Please check my last blog under Social Security to see that neo-liberals are now building the structures to end Social Security as the Social Security and Medicare Trusts have been looted to build the Homeland Security/NSA network. The American people have plenty of money----it simply needs Rule of Law reinstated and the fraud recovered.
IF YOU DO NOT HEAR YOUR INCUMBENT SHOUTING FOR JUSTICE FROM MASSIVE CORPORATE FRAUD.....IF THEY ARE PRETENDING AMERICANS ARE POOR......IF THEY ARE FIGHTING FOR UNEMPLOYMENT BENEFITS AND NOT THE HUNDREDS OF THOUSANDS OF DOLLARS EACH CITIZEN IS OWED FROM CORPORATE FRAUD-----THEY ARE WORKING FOR GLOBAL CORPORATIONS. ALL MARYLAND POLS ARE GLOBAL CORPORATE POLS.
The next few days I want to look at the health care reform----Affordable Care Act. By now people understand it is bad for the American people and has nothing to do with making health costs for citizens more affordable or increasing access to care for the poor. That is just the progressive bones corporate neo-liberals throw when working for wealth and profit. I want to look first at the mental health issue and how Medicare and Medicaid are continually under attack from fraud and corruption. There is something more important than losing health coverage in the Affordable Care Act------there is the opening for yet more loss of civil liberties that take the US to autocratic policies of third world countries. Again, it is being pushed under the guise of progressive bones and none of it is progressive.
EXPANDED AND IMPROVED MEDICARE FOR ALL IS THE ONLY SOLUTION TO HEALTH CARE COSTS AND QUALITY HEALTH CARE AND ACCESS FOR ALL!
Regarding the race for Governor of MD and health care reform:
In Maryland, citizens get an up-close look at what elections look like in third world countries. You have candidates running for governor with absolutely no administrative experience and two in the democratic primary, Brown and Gansler, with proven failures in office in administration on just a smaller scale. Cindy Walsh for Governor of Maryland has 3 decades of management/administrative experience and training on top of knowing more about the political issues of the day than my opponents who just repeat political talking points over and over.
So, the neo-liberal plan was to pass a republican health care policy getting all of its base mad and then fill the airwaves with propaganda on this issue that has no relevance to people's lives. Neo-liberals in Congress and Obama push a state run health insurance system with consolidation and deregulation and then VOILA----republicans have control of Congress and Hillary is elected and 'forced' to create the conditions for the predatory and profit-driven health systems to become Wall Street banks as she and Bill did their last terms. What? The Trans Pacific Trade Pact (TPP) has the US forcing public health all over the globe to end in order to maximize profits, drug costs soar because Bill Gates is now in the PHARMA business?
WELL, HILLARY WILL SIMPLY HAVE TO PUSH AND PASS TPP BECAUSE IT IS ALL THE REPUBLICANS FAULT.
This is the political scenario silenced by the constant talk of failed health system roll-outs. Doug Gansler has his face on buses telling the underserved communities he will fight for health insurance for the poor and yet, 1/2 of Medicare and Medicaid funding has been stolen under his watch as Maryland Attorney General. Anthony Brown is not worried about having no talent in administering public policy because the goal of this health care reform was setting up these private health systems that will end public health and send Medicare and Medicaid to states, ending these Federal programs. So, who cares as hundreds of millions of dollars are blown on roll-out-----the policies of health care privatization and ending entitlements is being installed under O'Malley/Brown. OPERATION SUCCESS SAY NEO-LIBERALS AND THEIR GLOBAL CORPORATE HANDLERS. His campaign ads have him FIGHTING FOR HEALTH JUSTICE at every turn. Let's look at the reality of this 'health justice' neo-liberals are planning for the citizens of Maryland.
First, let's look at mental health.....you know, the mantra of gun control pols pretending to be hard on policy and then not funding these policies they pretend to support. Mental health is a huge issue in America because since the Reagan/Clinton years this public sector has been defunded and is now a skeleton crew. Much of Medicaid spending goes to mental health and we know the entire system is full of fraud and corruption and people actually struggling with mental health issues almost always cannot get help. The system is set up to get mental health clients into a clinic with just enough time to give him/her medications to bill to Medicaid and then send them on their way with little followup. The current conditions having most of these people either failing to take medication, selling it, or having it stolen. That does not matter because the goal is MAXIMIZING PROFITS FOR PHARMA AND THE MORE THAT GOES OUT THE DOOR THE BETTER. Depression, bi-polar, and hyper-activity meds have our nation dosed out of what often is normal behavior.
I showed earlier that Bill Gates is now the owner of Prozac and many other mental health PHARMA soaring in profits from these policies. Abuse, fraud, and corruption drives these profits and it can all stop with rebuilding public oversight and accountability. These medications are not all bad it is just the way the system administers these mental health programs that make it a disaster for the Medicare/Medicaid Trusts, taxpayers, and these patient clients.
We know Affordable Care Act was written deliberately giving the health institutions the power to decide how to operate with less money from Medicare and Medicaid and the first thing that happens is these programs become worse and the emphasis on getting the drugs out the door increases.
INCREASE IN MASS SHOOTINGS TIED TO THE DISMANTLING OF THE MENTAL HEALTH SECTOR------YOU BETCHA!!!!!
THIS HEALTH REFORM ADDRESSING MENTAL HEALTH CRISIS------OH, REALLY??????
Features » April 1, 2014
The ACA Could Be the Death Knell for Chicago’s Public Mental Health Clinics
In 2012, Mayor Emanuel’s budget forced half the city’s public mental health clinics to close; now the remaining six are in danger, too.
BY Kari Lydersen
Mental health and labor advocates ... fear that city officials are trying to divert insured clients from the remaining clinics because they ultimately want to close them. They suspect reducing the client population and the number of employees at the clinics is a way to lay the groundwork for shuttering them altogether.
Thanks to the Affordable Care Act's expansion of Medicaid, many more Chicagoans will have access to mental health care in the near future. But ironically, the increased availability of health insurance could starve Chicago’s six remaining public mental health clinics of resources—and cause havoc for the city residents who depend on them.
In addition to serving those without insurance, the clinics have long provided care to locals with insurance who could have gone elsewhere, but saw the facilities as their most accessible and supportive option.
Over the past year, however, city officials reportedly started directing people with existing insurance to private or county mental health providers instead. And as formerly uninsured Chicagoans get new coverage from the Affordable Care Act, some say they, too, are being discouraged from attending the city clinics. While they theoretically could get care elsewhere, mental health advocates say that in reality, many are likely to fall through the cracks rather than moving to a provider they don’t trust.
