tendencies.
The meds seem to also inhibit self control and shut off the internal monologue most people have wherein one asks oneself “is this a good idea” before doing or saying something out of the ordinary. I have described it as the person being on a train track once one of their tendencies is stimulated, and being unable to alter their course regardless of incoming information or advice that the course is not going to end well.
[email protected]
Oct 10 at 4:32 PM
I read with interest the article “Gun Violence and Mental Illness: It’s Time to Change the Status Quo”.
Additionally, I found a written response by Robert B. Young, MD to that article that as far as I can tell, was not printed. Even though the response was concise and well represented with citations.
When I see an article on a topic as volatile as this, with but one angle, using dated and questionable “facts”, it immediately brings into question the integrity of the media and those who author and edit it.
Robust, civil discussion is a cornerstone of a healthy society. Only one viewpoint invariably leads to inaccurate conclusions, and unfortunately, in some cases, physical or mental harm when medical well-being is the focus. Second opinions are sought for a reason. Disallowing a second opinion is a disservice to all.
Expect to see it more often on any hot button issue where people have opinions at variance from the liberal ideology of the media outlets. We are living in an age of outright censorship. The internet that was supposed to make us freer and more educated has been perverted to political purposes.
Nice reply, DY!
@ SoCalJack says:
October 10, 2019 at 19:56
You’re missing the point. The term is still arbitrary and subjective no matter who came up with it and no matter what the next terminology might be. No different than calling an AR a “weapon of war” or some other meaningless verbiage designed for purely political power purposes.
What about the 13% that kill the highest % eg of people with weapons,,, why does no one want to talk about that??? & why are we letting the 13% ers control the American public narrative? Fake News at work.
3%, not 13%. Black males, approximately ages 17-34, compromise only 3% of the U.S. population but commit 52% of murders.
FBI UCR has consistent data showing all African Americans, male and female, all ages combined, currently 13.7% of the population, commit 52% to 54% of all murder in the last 10 UCRs.
If you look at the breakdown of male to female, for African American males it is 49% to 51% of all murder.
But if we manipulate the figures even more, we find that 100% of all murders are done by people.
It’s in the best interests of study to find out (in this particular case) just who is committing most murders. That means drilling down, not up.
If, in this case, those who commit over half of all murders in the US are male blacks under the age of 35, drilling up only paints the rest of the population of blacks unfairly.
I always send pro-2a comments in to the electronic NY Times. Most of them are published but I have to be careful how I word the comments.
‘Fighting Myths and Misinformation About ‘Gun Violence’”
The first myth is that a gun,a inanimate object can commit violence,a person can commit violence with or with out a firearm but a gun can not commit anything on it’s own devices. Nothing more than a Leftard method of pushing the disarmament agenda and I might add total B S .
Remove the cliches, hysteria, and ignorance from multi dimensional the issue of guns and what we have left is a brilliant examination of the subject at hand.
Too boring. That’ll never get you much airtime. It’s much easier to scream and yell and fearmonger.
No progressive outlet would ever allow a letter this clear, well-reasoned, and evidence-based to appear in its publications. The NPCs might get their own ideas.
That’s the issue. The response is excellent, but it will not be seen by those who need to see it most. Not that I’m saying people shouldn’t make the attempt, and shouldn’t go leave comments when that is an option. But most people won’t read the comments, and the articles are 95% pro civilian disarmament. Heck, the majority of people probably don’t even read the article, just the headline.
Even when a legitimate and legal interest in firearms is considered, there remains certain questions that never gets resolved and ultimately (I think) drives people crazy.
There is such a dicotomy between:
a left leaning liberal that actively seeks to destroy the country, it’s people, it’s religion, and it’s very right to exist
And a right leaning conservative that is perfectly happy to sit back and just let it all happen
As various levels of goverment are concerned anyway.
There is such a buildup of what’s referred to as a “culture of death” as more people deny their creater (religeous or paternal).
Everyone watches genocide take place ‘legally’ as a woman has a right to choose (choosing death) while shouting rhetoric have how we must ‘save the children’.
Personal responsibility is mocked and ridiculed as the strongest message from all angles is that government will take care of everything.
Children are tought at the very earliest ages all manner of lies so deeply that they grow up spreading those lies with such a twisted sense of reality that there is no reality. So escape through drugs and alcohol become the only way through life.
No caring loving parents
No role models
No truth
No beliefe in anyone or anything
No sense of trust or purpus
No faith
No morals
No future
In a world filled with guns, drugs, sex/prostiution, everything is disposable (including people)
Just what is it that these so-called psyciatrists think when they prescribe there drugs and gun bans? These kids are watching, listening, and learning. They do understand that those performing abortions are also called “doctor” while stories are told of selling body parts for profit.
Of course Trump is the problem
Of course Christians are the problem
Of course conservatives are the problem
Of course they are more likely to believe news ankers
We have our own eco chamber here knowing the ones that need to hear what we are saying are never going to see any of this. We might understand that AR does not mean Assault Rifle but the ones that need to know this truly feel that it is a distinction that does not matter at all anyway. Even the high paid lawyers call the assault weapons. Who are they to believe when we tell them to never trust what you read online. While Madonna makes millions, who am I to tell anyone what’s what? Tu Pac sounds cool anyway (and has an interesting story to tell).
Hhhmmm
Just things to think about while your boycotting Dicks and Walmart on the way to that concert you heard about at the movie theater. Just something to think about as you watch something on Netflix after checking you Gmail account on your Iphone over your Comcadt wifi knowing your 8 year old has been on Facebook and Twitter all day.
A pro-gun white male is not going to get any play from the new hate media. None.
I always send pro-2a comments in to the electronic NY Times. Most of them are published but I have to be careful how I word the comments.
زوج درمانی قطعی
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