Sunday, January 27, 2013

Stigma

Treatment for the mentally ill, and separation of the individual issues at hand.

I felt I should start with, what I personally believe to be, some positive and possible answers to this very complex, and easily convoluted issue of mental illness and gun violence. It is one of the rare times, where the question, and the description of what is the actual problem, is actually much more complicated than the answer (or, one of many possible answers, but this seems to be the most reasonable and forward thinking of the potentials, in my opinion).

Gun violence and mental health issues, are being tied together in a way that could easily muddy the waters, and cause NEITHER issue to be handled in a way that will lead toward some real answers and changes for the better, and health of the nation, and the people within. The dangers that lurk here, go beyond the simplistic view of a "crazy person" riddling a crowd of innocents with bullets, fired from guns that were too easily available - OF COURSE those incidents need to stop. That is not the debate lingering, it is the combination of issues, that are actually mostly unrelated, despite being lethal when put in combination together, and the potential for laws being pushed and passed out of fear.

People of ALL political persuasions are fearful of the "mad gunman" scenario, but that fear should not rule our collective minds. The fact of the matter is, there is a stigma against mental health. This is not new. This aspect of the subject requires its own separate focus, but is getting tied into the gun control issue, because of specific, highly publicized events like the recent Newtown elementary school tragedy. Mentally ill people, going on a rampage, makes for tragic and dramatic news stories, but the actual connection to gun violence and the mentally ill, has only a very slight overlap, and there are countless studies conducted over the past many decades that back this up.

As easy as it would be to assume that there is a stronger connection between mental illness and gun voilence, the truth is, that there is actually very little connection, and many mass shootings were not perpetrated by individuals who have been diagnosed with mental health problems, identified as being "dangerous", or even been involved with the mental health system. Not only that, but mental health professionals typically find it actually very difficult to identify individuals who are likely to go on to commit acts of violence, and even when they do manage to identify potentially violent people, current treatments are not necessarily effective in preventing their violent behaviors (especially if they have inconsistent medication intake, if they are, in fact, even on medication in the first place). This is a much more complicated issue, than seeing someone walking down the street, on a subway or bus, and tagging them as "dangerous", when, despite seemingly disturbing behavior, they may not actually be a danger to anyone, even themselves.

An aspect of a solution that many have proposed lately, has been to make lists of "potentially dangerous individuals", and THAT is a primary aspect of this issue with which I have a problem. As I said, to a large part of the general population, there already exists a stigma against mental health, and a "list" would do nothing, but complicate the issue for literally millions of Americans. As it is already, many people with mild, potentially treatable conditions, or issues that could at least be managed and controlled more easily, rightfully fear the stigma that any involvement with the mental health system may bring, adding a very real aspect of paranoia, that has nothing to do with possessing a mental condition of paranoia.

These lists would drastically aggravate this issue, and could easily affect the individual's employment potential, or even schooling, especially if financial aid or grants became involved. Suddenly, our "land of opportunity" would be one very scary step closer to certain totalitarian governmental policies in the not-too-distant past, like Nazi Germany, or even reminiscent of the "red scare" in our own United States.

No one would want to be on that list, and it certainly wouldn't catch and identify people like the Newtown shooter, ahead of time, and preventing the tragedies they perpetrate. What it WOULD do, would be to potentially, and unnecessarily harass people who might just be socially awkward or even excessively bright or creative, who already face the bullying of their peers. Just because someone is "different" does NOT make them a threat to others, nor a potentially dangerous person; it is often the people who appear "normal" (on the outside), that are the ones who commit atrocities (eg. Ted Bundy). In fact, these "out of the box thinkers" are much more of a benefit to society, than a threat.

This begins to tread into yet another controversy, about certain traits being described by some, as being "disorders" (ADD, ADHD, etc), while being considered by others, as just being"energetic and intelligent", or "out of the box" thinkers, or "creative" traits. I will not go down that path here and now, except only to say that this issue would also become aggravated, if there was suddenly a "hit list" that identifies people who have had been diagnosed as such, or had any sort of treatment of any kind, in the mental health system. A list that could all too easily, be abused far beyond its original intentions; a very slippery slope indeed.