Members of the grassroots coalition Mental Health Movement say that starting in 2013, public clinic staff members began pressuring uninsured clients to enroll in CountyCare, part of the state’s expanded Medicaid program. In turn, the clients say they’ve been told that once they have CountyCare or other insurance coverage, they will no longer be able to receive care at the public clinics.
A March 14 memo, obtained by In These Times and sent from Chicago Department of Public Health deputy commissioner Edie Bamberger, says that people with insurance and mental health needs “will be educated” about the “benefits of accessing integrated health care services through their insurance network,” which would not include the city clinics. If the client wants to attend a city clinic, the memo directs, public health staff should consult the clinic director; such requests will be considered on a case-by-case basis. People already attending a city clinic will be allowed to continue attending the clinic once they get insured, it continues, but the clinic director “must be made aware of this request.”
In other words, insured people who are already clients won’t be expressly prohibited from attending the city clinics, but staff are supposed to make an effort to divert them to other providers. And new insured clients won’t be expressly prohibited from the public clinics, but their attendance will have to be specifically approved. Previously, the DPH had a more strident ban on insured people obtaining services from the clinics; the shift in policy apparently came after the department faced a wave of criticism.
On April 2, aldermen who are part of the Chicago City Council’s Progressive Caucus will introduce a resolution calling for public hearings before the Council’s Health and Environmental Protection Committee on the state of mental health care in the city. At a press conference at City Hall on March 27, Aldermen Robert Fioretti and Scott Waguespack explained that the issue of whether and to what extent the public clinics will accept clients with insurance would be a central talking point at those hearings.
Chicago resident and Mental Health Movement member Horace Howard, who attended the press conference, says he has been receiving services from the public Greater Grand Boulevard clinic on the South Side since the Woodlawn clinic closed in 2012; he was part of the high-profile occupation at Woodlawn in April of that year. He claims that after several months going to Greater Grand, he still hasn’t been able to get an appointment with a doctor. (Clients at the public clinics typically meet with therapists on a regular basis and have less frequent meetings with psychiatrists.) But Howard still feels at home at the public clinics and doesn’t want to switch to another provider.
“We’re being kicked out because of managed care,” says Howard, 56, sporting a T-shirt bearing a portrait of Helen Morley, the Mental Health Movement member who died in 2012 of heart complications after famously telling Mayor Rahm Emanuel, “If you close my clinic, I will die.” Howard says the city should reopen the Woodlawn clinic “in memorial to Helen.”
Mental Health Movement member Ronald “Cowboy” Jackson says he knows several former clients of public clinics who were told since obtaining CountyCare coverage that they should go to the county hospital in Chicago instead. But people have had trouble getting appointments at the over-crowded county system, Jackson says; as a consequence, they have grown frustrated and stopped trying to get care.
Alderman Fioretti argues the changes to the system are only making it harder for Chicagoans in need. “They’re creating confusion out there,” he says. “For years, people have been going to these clinics. Now they’re being told they can’t … it’s adding more confusion, more disorientation for people in need of care.”
Because the Chicago Department of Public Health has so far not joined a healthcare provider network, including CountyCare, the public mental health clinics cannot be reimbursed under Medicaid as the state switches to managed care in coming weeks, meaning their funding will be put in danger. Just why the city hasn’t joined a network yet, however, remains unclear. (The department did not respond to an interview request for this story.) The March 14 memo claims that the department is encouraging insured people to go elsewhere because it “remains focused on preserving our limited capacity to serve uninsured residents with more limited options.”
A fact sheet handed out at the press conference rebuts that statement, though. It reads:
Turning away people with insurance means turning away money—revenue that could help strengthen the city clinics for everybody. Turning away that revenue will lower the number of people at the city clinics, lower the funding coming into them and likely end up causing more of them to close.
Mental health and labor advocates—including AFSCME, the union representing public clinic staff—fear that city officials are trying to divert insured clients from the remaining clinics because they ultimately want to close them. They suspect that reducing the client population and the number of employees at the clinics is a way to lay the groundwork for shuttering them altogether.
“Once you have no one going to the clinic because they don’t accept insurance, then you can justify closing it because you have an empty building,” says N’Dana Carter, a leader of the Mental Health Movement.
Fioretti said that in closing and sidelining the clinics, Chicago’s leaders “throw our hands up and say we’re not going to do this service anymore.”
He and other aldermen have apologized for voting in 2011 for Mayor Emanuel’s 2012 budget, which closed six of the city’s 12 mental health clinics. “We made a big mistake,” he says.
Though Emanuel initially claimed the clinic’s closures would lead to an estimated $2.3 million in savings, Fioretti and his fellow progressive aldermen argue that this number “failed to account for the additional costs of increased emergency room visits, hospitalizations, police interventions and incarcerations.”
Alderman Waguespack says he has been disappointed by the city’s misplaced spending priorities. “You look at an $8 billion budget, and we can’t find $2.3 million?” he scoffs. “The city says we’re going to take away the safety net for such a small [savings]?”
Jackson, meanwhile, points to the mid-March standoff along Lake Shore Drive as an example of how unaddressed mental health crises can cause widespread trauma and cost taxpayers millions down the line. In that incident, a man with a history of mental illness who was suspected of killing his wife engaged police in an eight-hour showdown, closing off the major city thoroughfare along with nearby businesses.
“There’s a real effect on families and communities and schools” when people lack mental health care, Jackson says.
At a March 31 seminar on incarceration called “The $2 Billion Question” sponsored by the Chicago Community Trust and other groups, various speakers agreed that unavailable resources can have an enormously detrimental impact on individuals and their networks. They described, for instance, how a lack of mental health care can lead to the imprisonment of people who really need treatment, not punishment.
“We have a growing mentally ill population, both at the county and state level, that we’re struggling with how to deal with,” says Cook County Sheriff’s senior advisor Cara Smith.
At the seminar, she gave one example of the type of situations that land people with mental health issues in jail: A man grabbed a set of sheets or towels from a North Side Walgreens, walked out the door and told the clerk to “charge it.”
“$29.99 was the value of the item that he did not successfully steal,” Smith recounts. “And he was with us [in jail] for quite a long time … He had a very significant criminal history, mostly committing crimes of what I would call ‘survival’—criminal trespassing, retail theft—things to get shelter.”
“Because of the lack of services in the community, I can sit here and say many people are better off in the jail when they have severe mental illness because they’re getting care,” Smith continues. “Which is an awful thing to have to say.”
AFSCME is a website sponsor of In These Times. Sponsors have no role in editorial content.
