On the August 29, 2015 New York Times op ed page, Jeffrey Lieberman, MD, Chairman of the Department of Psychiatry at Columbia University College of Physicians and Surgeons, wrote an op-ed article entitled “How to Halt the Violence.” It is a superb effort to address head on the pointless 24 hour news cycle hand wringing that that follows each new atrocious gun violence event that now, like an epidemic, infects American daily life.
Dr. Lieberman correctly suggests that there are proven medical methods and legal approaches to identifying psychotic and pre-psychotic individuals and treating them preventatively. A very few but highly dangerous minority of these individuals enact horrific violence as a product of their delusional states. Today, Psychiatry is neither helpless nor ignorant about what needs to be done to effectively reduce this deadly epidemic. What is missing is a public commitment to adequately finance and legally empower the identification and, if necessary, compulsory treatment of dangerous individuals who represent no less a public health threat than any deadly microbe.
It is important to note, however, that despite the fear and anxiety engendered in the general public by severely mentally ill people we all encounter in the street, for example homeless people panhandling or sleeping in urban doorways, the actual fact is that mentally ill people, even those who seem bizarre, are in fact less dangerous than the general population. Only those suffering from acute paranoid psychotic thinking are more dangerous and they can be lethally dangerous, especially if they have access to powerful weapons.
There is no doubt that part of the solution is overcoming the enormous financial power and fear mongering of the National Rifle Association whose apparent mission is to lobby Congressmen and women, contributing to their re-election treasuries in exchange for their voting to liberalize access to firearms, thereby promoting widespread gun ownership among Americans.
However, from the mental illness side of the toxic cocktail of firearms and psychosis that results in the current American epidemic of shooting deaths among innocent civilians, there is much that psychiatry knows how to do today to identify and treat those among us who are most vulnerable to becoming aggressively psychotic and violent. However, in order to curtail this epidemic, just as our forebears did with tuberculosis and polio, we need a well funded and legally empowered public mandate to succeed. This is an achievable goal. It is time for the public to pressure our representatives at the State and Federal levels to stop merely talking and finally take action. We may not be able to convince them to reject donations from the NRA. But we can at the very least pressure them to adequately fund psychiatric intervention programs and laws that will in fact make the public more safe.
Australia did it successfully reducing their incidents of firearm violence (including suicide by firearms) by 50%. The time is long past for America to do the same?
Mark Levy MD