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[Opinion] Texas and Ohio Mass Shootings: Gun Violence Associated with Mental Health Is A Myth

8/6/2019

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The National Alliance on Mental Illness (NAMI) denounced the relationship between gun violence and mental health after the recent mass shootings in Texas and Ohio purporting the need for common-sense legislation to address this public health crisis since research suggests the mentally ill are more likely to be victims of violence rather than the perpetrators.
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​The National Alliance on Mental Illness (NAMI) released a formal statement indicating that the public is misled when people with mental illness are iniquitously presumed culpable in the national conversation on gun violence everytime we experience a mass shooting tragedy

According to NAMI (2019), the national discourse on gun violence is contrary to research findings and only “serves to perpetuate stigma and distract from the real issues.”

NAMI further advocates gun violence restraining orders, or “Red Flag” laws for ending gun violence to remove guns from anyone who poses a real, evidence-based risk of violence, and to prevent erroneously targeting people with mental health conditions.

Evidence-based criteria on the relationship between gun violence and mental health
There are certain conditions that increase the risks of violence among a small portion (only about 4%) of the mentally ill.

Determinant factors that increase risk of violence:
  • Co-occurring abuse of alcohol or illegal drugs
  • History of violence
  • Being young and male (not race specific)
  • Untreated psychosis

According to NAMI, although treatment is the most comprehensive way to reduce risk of mental illness escalating to gun violence. less than 1/3 of adults and 1/5 of children diagnosed with mental illness are treated in a given year.

Still, research suggests that most people with mental illness are not violent and are most likely to harm themselves or fall victim to violence rather than become perpetrators.

The hypocrisy, deflection, and rhetoric that undermine appropriate gun laws
It is important to point out that the current Administration immediately revoked the Obama-era legislation preventing the mentally-ill from buying or owning guns.

The very group touted as a root cause of the gun violence epidemic.

On February 28, 2017, President Trump signed the H.J. Res. 40 (Public Law No. 115-8) into law which reversed Obama’s Executive Order to add the names of approximately 75,000 recipients of Social Security for mental illness to the national background database (NICS).

Spokesmen for the Trump Administration claimed that the Obama bill was rolled back because it included all disabled persons who were capable of responsible gun ownership.
This is untrue.

The Obama rule would have, however, made it difficult for persons with mental illness to purchase or possess guns.

The NRA suggests that the Obama regulation infringed on Second Amendment Rights to buy guns when, in fact, the rule specifically targeted people receiving social security checks with a clinical mental health diagnosis.

In recent statements, the GOP blamed mental illness and video games for the rise in gun violence and mass shootings.

​But critics indict Trump and the GOP as complicit in the crisis along with those who have the propensity, capability, and access to exact mayhem on the public by avoiding the real issues like banning military-style assault weapons and racism.

National Disparities in Access to Mental Health Care
NAMI reports, of the one in five Americans who suffer with mental health conditions, only 43% accessed care in 2018.

​The lack of mental health professionals throughout the country is a significant factor in the mental health treatment disparity.

According to the National Alliance on Mental Illness (NAMI), more than 60% of U.S. counties do not have a single psychiatrist causing long waits in accessing care for victims, survivors, and first responders impacted by gun violence tragedies.

NAMI calls for a national priority for access to mental health care by Congress and the Administration to assist those who are traumatized and protect communities especially during times of senseless violence.

It is recommended that policies and programs are available which provide access to:
  • Early diagnosis and intervention
  • Appropriate treatment and support
  • Integrated treatment for co-occurring substance use disorders (SUD)
  • Family education and support
  • Crisis intervention (emergency services)

Federal and state policy and program recommendations are based on removing barriers for people who are willing to seek treatment when they need it and improving access to treatment as a solution to gun violence associated with mental illness.

​Links are provided below for more recommendations for federal standards to remedy gun violence associated with mental health.
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Mental Health Care Disparities in Michigan
Southwest Solutions released a report of unmet mental health and substance abuse treatment needs in Michigan according to a study by the Michigan Health Endowment Fund (July 2019).

According to the report, one in six Michiganders experience mental illness, yet approximately 38% are not receiving treatment.  That is nearly 660,000 individuals with mental health conditions are going untreated.

About 50% of untreated mental health cases are in the Detroit area.

​Likewise, an estimated 80% of the 638,000 Michigan residents with substance use disorders (SUD) are also untreated.

Related factors in untreated mental health care:
  • Of the 2 million Medicaid recipients in Michigan, 481,000 experience mental illness and 148,000 have substance use disorders (SUD).
  • Of the 5.6 million Michigan residents with private health insurance, 890,000 experience mental illness and 372,000 have substance use disorders (SUD).