Kari Lydersen
Kari Lydersen, an In These Times contributing editor, is a Chicago-based journalist and instructor who currently works at Northwestern University. Her work has appeared in the New York Times, the Washington Post, the Chicago Reader and The Progressive, among other publications. Her most recent book is Mayor 1%: Rahm Emanuel and the Rise of Chicago's 99 Percent. She is also the co-author of Shoot an Iraqi: Art, Life and Resistance Under the Gun and the author of Revolt on Goose Island: The Chicago Factory Takeover, and What it Says About the Economic Crisis. Look for an updated reissue of Revolt on Goose Island in 2014. In 2011, she was awarded a Studs Terkel Community Media Award for her work. She can be reached at kari.lydersen@gmail.com.
______________________________________
Keep in mind that the federal government and states gutted Medicaid funding these few years to pay for the massive corporate fraud of tens of trillions of dollars. So, when your pol acts as though they are adding funding to mental health after this huge gutting of funds-----THEY ARE LYING TO YOU! What is surfacing is a huge attack on all civil liberties and a further move towards totalitarianism. Can you imagine a government having the ability to force people to take drugs they do not want in the confines of their homes because the entire public health system with group living situations are being dismantled?
IT IS CRAZY AND YOUR NEO-LIBERAL IS MOVING THAT WAY EVEN IF THEY ARE NOT OPENLY SUPPORTING THIS BECAUSE WHEN PEOPLE ARE LEFT WITH ONLY HOME CARE AND LAWS ARE BROAD FOR THESE KINDS OF TREATMENTS THERE WILL BE ABUSE AND YOUR POLS KNOW THIS.
Remember, the problem with mass shootings by people with severe mental illness is that these people cannot access the kind of care and facilities they need to control these illnesses. We can effectively treat these diseases but that costs money and neo-liberals and neo-cons do not see any money coming for public services and programs. So, they easiest solution------forced medication with home care people overseeing what are catatonic conditions. Think of conditions for mental health institutions without proper oversight and then place individuals in their homes with only national chains providing barely trained home care employees. THIS IS DICKENSIAN.
I will add that US citizens are being assaulted by police acting outside of Constitutional policing -----imagine these officers having the power to determine people's mental health status. We are already going to jail because police are using illegal tactics for jailing protesters and killing citizens. Police need to remain out of the diagnostic loop for mental illness.
HAVE YOU SEEN PEOPLE PLACED ON THESE SCHIZO PHARMA? THEY ARE OFTEN CATATONIC AND HELPLESS.
Why are we reforming our mental health guidelines written at a time when all people had civil rights and liberties when the problem was funding and access to quality care?
'And its backing of the expanded use of involuntary outpatient treatment has drawn opposition from some advocacy groups'.
Mental Health Groups Split on Bill to Overhaul Care
By BENEDICT CAREY APRIL 2, 2014
Lawmakers, patient advocates and the millions of Americans living with a psychiatric diagnosis agree that the nation’s mental health care system is broken, and on Thursday, Congress will hear testimony on the most ambitious overhaul plan in decades, a bill that has already stirred longstanding divisions in mental health circles.
The prospects for the bill, proposed by Representative Tim Murphy, Republican of Pennsylvania, are uncertain, experts say, given partisanship in both the House and the Senate and the sheer complexity of the mental health system. And its backing of the expanded use of involuntary outpatient treatment has drawn opposition from some advocacy groups.
But the bill, the Helping Families in Mental Health Crisis Act, does have more than a dozen Democratic co-sponsors in the House, and several mental health organizations are supporting it. Last week, both houses of Congress adopted one of its central provisions, expanding funding for outpatient treatment programs through other legislation. On Thursday, the House Energy and Commerce health subcommittee is scheduled to hear testimony on the entire bill, which includes more than two dozen measures.
“It’s the most comprehensive mental health bill we’ve seen in a long, long time, and that in itself is an accomplishment,” said Keris Myrick, chief executive of the Project Return Peer Support Network and president of the board of the National Alliance on Mental Illness, which supports some parts of the bill. “I think almost everyone sees things in the bill that are long overdue, but also things they’re very concerned about.”
Among those opposing the bill because of its involuntary treatment provisions is the Bazelon Center for Mental Health Law, whose president, Robert Bernstein, said, “Many serious organizations seem to have an ‘any port in the storm’ mentality, supporting this bill even though it includes dangerous provisions.”
Mr. Murphy, a clinical psychologist from Pittsburgh, put together the legislation at the behest of House Republican leaders after the massacre at Sandy Hook Elementary School in Newtown, Conn., in 2012. He spent a year hearing testimony about the current system, a patchwork of community clinics and state hospitals chronically short of funding that leaves millions of people with mental illness without treatment, often homeless or in prison.
“It’s a broken system, and we’re not going to fix it by throwing a little money here or there,” Mr. Murphy said in an interview. “We know that when people get care, they get better, but there are simply not many options: Clinics are reducing services, there are not enough psychiatrists or psychologists to go around — we found all sorts of barriers to care.”
Widely backed provisions of the bill include streamlining payment for services under the Medicaid program, and providing funds for clinics that meet standards for rigorous, scientifically supported care.
The bill also provides money for suicide prevention programs and for so-called telepsychiatry, or remote video therapy, which is seen as especially crucial in rural areas.
Provisions calling for increased training for police officers and emergency medical workers in how to identify and treat people with mental disorders are also widely approved. The police and paramedics often act as ad hoc social workers, dealing with people with mental problems when they are hurt or break the law.
About 350,000 Americans with a diagnosis of a severe mental illness like schizophrenia or bipolar disorder are in state jails and prisons, while the number of psychiatric beds available has shrunk to 35,000, according to a coming analysis by the Treatment Advocacy Center, a nonprofit group that favors expanded access to treatment.
“The situation has been getting progressively worse for 50 years, to the point where we now have 10 times more people with severe mental illness in prisons and jails than in mental hospitals,” said Dr. E. Fuller Torrey, of the Stanley Medical Research Institute, a nonprofit organization supporting research in schizophrenia and bipolar disorder, and a strong supporter of the bill.
But the bill’s backing for involuntary treatment is highly contentious. It would provide state grants for so-called assisted outpatient treatment programs under which certain mentally ill people with a history of legal or other problems get court-ordered therapy, which in most cases means trying to ensure they take their medication.
The result: more people treated earlier, and more treated against their will.
“This becomes a civil rights issue quickly, and it can drive people away from seeking services when they fear treatment will be forced on them or they’ll be locked up,” said Gina Nikkel, president and chief executive of the Foundation for Excellence in Mental Health Care, which advocates a more holistic, less medication-oriented approach to recovery.
In the last two decades, 45 states have adopted laws allowing compelled treatment in some cases, with varying requirements and levels of enforcement. Kendra’s Law, passed in New York in 1999, is one that researchers have monitored closely. One recent analysis, led by investigators at Duke University, found that since the law was passed, patients were much less likely to land back in the hospital or be arrested. Mental health and Medicaid costs for them dropped by about half.
