We may never know what was wrong with Adam Lanza. And something was definitely wrong for him to brutally murder 20 children and eight adults, including his mother and himself. We know that Lanza had a "developmental disorder," and several of his classmates said they were told he had Asperger's Syndrome. That would match his brother Ryan's description of Adam as "somewhat autistic" and troubled by "personality disorder." Well, that could be anything from antisocial personality disorder — a.k.a. the thing that makes psychopaths psychopathic — to schizoid personality disorder. In any case, it appears that Adam Lanza suffered from mental illness, like many of the mass shooters in America before him. And it's inevitable that our nation is gearing up for a serious conversation about mental health and violence. Let's be careful what we say, okay?
Mental health is a deeply stigmatized topic in the United States. We've come a long way since the days that the mentally ill were treated like animals, though. The days of straight-jackets and lobotomies are behind us, but it's not really clear where we go from here. One suggestion that's been floated in the days since the shooting in Newtown is better funding for mental health care system. Great idea! Mental health advocacy groups have been saying this for decades, and when it looked like we might be making process a few years ago, the recession hit, setting efforts back significantly. Mental health is expensive. It's hard to find. Anything we can do to make it cheaper and easier would be a tremendous improvement for everyone.
Simply improving the mental health care system isn't going to stop mentally ill people from committing crimes, though. This is why many pundits are connecting the burgeoning discussion about mental health in America with the unending debate about gun control laws. "The mental health community needs to step up in a kind of way and figure out a way to keep the guns of the hands of people they know to be dangerous," The Atlantic's Jeffrey Goldberg said on Face the Nation Sunday. "We have a terrible problem. The vector is easy access to guns and dangerously mentally ill people." Others, like Utah Rep. Jason Chaffetz, have suggested that we take mental health into account when overhauling gun control laws.
This is where the conversation about mental health in the wake of Newtown gets dicey. Here, we stand the chance of discriminating against the mentally ill even more than we already do. The link between these mass shootings and mental illness is apparent, but more broadly speaking, the mentally ill are actually more likely to be victims of crimes than perpetrators. University of Michigan psychiatry professor Jonathan Metzl pointed out in an essay last year that “less than 3 to 5 percent of American crimes involve people with mental illness, and the percentages of these crimes that involve guns are actually lower than the national average – particularly when alcohol and drugs are taken out of the mix.” Metzl continues:
Beneath seemingly absolute questions of whether particular assailants meet criteria for particular mental illnesses lie ever-changing categories of race, violence, and indeed of diagnosis itself. As history reveals, decisions about which crimes American culture diagnoses as “crazy”, and which crimes it deems as “sane”, are driven as much by the politics and anxieties of particular cultural moments as by the innate neurobiologies of particular assailants. …
Ironically, the question of whether “the insane” should be allowed to “bear arms” becomes the only publicly permissible way to talk about questions of gun control. Meanwhile a host of other narratives, such as the mass psychology of needing so many guns in the first place or the anxieties created by being surrounded by them, remain oft-unspoken.
Of course, to let violence guide the conversation about mental health will inevitably stigmatize mental health further. Take the warning of Ron Fournier, a National Journal writer whose son has Asperger's. In the wake of the Newtown shootings, he begged readers not to let this event further stigmatize his son's disorder which we already don't know enough about to really say whether or not it could be linked to violent tendencies. "Don’t overgeneralize. Don’t stigmatize in a rush to explain inexplicable evil," says Fournier. "Autism did not cause this tragedy."
The sad truth is that while each successive shooting has prompted plenty of heated debate over gun control laws, there's been less of a focus on mental health. It seems that many people simply write off mass shooters as crazy before jumping back into arguing about guns, rather than figuring out how to get to the root of both facets of the issue. We can't ignore the fact that mental health services are frustratingly difficult to access in this country; let's also not ignore that in 2003, Medicaid provided around 26 percent of all national mental health services, and with the fiscal cliff looming, Medicaid is still on the chopping block. So while the gun debate is sure to rage far into the future, we cannot continue to pretend that mental health is an issue to be paid no more than lip service.
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