Across payor types, Medicaid recipients are most likely to remain untreated for mental illness.
  • Half of Medicaid enrollees, or 49%, that is, almost 236,000 people with mental illness and 69% of Medicaid recipients, or 102,000 people with substance use disorders (SUD) are not receiving treatment.
  • 1/3, or 34% of the privately-insured, that is, more than 305,000 people with mental illness and 87%, or, 324,000 with substance use disorders (SUD) not receiving care.
  • 1/5 of Medicare enrollees

Mental health disparities for people with specific disorders who lack appropriate care or do not receive treatment are also highlighted in the report:
  • 46% of people with anxiety disorders
  • 53% of people with depressive disorders
  • 85% of people with alcohol use disorders

Additionally, 41% of male children and more than 1/3 of female children (ages 0 -17) with mental illness are not receiving care in Michigan.

The study cites a combination of factors for the mental health care crisis in Michigan, such as a shortage in mental health professionals including psychiatrists and other behavioral health providers which limits access to treatment.

According to the report, the availability of mental health services fall short of national ratio standards particularly in the northern half of the Lower Peninsula and parts of the Upper Peninsula.

Michigan has 11 child and adolescent psychiatrists per 100,000 residents far below the recommended 47 to 100,000 ratio.

Mental health residential treatment facilities are also in short supply in Michigan.  With only 17 facilities over-populated with 590,000 consumers per facility far beyond the U.S. average of 240,000 per residential facility is also an indicator for the gap in services.

Other factors for untreated mental illness in Michigan:
  • Unaffordability
  • Inadequate insurance
  • Reduction in services
  • Shortage of treatment professionals and facilities
  • Lack of transportation
  • Stigma
  • Medication management concerns
  • Insufficient education in understanding mental illness and substance use disorders (SUD) that benefit treatment and outcomes.

A link is provided below for more information on policy and program recommendations to improve access to mental health care in Michigan.

​Michigan Gun Laws
Michigan ranked #26 as one of the best states for gun owners in 2018.

Why? Because the Republican controlled Michigan Legislature has worked to relax gun restrictions for the past eight (8) years despite the rise in mass shootings, although not in Michigan, but around the country.

Former Republican Governor, Rick Snyder considered red flag legislation in 2018 that is currently supported by Democratic Governor-elect, Gretchen Whitmer.

The proposal allows for family or law enforcement to obtain an “extreme risk protection order” on an individual who poses a valid threat of danger to themselves or others to be banned from buying or owning a firearm for a specified amount of time.

But due to partisan divides and Republican control of both chambers it is not likely in the foreseeable future that legislative reforms to purchase or carry in Michigan will change.

Michigan GOP leaders posit that “red flag laws would violate an individual’s rights to due process and ignore the underlying issue of the country’s mental health crisis”, according to Rep. Beau LaFave (R-Iron Mountain),

The problem with this assertion is that studies by reputable mental health organizations suggest that mental illness, the most pervasive public health crisis in America is rarely associated with the rise and extent of mass shootings we’ve experienced in recent years.

While some argue that mental health is the fundamental problem, others cite the growing deterioration of race relations (racism) as the real issue.

And, in fact, young, male, white nationalists have tended to be the recurring theme as culprits in the majority of these “hate crime” massacres as of late.

What is President Trump doing to address gun violence?
In the press conference held in the wake of the El Paso and Dayton shootings, President Trump addressed with his proposed plans to address both the gun violence and mental health crisis.

The president persisted in the rhetorical dialogue that culture, video games, and mental illness underpin domestic terrorism.

In an attempt to condemn racist acts of violence, President Trump states, “culture must be shifted from one that celebrates violence to one that celebrates the inherent dignity and worth of every human life.”

He further quotes, “Mental health and illness pulls the trigger not the guns.”

Some of the steps he promises to take to end and prevent gun violence include:
  • Ordering the Department of Justice (DOJ) to work with state and local authorities as well as social media companies to develop new technology as tools to detect mass shooters before they strike.
  • Reform mental health laws to better identify those who may commit acts of violence, make sure they get treatment, make sure they do not have access to guns, or, if necessary, remove those guns from them through rapid due process.
  • Recommends the involuntary confinement of mentally disturbed persons who pose grave risk to public safety.
  • Instituting the “extreme risk protection orders” red flag law.
  • Encouraging the DOJ to propose laws that will reinstate capital punishment for domestic terrorists.

There was no mention of reversing the H.J. Res. 40 to add the names of individuals with mental health diagnoses to the national database system.