But involuntary treatment programs have led thousands of former psychiatric patients to become fierce critics of the mental health system.
Dr. Bernstein of the Bazelon Center and Dr. Nikkel said that extending such programs would “eviscerate civil right protections” and further erode trust between patient and provider.
The Murphy bill also proposes amending federal medical privacy protections — the now-familiar Hipaa laws — to allow parents or other caregivers access to a patient’s medical information. Under current law, those records are private once a person becomes an adult, and as a result, caregivers are often effectively cut out of treatment decisions. The bill seeks to bring them back in, with a provision that will also generate strong political resistance, experts said.
Finally, the bill proposes to sharply scale back many of the programs funded by the Substance Abuse and Mental Health Services Administration. This agency, with a $3.6 billion budget, has long financed programs that critics say are not backed by good evidence.
“When something has been funded for a long time, it’s tough to let it go,” Mr. Murphy said. “What we’re saying is that if a program works, then show us the evidence that it does, and we’ll keep it. If the evidence is not there, then the taxpayers shouldn’t pay for it.”
______________________________________________
Citizens of Maryland have a front seat to neo-conservative public policy because much of public policy pushed by Maryland neo-liberals is written by Johns Hopkins----the most neo-conservative institution in the world. You can see why Maryland has no democratic party when they all work for Johns Hopkins. Maryland's gun control policy mirrors this mental health policy-----it writes law that looks at mental illness very broadly making it possible to take gun ownership rights away for the most common of mental health issues. Now, gun control advocates may think this is good----but it will be used to end people's civil liberties and this extends to mental health diagnosis and treatment.
When everyone knows the problem with gun violence has little to do with mental health issues needing new laws.....why are are we allowing a government controlled by neo-liberals and neo-cons write laws at a time of NSA and totalitarianian suspension of Rule of Law and mass fraud and corruption. The worst of totalitarian regimes use these issues to throw people into jail and losing our public justice and Bill of Rights set this tone.
MARYLAND IS IN THE CATEGORY OF DEFUNDING AND DISMANTLING ALL PUBLIC HEALTH WHILE TRYING TO PASS LAW THAT TAKES CIVIL RIGHTS AWAY. THIS IS VERY, VERY, VERY BAD.
In Gun Debate, a Misguided Focus on Mental Illness
By RICHARD A. FRIEDMAN, M.D.
Published: December 17, 2012
In the wake of the terrible shooting at an elementary school in Newtown, Conn., national attention has turned again to the complex links between violence, mental illness and gun control.
The gunman, Adam Lanza, 20, has been described as a loner who was intelligent and socially awkward. And while no official diagnosis has been made public, armchair diagnosticians have been quick to assert that keeping guns from getting into the hands of people with mental illness would help solve the problem of gun homicides.
Arguing against stricter gun-control measures, Representative Mike Rogers, Republican of Michigan and a former F.B.I. agent, said, “What the more realistic discussion is, ‘How do we target people with mental illness who use firearms?’ ”
Robert A. Levy, chairman of the Cato Institute, told The New York Times: “To reduce the risk of multivictim violence, we would be better advised to focus on early detection and treatment of mental illness.”
But there is overwhelming epidemiological evidence that the vast majority of people with psychiatric disorders do not commit violent acts. Only about 4 percent of violence in the United States can be attributed to people with mental illness.
This does not mean that mental illness is not a risk factor for violence. It is, but the risk is actually small. Only certain serious psychiatric illnesses are linked to an increased risk of violence.
One of the largest studies, the National Institute of Mental Health’s Epidemiologic Catchment Area study, which followed nearly 18,000 subjects, found that the lifetime prevalence of violence among people with serious mental illness — like schizophrenia and bipolar disorder — was 16 percent, compared with 7 percent among people without any mental disorder. Anxiety disorders, in contrast, do not seem to increase the risk at all.
Alcohol and drug abuse are far more likely to result in violent behavior than mental illness by itself. In the National Institute of Mental Health’s E.C.A. study, for example, people with no mental disorder who abused alcohol or drugs were nearly seven times as likely as those without substance abuse to commit violent acts.
It’s possible that preventing people with schizophrenia, bipolar disorder and other serious mental illnesses from getting guns might decrease the risk of mass killings. Even the Supreme Court, which in 2008 strongly affirmed a broad right to bear arms, at the same time endorsed prohibitions on gun ownership “by felons and the mentally ill.”
But mass killings are very rare events, and because people with mental illness contribute so little to overall violence, these measures would have little impact on everyday firearm-related killings. Consider that between 2001 and 2010, there were nearly 120,000 gun-related homicides, according to the National Center for Health Statistics. Few were perpetrated by people with mental illness.
Perhaps more significant, we are not very good at predicting who is likely to be dangerous in the future. According to Dr. Michael Stone, professor of clinical psychiatry at Columbia and an expert on mass murderers, “Most of these killers are young men who are not floridly psychotic. They tend to be paranoid loners who hold a grudge and are full of rage.”
Even though we know from large-scale epidemiologic studies like the E.C.A. study that a young psychotic male who is intoxicated with alcohol and has a history of involuntary commitment is at a high risk of violence, most individuals who fit this profile are harmless.
Jeffrey Swanson, a professor of psychiatry at Duke University and a leading expert in the epidemiology of violence, said in an e-mail, “Can we reliably predict violence? ‘No’ is the short answer. Psychiatrists, using clinical judgment, are not much better than chance at predicting which individual patients will do something violent and which will not.”
It would be even harder to predict a mass shooting, Dr. Swanson said, “You can profile the perpetrators after the fact and you’ll get a description of troubled young men, which also matches the description of thousands of other troubled young men who would never do something like this.”
Even if clinicians could predict violence perfectly, keeping guns from people with mental illness is easier said than done. Nearly five years after Congress enacted the National Instant Criminal Background Check System, only about half of the states have submitted more than a tiny proportion of their mental health records.
How effective are laws that prohibit people with mental illness from obtaining guns? According to Dr. Swanson’s recent research, these measures may prevent some violent crime. But, he added, “there are a lot of people who are undeterred by these laws.”
Adam Lanza was prohibited from purchasing a gun, because he was too young. Yet he managed to get his hands on guns — his mother’s — anyway. If we really want to stop young men like him from becoming mass murderers, and prevent the small amount of violence attributable to mental illness, we should invest our resources in better screening for, and treatment of, psychiatric illness in young people.
All the focus on the small number of people with mental illness who are violent serves to make us feel safer by displacing and limiting the threat of violence to a small, well-defined group. But the sad and frightening truth is that the vast majority of homicides are carried out by outwardly normal people in the grip of all too ordinary human aggression to whom we provide nearly unfettered access to deadly force.
