And despite all the hype in the news, we are not necessarily violent. Walsh, Buchanan, and Fahy (2002) reviewed the relevant literature and concluded that although the rate of violence among people with mental disorders can be four times higher than the general population, "only a small proportion of societal violence can be attributed to persons with schizophrenia." And in their own study in Victoria, Australia, Wallace et al. (1998) found "the probability that any given patient with schizophrenia will commit homicide is tiny." Even the Surgeon General said, "There is very little risk of violence or harm to a stranger from casual contact with an individual who has a mental disorder.... The overall contribution of mental disorders to the total level of violence in society is exceptionally small" (U.S. Department of Health and Human Services, 1999, p. 7).
Applebaum and Swanson (2010) extensively researched psychiatric gun law and said, "The net increment to public safety from restricting gun access by persons with mental illnesses is likely to be small."
The Criteria for "Mentally Defective" in NICS
As it stands, The Brady Act established the National Instant Criminal Background Check System (NICS) computer database to include people who have been "adjudicated as a mental defective or been committed to any mental institution."
The Code of Federal Regulations defines mental defective as anyone who is "adjudicated by a lawful authority (to be) a danger to himself or to others: or lacks the mental capacity to contract or manage his own affairs. The term shall include a finding of insanity by a court in a criminal case; and those persons found incompetent to stand trial or found not guilty by reason of lack of mental responsibility... " The Code also defines "committed to a mental institution" as "a formal commitment of a person to a mental institution by a court, board, commission, or other lawful authority. The term includes a commitment to a mental institution involuntarily. The term includes commitment for mental defectiveness or mental illness. It also includes commitments for other reasons, such as for drug use. The term does not include a person in a mental institution for observation or a voluntary admission to a mental institution."
But state laws vary in their criteria of which mentally ill people cannot buy a gun. "In the District of Columbia, Hawaii, Illinois, Maryland, and Oklahoma, psychiatric diagnosis and/or voluntary treatment can be enough to trigger a prohibition." (Simpson (2007).
I am opposed to an expansion of the mental health registry. We should weaken what we already have. An illness is not a crime. NICS should only reference documented cases of violent offenders or individuals who threaten violence, disabled or not. It's unjust to include people who might or might not commit a crime. How does a judge decide if someone is a danger if he hasn't done anything dangerous? It's not so black and white.
But if the government keeps adding names to its list, the general public should never have access to it. The United States has a HIPPA Privacy Rule restricting the release of medical information. We should not relax this law in order to strengthen the others.
What if instead we tallied a list of temper-prone "normal" people who claim they have a constitutional right to assault rifles, as though there's a right to hand grenades, and stopped them from buying guns? It is possible that vengeful people with no psychiatric history, such as bullied teenagers or fired employees, perpetuate the horrific incidents of mass violence we hear about so much on TV. They're not necessarily crazy. Maybe they're just angry. Instead of releasing a punch, they're triggering an automatic weapon. We usually don't call the average young man who gets into a fist fight a "rabid madman," but these two behaviors are somewhat alike, even though the consequences are different. In fact, "…the vast majority of people who are violent do not suffer from mental illnesses (American Psychiatric Association, 1994)."
Stigma makes everything worse. A sitcom mocking "mental defectives" is supposed to be funny. Unlike racial slurs, parents rarely correct children who say "psycho." They act as though schizophrenics aren't human since they might lose their ability to reason. These words hurt my feelings. Besides, medication can usually mend the disorganized thoughts.
Stigma causes discrimination. After I told a landlord I had a mental health problem, he told me my illness was his reason for denying me an apartment in a good neighborhood. When I was a teacher at a school for psychiatric children and in the closet about my illness, the principal told me she wouldn't hire a schizophrenic. If it happened to me, it happens to many. How would my neighbors treat me if they found out from a public database I had a mental illness?
A registry of mental disorders makes a bad stigma worse. It could actually cause the next Columbine disaster, because a psychologist can teach a potential shooter how to manage his anger, given the opportunity, but a young man who's been mocked and ostracized for being gay just might say to himself, "I'm not like that list of psychos and I don't need a shrink," then turn up at the next gun show, and riddle his classmates with bullets.
Who Will Be Next?
It feels like the The National Rifle Association is scapegoating us to divert attention off the subject of why we have too many guns. So let me ask the readers of this article, "How would you feel if the FBI had you on a list because of who you were, not because of something you did?" Would it make you more paranoid if you were already prone to paranoia? Besides, in my opinion, given the grand scope of psychiatric DSM illnesses, everyone in the country who might walk into a psychiatrist's office in their worst of times can be diagnosed with some kind of mental disorder. What are we going to do, include everyone in NICS and deny guns to everyone? I ask the reader again, "How do you know you won't be included? You mean you've never been too anxious or depressed?"
Nevertheless, perhaps more critically for the nation than for a small group of its citizens, as we approach the big-brother-is-watching-you society George Orwell predicted in Nineteen Eighty-Four, we should rein in the will of the majority. In our feverish pursuit of security, a restriction on the privacy of one chips away at the freedom of all. The United States has long held the beacon of democracy as a guide for the rest of the world. At what point do we cut off the power to the flame that sheds its light over Manhattan Island? We may never know. Liberty may slip away bit by bit with no clear sign of its moment of departure. Perhaps much later on, when one big chunk breaks off into a wider expanse of time, when we have accumulated a sum total of many smaller losses, will we notice that we are not as free as we thought and wrestle back control from the bold reach of Bush-era government.
American Psychiatric Association. (1994). Fact Sheet: Violence and Mental Illness. Washington, DC: American Psychiatric Association. See this fact sheet.
Applebaum, P. and Swanson, J. (2010). Law and psychiatry: Gun laws and mental illness: How sensible are the current restrictions? Psychiatric Services. 61, 7. Full Text
U.S. Department of Health and Human Services. (1999) Mental health: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health Full Text
Wallace, C., Mullen, P., Burgess, P., et al. (1998) Serious criminal offending and mental disorder. Case linkage study. British Journal of Psychiatry. 172, 477-484. Abstract/Full Text
Walsh, E., Buchanan, and A. Fahy, T. (2002) Violence and schizophrenia: examining the evidence. British Journal of Psychiatry Psychiatry. 180, 490-495. Abstract/Full Text