The harrowing mass shooting in Lewiston, Maine, has again thrust the U.S. back into the all-too-familiar and increasingly frustrating cycle of grief, rage and legislative stagnation. A predictable pattern ensues: gun violence, assault weapons blamed, redirection of focus to mental illness as the scapegoat and heads back into 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 ultimate inaction.
First, a reality check. While the trauma of Maine will continue to haunt its citizens for years, the gun violence experienced is unparalleled elsewhere in the world. Developed allies like Australia, the U.K., Canada and Switzerland report comparable prevalence of mental illness. However, they have significantly lower rates of gun violence. Why? They have stricter gun laws.
So, why does it come back to mental illness? The myth of mental illness as a predisposition to violence reigns in the U.S., even though research has shown for decades that those with severe mental illnesses are more likely to be victims of violence than perpetrators of violent acts themselves. Undoubtedly, in very rare instances, serious mental diseases that are not well-managed can increase the risk of violent behavior. Let’s face it: If someone kills another, then there is arguably a de facto element of disconnect from morals, laws or reality.
We can’t ignore that the Maine gunman struggled with paranoia and hallucinations. Here again, a spotlight on our military’s mental health, suicide and gun violence remains insignificantly addressed. But pointing a finger at mental illness alone, thereby restricting background checks for firearms to those within this population, is shortsighted and potentially dangerous.
Plus, focusing on keeping firearms out of the hands of the mentally ill is naive. Consider these logical points. Individuals may avoid mental health care in order to not be labeled. The Maine shooter purchased his guns prior to visiting a professional for mental health care. The restriction wouldn’t have worked. Patient privacy, provider-patient confidentiality ethics and health care data security would be at risk. These are issues likely to hold up new policies in the courts for years. Implementing the necessary database to track this information would be monumental, necessitate interstate cooperation and networks and would be open to immense human error. Psychiatric conditions may change, fall into remission and/or be cured. And we haven’t even begun to crack the surface of arguments about whether there are distinctions between mental illnesses — insomnia vs. paranoia vs. grief. The point is that targeted background checks based on mental illness diagnosis will clearly not be a panacea, if even tenable.