How the TPP Would Impact Public Health
How the Trans-Pacific Partnership
exposethetpp.org
IF YOU DO NOT HEAR YOUR INCUMBENT SHOUTING FOR JUSTICE FROM MASSIVE CORPORATE FRAUD.....IF THEY ARE PRETENDING AMERICANS ARE POOR......IF THEY ARE FIGHTING FOR UNEMPLOYMENT BENEFITS AND NOT THE HUNDREDS OF THOUSANDS OF DOLLARS EACH CITIZEN IS OWED FROM CORPORATE FRAUD-----THEY ARE WORKING FOR GLOBAL CORPORATIONS. ALL MARYLAND POLS ARE GLOBAL CORPORATE POLS.
The next few days I want to look at the health care reform----Affordable Care Act. By now people understand it is bad for the American people and has nothing to do with making health costs for citizens more affordable or increasing access to care for the poor. That is just the progressive bones corporate neo-liberals throw when working for wealth and profit. I want to look first at the mental health issue and how Medicare and Medicaid are continually under attack from fraud and corruption. There is something more important than losing health coverage in the Affordable Care Act------there is the opening for yet more loss of civil liberties that take the US to autocratic policies of third world countries. Again, it is being pushed under the guise of progressive bones and none of it is progressive.
EXPANDED AND IMPROVED MEDICARE FOR ALL IS THE ONLY SOLUTION TO HEALTH CARE COSTS AND QUALITY HEALTH CARE AND ACCESS FOR ALL!
Regarding the race for Governor of MD and health care reform:
In Maryland, citizens get an up-close look at what elections look like in third world countries. You have candidates running for governor with absolutely no administrative experience and two in the democratic primary, Brown and Gansler, with proven failures in office in administration on just a smaller scale. Cindy Walsh for Governor of Maryland has 3 decades of management/administrative experience and training on top of knowing more about the political issues of the day than my opponents who just repeat political talking points over and over.
So, the neo-liberal plan was to pass a republican health care policy getting all of its base mad and then fill the airwaves with propaganda on this issue that has no relevance to people's lives. Neo-liberals in Congress and Obama push a state run health insurance system with consolidation and deregulation and then VOILA----republicans have control of Congress and Hillary is elected and 'forced' to create the conditions for the predatory and profit-driven health systems to become Wall Street banks as she and Bill did their last terms. What? The Trans Pacific Trade Pact (TPP) has the US forcing public health all over the globe to end in order to maximize profits, drug costs soar because Bill Gates is now in the PHARMA business?
WELL, HILLARY WILL SIMPLY HAVE TO PUSH AND PASS TPP BECAUSE IT IS ALL THE REPUBLICANS FAULT.
This is the political scenario silenced by the constant talk of failed health system roll-outs. Doug Gansler has his face on buses telling the underserved communities he will fight for health insurance for the poor and yet, 1/2 of Medicare and Medicaid funding has been stolen under his watch as Maryland Attorney General. Anthony Brown is not worried about having no talent in administering public policy because the goal of this health care reform was setting up these private health systems that will end public health and send Medicare and Medicaid to states, ending these Federal programs. So, who cares as hundreds of millions of dollars are blown on roll-out-----the policies of health care privatization and ending entitlements is being installed under O'Malley/Brown. OPERATION SUCCESS SAY NEO-LIBERALS AND THEIR GLOBAL CORPORATE HANDLERS. His campaign ads have him FIGHTING FOR HEALTH JUSTICE at every turn. Let's look at the reality of this 'health justice' neo-liberals are planning for the citizens of Maryland.
First, let's look at mental health.....you know, the mantra of gun control pols pretending to be hard on policy and then not funding these policies they pretend to support. Mental health is a huge issue in America because since the Reagan/Clinton years this public sector has been defunded and is now a skeleton crew. Much of Medicaid spending goes to mental health and we know the entire system is full of fraud and corruption and people actually struggling with mental health issues almost always cannot get help. The system is set up to get mental health clients into a clinic with just enough time to give him/her medications to bill to Medicaid and then send them on their way with little followup. The current conditions having most of these people either failing to take medication, selling it, or having it stolen. That does not matter because the goal is MAXIMIZING PROFITS FOR PHARMA AND THE MORE THAT GOES OUT THE DOOR THE BETTER. Depression, bi-polar, and hyper-activity meds have our nation dosed out of what often is normal behavior.
I showed earlier that Bill Gates is now the owner of Prozac and many other mental health PHARMA soaring in profits from these policies. Abuse, fraud, and corruption drives these profits and it can all stop with rebuilding public oversight and accountability. These medications are not all bad it is just the way the system administers these mental health programs that make it a disaster for the Medicare/Medicaid Trusts, taxpayers, and these patient clients.
We know Affordable Care Act was written deliberately giving the health institutions the power to decide how to operate with less money from Medicare and Medicaid and the first thing that happens is these programs become worse and the emphasis on getting the drugs out the door increases.
INCREASE IN MASS SHOOTINGS TIED TO THE DISMANTLING OF THE MENTAL HEALTH SECTOR------YOU BETCHA!!!!!
THIS HEALTH REFORM ADDRESSING MENTAL HEALTH CRISIS------OH, REALLY??????
Features » April 1, 2014
The ACA Could Be the Death Knell for Chicago’s Public Mental Health Clinics
In 2012, Mayor Emanuel’s budget forced half the city’s public mental health clinics to close; now the remaining six are in danger, too.
BY Kari Lydersen
Mental health and labor advocates ... fear that city officials are trying to divert insured clients from the remaining clinics because they ultimately want to close them. They suspect reducing the client population and the number of employees at the clinics is a way to lay the groundwork for shuttering them altogether.
Thanks to the Affordable Care Act's expansion of Medicaid, many more Chicagoans will have access to mental health care in the near future. But ironically, the increased availability of health insurance could starve Chicago’s six remaining public mental health clinics of resources—and cause havoc for the city residents who depend on them.
In addition to serving those without insurance, the clinics have long provided care to locals with insurance who could have gone elsewhere, but saw the facilities as their most accessible and supportive option.
Over the past year, however, city officials reportedly started directing people with existing insurance to private or county mental health providers instead. And as formerly uninsured Chicagoans get new coverage from the Affordable Care Act, some say they, too, are being discouraged from attending the city clinics. While they theoretically could get care elsewhere, mental health advocates say that in reality, many are likely to fall through the cracks rather than moving to a provider they don’t trust.
Members of the grassroots coalition Mental Health Movement say that starting in 2013, public clinic staff members began pressuring uninsured clients to enroll in CountyCare, part of the state’s expanded Medicaid program. In turn, the clients say they’ve been told that once they have CountyCare or other insurance coverage, they will no longer be able to receive care at the public clinics.
