Mental health maze on gun control

Feb. 02, 2013 @ 06:46 PM

Psychologist Chris Lootens understands, in the wake of the Newtown, Conn., elementary school massacre, why the public and politicians have turned to the issue of limiting access to weapons by mentally ill individuals.
But Lootens and other health care professionals wonder if the push to pass new laws and practices will recognize the endless complexities with diseases and abnormalities of the mind.
“What this debate boils down to is that you are trying to make predictions about behavior. The goal of this effort is to predict who will be violent, who will shoot people. When it comes to predicting violence, so many factors go into that. So how could we predict that for any one person?” said Lootens, assistant professor of psychology at High Point University.
Dr. Stephen Kramer, a psychiatrist and faculty member with Wake Forest Baptist Medical Center, said it’s understandable why the public and elected officials want to address the issue because of mass shootings.
“Everyone wants to make the situation better, and no one has a good solution,” Kramer said.


                                            LOCAL CASE REFLECTS CHALLENGE


A recent local case that didn’t lead to anyone getting injured reflects the complexity and volatility of mentally disturbed people and firearms. A High Point man was the subject of an alert last month by the University of North Carolina at Greensboro after he reportedly tried to get a gun.
Andrew James Walker, 38, eventually was located in Indiana, where he had family, with the goal of getting him mental health treatment. The UNCG Police Department indicated last month that he no longer was considered an imminent threat to faculty and students on campus. Walker was sought after expressing hostility toward people at UNCG and possibly attempting to secure a firearm in High Point.
Current federal law dictates that when a severely mentally ill person is involuntarily committed, and the commitment is upheld by a judge, the name of the person is entered into a data bank to screen for weapon sales, Kramer said. But in some cases, an attorney representing a client can legally get a case continued so the person can be treated and discharged before a judge makes the commitment formal.
“These high-profile cases aren’t representative of the typically treated person with psychiatric disorder,” Kramer said. The people who commit acts of violence are a small percentage of the overall population with serious mental disorders, the doctor said.


                          EXTRAORDINARY COMPLEXITIES OF MENTAL ILLNESS


Mental illness covers a broad range of hundreds of ailments that can affect people in a range of ways. The National Institute of Mental Health estimates that about one in five people will struggle at some point with a psychological problem, Lootens said.
“To talk about limiting access to weapons for people who are mentally ill means limiting access to weapons, potentially, for 20 percent of the population,” Lootens said. “Mentally ill means lot of things. It means depression, anxiety, as well as people who have the potential to be violent.”
Some laws and policies that come out of reaction to a tragedy such as Newtown can produce results, said Will Pizio, associate professor of justice and policy studies at Guilford College. Others may have the best of intentions, but not become effective or lead to unexpected consequences, said Pizio, a former law enforcement officer.
“We are very policy-reactive country,” Pizio said.


                         IMPOSSIBLE TASK OF PINPOINTING WHO MIGHT ACT


Even within the subset of mentally ill people more prone to violence, not all of them will commit malevolent acts, Lootens said.
“For example, one of the groups of people that’s more likely to engage in violent behavior are people with personality disorders,” Lootens said. “But not everyone with personality disorders or anti-social behavior engages in criminal behavior. It becomes, to some extent, impossible to predict what one person will do.”
Lootens said the most practical lesson that public policy-makers can take from mental health studies is that previous violent behavior by someone is a strong indicator of future violent behavior.
“One of the easiest places to start would be limiting access to weapons to people who have previously engaged in violent behavior,” Lootens said.
Another concern about implementing checks on the mentally ill is the necessary privacy statutes and medical professional rules that protect health care information of patients, Lootens said.
“That, to me, is the biggest logistical factor. How do you get around the fact that the person’s history with regard to their behavior and mental health is sensitive and private? How would get around sharing that publicly in some kind of data base without compromising that person’s trust in the mental health system?” Lootens said.
Some patients might react to the possibility of their mental health care information being compromised by not being as candid with psychologists or psychiatrists, which leads them to not receiving the help they need to cope and improve, Lootens said.

pjohnson@hpe.com | 888-3528