The bottom line is, those with mental health issues need TREATMENT, not further stigmatization. These issues are not as simple as an individual going in to a doctor, diagnosing an ear infection, and taking antibiotics to clear it up. These issues are different from person to person, and the treatments vary widely. Some individuals would have the best results from consistent counseling (psychology), others may respond better to certain drug/chemical treatments (psychiatry), and even then, what works for one individual, does not necessarily work for another, which is why people who take antidepressants, often have to shift from one kind to another, as the patient and doctor identify what works best for them. There are simply too many factors to make it an easy, "talking point" answer.

As I stated earlier, this is not a new issue, the understanding of the brain, its chemistry, and complex workings, IS a relatively new science. We know so much more now, than we did even 30 years ago, but there is a lot of work yet to be done in this field. Making "witch lists" would only complicate the problem, causing many people choose to go undiagnosed (and untreated), and further complicating the entire issue. Taking that even a step further, to MANDATORY testing, and analysis, would not help, either. In the end, the real madness would be those who would seek to impose such totalitarian concepts on our society, that strives to be free to pursue happiness.

If the solution to this issue is truly being sought, it should be sought in the form of supporting the desperately under-funded state mental health systems (as just one example, just look at the details of Michigan's mental health system, if you want to have a rude awakening on this subject). The money spent on creating some national witch-hunting list of the mentally ill, would be money spent complicating the issue, which would not yield tangible results, and would be money much better spent on improving the mental health systems themselves, including research. To REDUCE the stigma, not accentuate it, is the path to preventing further tragedies that result when the mentally ill, and guns get into a lethal combination.

The hard fact of the matter is, no one thing will be a magic solution to this issue, but we need not further complicate it, or toss into the melting pot, multiple aspects of the overall problem, and try to make it all one comprehensive issue. That is a drastic over-simplification, and would result in further tragedies. I do not blame any political party, there is no "bad guy" in this discussion, it is just merely the FEAR, that is the negative element, and just as President Franklin D. Roosevelt famously said, "the only thing we have to fear, is fear itself!"

We cannot stand by, like a mindless mob, full of anger (against the violence delivered upon the innocents) and fear (of the mentally ill), and allow these issues to be bundled up together, and made into laws which will inevitably disenfranchise an entire segment of our society. With treatment, better funded mental health systems, and an atmosphere encouraging people to seek diagnosis and treatment, without fear of "reprisals", be it from some national "list", or a potential future employer, or a bank possibly making a mortgage loan on a house, we can help to revive the overall mental health of our nation, and the positive effects will very naturally follow. Or we can stubbornly not learn from history, and repeat its tragedies, take a negative stance against mental health (while undoubtably CLAIMING to be doing something for the GOOD of the mentally ill), and negative effects will inevitably follow, it IS our choice, and we DO have a choice at this point in time.

To punctuate the point even further, what if the qualifications of what is considered "dangerous" or "mentally ill" suddenly shift in your lifetime, and suddenly encompass YOU? By then, it would be too late to change the laws in place (not to mention the fact that no one would listen to someone on "the list"), and the things you would have to fear, would be far greater than some "crazy person" shooting up the mall, while you happened to be there... it would be a REAL threat to you, your family, your life, and your future, and a threat that would plague you, along with millions of others, constantly... so think about this issue NOW, before it becomes a bigger problem.

Gun violence, and the issues of gun control, high capacity clips and assault weapons bans, are very much the hot topic of the day. There are so many aspects to this issue, and when it is related to the Newtown shootings, the subject complicates, almost exponentially. Let us not carelessly jeopardize the freedoms that generations of Americans have enjoyed, fought for, lived for, and died for, by giving into a fear that is, itself, as insane as the madness of those we seek to prevent from harming us all. We should not replace one tragedy with another.

There are no simple answers, but by separating the individual issues, and addressing each issue on its merits, we can arrive at more thoughtful conclusions to the issue as a whole, when it is reconstructed.

1 comment:

Young said...

Thanks for your first post, Patrick! I absolutely agree about the effort to stigmatize the mentally ill, instead of focusing on solving the easy availability of guns.

Interesting to note that the language you used to defend those with mental illness or disorder is very similar to the language used by the pro-gun folks, especially with regards to creating a "list" and the totalitarian or fascist government.

Obviously, the major difference is that guns are mere possessions of choice whereas a person does not choose to be mentally ill, just like one doesn't choose to be gay or of a certain ethnic group. And I am going to flesh this out for my next post--right vs. privilege, choice vs. no choice, luxury vs. necessity, etc.--not to mention that gun ownership and fascinations are massively fueled by the gun industry.

Keep on posting!