A March 14 memo, obtained by In These Times and sent from Chicago Department of Public Health deputy commissioner Edie Bamberger, says that people with insurance and mental health needs “will be educated” about the “benefits of accessing integrated health care services through their insurance network,” which would not include the city clinics. If the client wants to attend a city clinic, the memo directs, public health staff should consult the clinic director; such requests will be considered on a case-by-case basis. People already attending a city clinic will be allowed to continue attending the clinic once they get insured, it continues, but the clinic director “must be made aware of this request.”
In other words, insured people who are already clients won’t be expressly prohibited from attending the city clinics, but staff are supposed to make an effort to divert them to other providers. And new insured clients won’t be expressly prohibited from the public clinics, but their attendance will have to be specifically approved. Previously, the DPH had a more strident ban on insured people obtaining services from the clinics; the shift in policy apparently came after the department faced a wave of criticism.
On April 2, aldermen who are part of the Chicago City Council’s Progressive Caucus will introduce a resolution calling for public hearings before the Council’s Health and Environmental Protection Committee on the state of mental health care in the city. At a press conference at City Hall on March 27, Aldermen Robert Fioretti and Scott Waguespack explained that the issue of whether and to what extent the public clinics will accept clients with insurance would be a central talking point at those hearings.
Chicago resident and Mental Health Movement member Horace Howard, who attended the press conference, says he has been receiving services from the public Greater Grand Boulevard clinic on the South Side since the Woodlawn clinic closed in 2012; he was part of the high-profile occupation at Woodlawn in April of that year. He claims that after several months going to Greater Grand, he still hasn’t been able to get an appointment with a doctor. (Clients at the public clinics typically meet with therapists on a regular basis and have less frequent meetings with psychiatrists.) But Howard still feels at home at the public clinics and doesn’t want to switch to another provider.
“We’re being kicked out because of managed care,” says Howard, 56, sporting a T-shirt bearing a portrait of Helen Morley, the Mental Health Movement member who died in 2012 of heart complications after famously telling Mayor Rahm Emanuel, “If you close my clinic, I will die.” Howard says the city should reopen the Woodlawn clinic “in memorial to Helen.”
Mental Health Movement member Ronald “Cowboy” Jackson says he knows several former clients of public clinics who were told since obtaining CountyCare coverage that they should go to the county hospital in Chicago instead. But people have had trouble getting appointments at the over-crowded county system, Jackson says; as a consequence, they have grown frustrated and stopped trying to get care.
Alderman Fioretti argues the changes to the system are only making it harder for Chicagoans in need. “They’re creating confusion out there,” he says. “For years, people have been going to these clinics. Now they’re being told they can’t … it’s adding more confusion, more disorientation for people in need of care.”
Because the Chicago Department of Public Health has so far not joined a healthcare provider network, including CountyCare, the public mental health clinics cannot be reimbursed under Medicaid as the state switches to managed care in coming weeks, meaning their funding will be put in danger. Just why the city hasn’t joined a network yet, however, remains unclear. (The department did not respond to an interview request for this story.) The March 14 memo claims that the department is encouraging insured people to go elsewhere because it “remains focused on preserving our limited capacity to serve uninsured residents with more limited options.”
A fact sheet handed out at the press conference rebuts that statement, though. It reads:
Turning away people with insurance means turning away money—revenue that could help strengthen the city clinics for everybody. Turning away that revenue will lower the number of people at the city clinics, lower the funding coming into them and likely end up causing more of them to close.
Mental health and labor advocates—including AFSCME, the union representing public clinic staff—fear that city officials are trying to divert insured clients from the remaining clinics because they ultimately want to close them. They suspect that reducing the client population and the number of employees at the clinics is a way to lay the groundwork for shuttering them altogether.
“Once you have no one going to the clinic because they don’t accept insurance, then you can justify closing it because you have an empty building,” says N’Dana Carter, a leader of the Mental Health Movement.
Fioretti said that in closing and sidelining the clinics, Chicago’s leaders “throw our hands up and say we’re not going to do this service anymore.”
He and other aldermen have apologized for voting in 2011 for Mayor Emanuel’s 2012 budget, which closed six of the city’s 12 mental health clinics. “We made a big mistake,” he says.
Though Emanuel initially claimed the clinic’s closures would lead to an estimated $2.3 million in savings, Fioretti and his fellow progressive aldermen argue that this number “failed to account for the additional costs of increased emergency room visits, hospitalizations, police interventions and incarcerations.”
Alderman Waguespack says he has been disappointed by the city’s misplaced spending priorities. “You look at an $8 billion budget, and we can’t find $2.3 million?” he scoffs. “The city says we’re going to take away the safety net for such a small [savings]?”
Jackson, meanwhile, points to the mid-March standoff along Lake Shore Drive as an example of how unaddressed mental health crises can cause widespread trauma and cost taxpayers millions down the line. In that incident, a man with a history of mental illness who was suspected of killing his wife engaged police in an eight-hour showdown, closing off the major city thoroughfare along with nearby businesses.
“There’s a real effect on families and communities and schools” when people lack mental health care, Jackson says.
At a March 31 seminar on incarceration called “The $2 Billion Question” sponsored by the Chicago Community Trust and other groups, various speakers agreed that unavailable resources can have an enormously detrimental impact on individuals and their networks. They described, for instance, how a lack of mental health care can lead to the imprisonment of people who really need treatment, not punishment.
“We have a growing mentally ill population, both at the county and state level, that we’re struggling with how to deal with,” says Cook County Sheriff’s senior advisor Cara Smith.
At the seminar, she gave one example of the type of situations that land people with mental health issues in jail: A man grabbed a set of sheets or towels from a North Side Walgreens, walked out the door and told the clerk to “charge it.”
“$29.99 was the value of the item that he did not successfully steal,” Smith recounts. “And he was with us [in jail] for quite a long time … He had a very significant criminal history, mostly committing crimes of what I would call ‘survival’—criminal trespassing, retail theft—things to get shelter.”
“Because of the lack of services in the community, I can sit here and say many people are better off in the jail when they have severe mental illness because they’re getting care,” Smith continues. “Which is an awful thing to have to say.”
AFSCME is a website sponsor of In These Times. Sponsors have no role in editorial content.
Kari Lydersen
Kari Lydersen, an In These Times contributing editor, is a Chicago-based journalist and instructor who currently works at Northwestern University. Her work has appeared in the New York Times, the Washington Post, the Chicago Reader and The Progressive, among other publications. Her most recent book is Mayor 1%: Rahm Emanuel and the Rise of Chicago's 99 Percent. She is also the co-author of Shoot an Iraqi: Art, Life and Resistance Under the Gun and the author of Revolt on Goose Island: The Chicago Factory Takeover, and What it Says About the Economic Crisis. Look for an updated reissue of Revolt on Goose Island in 2014. In 2011, she was awarded a Studs Terkel Community Media Award for her work. She can be reached at kari.lydersen@gmail.com.