Conclusion
A common denominator in the two studies presented here indicate disparities in the treatment of mental illness as adequate and efficacious access to care.

But the erroneous assumption that mass shootings are inextricably related to mental illness is an impediment to empirical research evidence.

The narrative must be reframed in national dialogue if legislators and society-at-large are serious about the intervention and prevention of senseless killings whether its mass shootings, hate crimes, or other forms of gun violence.

It is a complicated issue that requires legislative urgency but also must involve comprehensive public policy reforms related to the primary issue.

For example, occupational licensing reform may be necessary so as to expand the scope of practice for paraprofessionals to fully leverage the reach of providers in meeting mental healthcare needs.

Gun violence laws must be approached in much the same common-sense way so as to target individuals who pose a real threat to public health and safety.

For example, the 41% of young males (not race specified) identified in the Michigan study as a mental health disparity due to the lack of access to treatment.  This would be an appropriate demographic that should be considered when constructing and proposing gun laws.

Consequently, young males were also identified in the national study.

Mental illness, however, can be a factor in relationship with mass shootings and other gun violence but under very specific and extremely rare conditions that should not be generalized to the entire mental health population.

Unfortunately, while President Trump fell short in declaring war on racism it also became clear that the president and his cohorts will continue on course to scapegoat mental illness as the priority target.

The real positive takeaway from the President’s response is the change in language.  Due to the NRA’s zero-tolerance approach to gun rights, reframing the problem as domestic terrorism just may ignite political action or, at least, a public outcry for action.

But the public overall has been transient on the issue of gun laws and reform mainly because of cultural wars where some individuals and communities resist the idea of government infringement not only on their rights but also on their social norms.

​But casting mass shootings in the framework of terrorism changes the level of the threat and provides some opportunity for change.

Consult the articles below for more information on proposed gun law legislation in Michigan and the potentiality of gun restrictions that may inadvertently target African-Americans.

Related Posts:
Michigan’s Health Report: Chronic Disease and Life Expectancy
https://www.canmichigan.com/blog/michigans-health-report-chronic-disease-and-life-expectancy
Community Resources: Mental Health and Drug Treatment Services
https://www.canmichigan.com/community-resources-michigan.html

Links:
NAMI Statement on Mass Shootings in Texas and Ohio
https://www.nami.org/About-NAMI/NAMI-News/2019/NAMI-Statement-on-Mass-Shootings-in-Texas-and-Ohio?fbclid=IwAR2naCqi_Hrr397UgK9DKMyBlJGQS77VfYJ8ZikMk6Ta-SFPJj8HV76G9-s

​NAMI: Violence and Gun Reporting Laws
https://www.nami.org/learn-more/mental-health-public-policy/violence-and-gun-reporting-laws

Trump made it easier for the mentally ill to get guns when he rolled back Obama regulation
https://www.nbcnews.com/news/us-news/president-trump-made-it-easier-mentally-ill-get-guns-when-n1039301

H.J. Res. 40 – 115th Congress (2017 -2018)
https://www.congress.gov/bill/115th-congress/house-joint-resolution/40

Southwest Solutions: Study Details Growing Crisis of Untreated Mental Illness in Michigan
http://www.swsol.org/study-details-growing-crisis-of-untreated-mental-illness-in-michigan/?fbclid=IwAR0fn399qwATeQEA4i_CH_zQr-fZUd62N8hU3P-_Rx92s1QBSPOFPGhzjbk

Massacres revive calls to strengthen Michigan’s middling gun laws
https://www.detroitnews.com/story/news/politics/2019/08/05/anger-but-action-michigan-gun-laws-spotlight-after-mass-shootings/1923417001/

​Actually, gun restrictions will target the black community
https://thehill.com/opinion/criminal-justice/456243-actually-gun-restrictions-will-target-the-black-community?rnd=156503347
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    Deborah Mitchell

    Welcome to The Community Advocate Network.  My name is Deborah Mitchell,  I am a graduate in Social Work and Registered Social Work Technician.  My human service background began in 2007 which includes medical case management and service navigation for the indigent population, outpatient mental health counseling with substance use and abuse disorders, supportive employment and job development for mental health consumers, and structured living domicile management.

    In 2016, I completed my Bachelors Degree in Social Work and began my graduate studies at Wayne State University in Detroit, Michigan.

    On this platform we will be reviewing social topics and news and providing resources to community programs and services.  It is my goal to maintain a recovery-focused, service-oriented environment while working to expand the capacities of individuals, families, groups, organizations, and communities in developing and restoring optimal social and economic functioning.

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