______________________________________
Keep in mind that the federal government and states gutted Medicaid funding these few years to pay for the massive corporate fraud of tens of trillions of dollars. So, when your pol acts as though they are adding funding to mental health after this huge gutting of funds-----THEY ARE LYING TO YOU! What is surfacing is a huge attack on all civil liberties and a further move towards totalitarianism. Can you imagine a government having the ability to force people to take drugs they do not want in the confines of their homes because the entire public health system with group living situations are being dismantled?
IT IS CRAZY AND YOUR NEO-LIBERAL IS MOVING THAT WAY EVEN IF THEY ARE NOT OPENLY SUPPORTING THIS BECAUSE WHEN PEOPLE ARE LEFT WITH ONLY HOME CARE AND LAWS ARE BROAD FOR THESE KINDS OF TREATMENTS THERE WILL BE ABUSE AND YOUR POLS KNOW THIS.
Remember, the problem with mass shootings by people with severe mental illness is that these people cannot access the kind of care and facilities they need to control these illnesses. We can effectively treat these diseases but that costs money and neo-liberals and neo-cons do not see any money coming for public services and programs. So, they easiest solution------forced medication with home care people overseeing what are catatonic conditions. Think of conditions for mental health institutions without proper oversight and then place individuals in their homes with only national chains providing barely trained home care employees. THIS IS DICKENSIAN.
I will add that US citizens are being assaulted by police acting outside of Constitutional policing -----imagine these officers having the power to determine people's mental health status. We are already going to jail because police are using illegal tactics for jailing protesters and killing citizens. Police need to remain out of the diagnostic loop for mental illness.
HAVE YOU SEEN PEOPLE PLACED ON THESE SCHIZO PHARMA? THEY ARE OFTEN CATATONIC AND HELPLESS.
Why are we reforming our mental health guidelines written at a time when all people had civil rights and liberties when the problem was funding and access to quality care?
'And its backing of the expanded use of involuntary outpatient treatment has drawn opposition from some advocacy groups'.
Mental Health Groups Split on Bill to Overhaul Care
By BENEDICT CAREY APRIL 2, 2014
Lawmakers, patient advocates and the millions of Americans living with a psychiatric diagnosis agree that the nation’s mental health care system is broken, and on Thursday, Congress will hear testimony on the most ambitious overhaul plan in decades, a bill that has already stirred longstanding divisions in mental health circles.
The prospects for the bill, proposed by Representative Tim Murphy, Republican of Pennsylvania, are uncertain, experts say, given partisanship in both the House and the Senate and the sheer complexity of the mental health system. And its backing of the expanded use of involuntary outpatient treatment has drawn opposition from some advocacy groups.
But the bill, the Helping Families in Mental Health Crisis Act, does have more than a dozen Democratic co-sponsors in the House, and several mental health organizations are supporting it. Last week, both houses of Congress adopted one of its central provisions, expanding funding for outpatient treatment programs through other legislation. On Thursday, the House Energy and Commerce health subcommittee is scheduled to hear testimony on the entire bill, which includes more than two dozen measures.
“It’s the most comprehensive mental health bill we’ve seen in a long, long time, and that in itself is an accomplishment,” said Keris Myrick, chief executive of the Project Return Peer Support Network and president of the board of the National Alliance on Mental Illness, which supports some parts of the bill. “I think almost everyone sees things in the bill that are long overdue, but also things they’re very concerned about.”
Among those opposing the bill because of its involuntary treatment provisions is the Bazelon Center for Mental Health Law, whose president, Robert Bernstein, said, “Many serious organizations seem to have an ‘any port in the storm’ mentality, supporting this bill even though it includes dangerous provisions.”
Mr. Murphy, a clinical psychologist from Pittsburgh, put together the legislation at the behest of House Republican leaders after the massacre at Sandy Hook Elementary School in Newtown, Conn., in 2012. He spent a year hearing testimony about the current system, a patchwork of community clinics and state hospitals chronically short of funding that leaves millions of people with mental illness without treatment, often homeless or in prison.
“It’s a broken system, and we’re not going to fix it by throwing a little money here or there,” Mr. Murphy said in an interview. “We know that when people get care, they get better, but there are simply not many options: Clinics are reducing services, there are not enough psychiatrists or psychologists to go around — we found all sorts of barriers to care.”
Widely backed provisions of the bill include streamlining payment for services under the Medicaid program, and providing funds for clinics that meet standards for rigorous, scientifically supported care.
The bill also provides money for suicide prevention programs and for so-called telepsychiatry, or remote video therapy, which is seen as especially crucial in rural areas.
Provisions calling for increased training for police officers and emergency medical workers in how to identify and treat people with mental disorders are also widely approved. The police and paramedics often act as ad hoc social workers, dealing with people with mental problems when they are hurt or break the law.
About 350,000 Americans with a diagnosis of a severe mental illness like schizophrenia or bipolar disorder are in state jails and prisons, while the number of psychiatric beds available has shrunk to 35,000, according to a coming analysis by the Treatment Advocacy Center, a nonprofit group that favors expanded access to treatment.
“The situation has been getting progressively worse for 50 years, to the point where we now have 10 times more people with severe mental illness in prisons and jails than in mental hospitals,” said Dr. E. Fuller Torrey, of the Stanley Medical Research Institute, a nonprofit organization supporting research in schizophrenia and bipolar disorder, and a strong supporter of the bill.
But the bill’s backing for involuntary treatment is highly contentious. It would provide state grants for so-called assisted outpatient treatment programs under which certain mentally ill people with a history of legal or other problems get court-ordered therapy, which in most cases means trying to ensure they take their medication.
The result: more people treated earlier, and more treated against their will.
“This becomes a civil rights issue quickly, and it can drive people away from seeking services when they fear treatment will be forced on them or they’ll be locked up,” said Gina Nikkel, president and chief executive of the Foundation for Excellence in Mental Health Care, which advocates a more holistic, less medication-oriented approach to recovery.
In the last two decades, 45 states have adopted laws allowing compelled treatment in some cases, with varying requirements and levels of enforcement. Kendra’s Law, passed in New York in 1999, is one that researchers have monitored closely. One recent analysis, led by investigators at Duke University, found that since the law was passed, patients were much less likely to land back in the hospital or be arrested. Mental health and Medicaid costs for them dropped by about half.
But involuntary treatment programs have led thousands of former psychiatric patients to become fierce critics of the mental health system.
Dr. Bernstein of the Bazelon Center and Dr. Nikkel said that extending such programs would “eviscerate civil right protections” and further erode trust between patient and provider.
The Murphy bill also proposes amending federal medical privacy protections — the now-familiar Hipaa laws — to allow parents or other caregivers access to a patient’s medical information. Under current law, those records are private once a person becomes an adult, and as a result, caregivers are often effectively cut out of treatment decisions. The bill seeks to bring them back in, with a provision that will also generate strong political resistance, experts said.
Finally, the bill proposes to sharply scale back many of the programs funded by the Substance Abuse and Mental Health Services Administration. This agency, with a $3.6 billion budget, has long financed programs that critics say are not backed by good evidence.
“When something has been funded for a long time, it’s tough to let it go,” Mr. Murphy said. “What we’re saying is that if a program works, then show us the evidence that it does, and we’ll keep it. If the evidence is not there, then the taxpayers shouldn’t pay for it.”
______________________________________________
Citizens of Maryland have a front seat to neo-conservative public policy because much of public policy pushed by Maryland neo-liberals is written by Johns Hopkins----the most neo-conservative institution in the world. You can see why Maryland has no democratic party when they all work for Johns Hopkins. Maryland's gun control policy mirrors this mental health policy-----it writes law that looks at mental illness very broadly making it possible to take gun ownership rights away for the most common of mental health issues. Now, gun control advocates may think this is good----but it will be used to end people's civil liberties and this extends to mental health diagnosis and treatment.
When everyone knows the problem with gun violence has little to do with mental health issues needing new laws.....why are are we allowing a government controlled by neo-liberals and neo-cons write laws at a time of NSA and totalitarianian suspension of Rule of Law and mass fraud and corruption. The worst of totalitarian regimes use these issues to throw people into jail and losing our public justice and Bill of Rights set this tone.
MARYLAND IS IN THE CATEGORY OF DEFUNDING AND DISMANTLING ALL PUBLIC HEALTH WHILE TRYING TO PASS LAW THAT TAKES CIVIL RIGHTS AWAY. THIS IS VERY, VERY, VERY BAD.
In Gun Debate, a Misguided Focus on Mental Illness
By RICHARD A. FRIEDMAN, M.D.
Published: December 17, 2012
In the wake of the terrible shooting at an elementary school in Newtown, Conn., national attention has turned again to the complex links between violence, mental illness and gun control.
The gunman, Adam Lanza, 20, has been described as a loner who was intelligent and socially awkward. And while no official diagnosis has been made public, armchair diagnosticians have been quick to assert that keeping guns from getting into the hands of people with mental illness would help solve the problem of gun homicides.
Arguing against stricter gun-control measures, Representative Mike Rogers, Republican of Michigan and a former F.B.I. agent, said, “What the more realistic discussion is, ‘How do we target people with mental illness who use firearms?’ ”
Robert A. Levy, chairman of the Cato Institute, told The New York Times: “To reduce the risk of multivictim violence, we would be better advised to focus on early detection and treatment of mental illness.”
But there is overwhelming epidemiological evidence that the vast majority of people with psychiatric disorders do not commit violent acts. Only about 4 percent of violence in the United States can be attributed to people with mental illness.
This does not mean that mental illness is not a risk factor for violence. It is, but the risk is actually small. Only certain serious psychiatric illnesses are linked to an increased risk of violence.
One of the largest studies, the National Institute of Mental Health’s Epidemiologic Catchment Area study, which followed nearly 18,000 subjects, found that the lifetime prevalence of violence among people with serious mental illness — like schizophrenia and bipolar disorder — was 16 percent, compared with 7 percent among people without any mental disorder. Anxiety disorders, in contrast, do not seem to increase the risk at all.
Alcohol and drug abuse are far more likely to result in violent behavior than mental illness by itself. In the National Institute of Mental Health’s E.C.A. study, for example, people with no mental disorder who abused alcohol or drugs were nearly seven times as likely as those without substance abuse to commit violent acts.
It’s possible that preventing people with schizophrenia, bipolar disorder and other serious mental illnesses from getting guns might decrease the risk of mass killings. Even the Supreme Court, which in 2008 strongly affirmed a broad right to bear arms, at the same time endorsed prohibitions on gun ownership “by felons and the mentally ill.”
But mass killings are very rare events, and because people with mental illness contribute so little to overall violence, these measures would have little impact on everyday firearm-related killings. Consider that between 2001 and 2010, there were nearly 120,000 gun-related homicides, according to the National Center for Health Statistics. Few were perpetrated by people with mental illness.
Perhaps more significant, we are not very good at predicting who is likely to be dangerous in the future. According to Dr. Michael Stone, professor of clinical psychiatry at Columbia and an expert on mass murderers, “Most of these killers are young men who are not floridly psychotic. They tend to be paranoid loners who hold a grudge and are full of rage.”
Even though we know from large-scale epidemiologic studies like the E.C.A. study that a young psychotic male who is intoxicated with alcohol and has a history of involuntary commitment is at a high risk of violence, most individuals who fit this profile are harmless.
Jeffrey Swanson, a professor of psychiatry at Duke University and a leading expert in the epidemiology of violence, said in an e-mail, “Can we reliably predict violence? ‘No’ is the short answer. Psychiatrists, using clinical judgment, are not much better than chance at predicting which individual patients will do something violent and which will not.”
It would be even harder to predict a mass shooting, Dr. Swanson said, “You can profile the perpetrators after the fact and you’ll get a description of troubled young men, which also matches the description of thousands of other troubled young men who would never do something like this.”
Even if clinicians could predict violence perfectly, keeping guns from people with mental illness is easier said than done. Nearly five years after Congress enacted the National Instant Criminal Background Check System, only about half of the states have submitted more than a tiny proportion of their mental health records.
How effective are laws that prohibit people with mental illness from obtaining guns? According to Dr. Swanson’s recent research, these measures may prevent some violent crime. But, he added, “there are a lot of people who are undeterred by these laws.”
Adam Lanza was prohibited from purchasing a gun, because he was too young. Yet he managed to get his hands on guns — his mother’s — anyway. If we really want to stop young men like him from becoming mass murderers, and prevent the small amount of violence attributable to mental illness, we should invest our resources in better screening for, and treatment of, psychiatric illness in young people.
All the focus on the small number of people with mental illness who are violent serves to make us feel safer by displacing and limiting the threat of violence to a small, well-defined group. But the sad and frightening truth is that the vast majority of homicides are carried out by outwardly normal people in the grip of all too ordinary human aggression to whom we provide nearly unfettered access to deadly force.
How the TPP Would Impact Public Health
How the Trans-Pacific Partnership
exposethetpp.org
RSS Feed
