Posted on 27 December 2012.
Debates over gun control vs. mental illness after a mass shooting are ridiculous kabuki dances that defy reason but have become so ingrained in our culture that their essential irrationality is invisible.
The dance begins with a tragic shooting rampage by a young man dressed in camo with a semi-automatic rifle or pistol. Gun-control advocates take to the airwaves calling, again, for greater regulation. Initially, the NRA and its shills, aware of their shameful political vulnerability at this moment, are quiet “out of respect for the grieving families. Soon, however, when pressed, they begin talking about mental illness and call for a “national conversation” about how to detect, treat, and handle these disturbed individuals and others who might become like them. Eventually, when the threat of regulation gains traction, they begin to play political hardball and fight any reforms at any cost. The Newtown killings were different only in that we got to watch the Executive Director of the NRA, Wayne LaPierre, prematurely and inelegantly open his organization’s kimono a bit and reveal the true extent of an underlying delusional and paranoid view of the world when he advocated armed guards in every school in America.
I’m not going to argue the mainstream progressive position on gun control, only because it is well known and, in my opinion, occupies the only rational and humane space in this debate.
With the exception of Wayne LaPierre’s dark ravings about ways to solve gun violence by putting more of them in the schools, the Right has made all the expected moves on the dance floor, beginning with their argument that gun control won’t stop deranged individuals and that unless we talk about mental illness, we’ll never get to the bottom of the problem. Obviously, intended primarily as a distraction — changing the subject by feigning concern for the mentally ill — the Right’s call for more skillful psychiatric detection and care is also morally and intellectually corrupt for other reasons that are rarely discussed.
For example, let’s say we pretend that calls for a “national conversation” about mental illness and violence aren’t just crass political dissembling. Let’s stipulate what I believe is self-evident anyway, namely, that Adam Lanza was extremely mentally ill, desperately needed psychiatric help, and didn’t get it. Finally, let’s even accept the sanctimonious contention by the Right that addressing the issue of mental illness is crucial to a long-term solution to the problem of rampage killings like the ones that occurred in Newtown.
The insincerity of conservatives talking about mental health and illness is immediately apparent: If the Right were serious about solving extreme gun violence by taking the mental health road rather than the gun-control road, the effort involved, not to mention the cost would make the War on Poverty and the Great Society look like a walk in the park and their cost mere chump change. It would involve the greatest expansion of government involvement in the lives of Americans in the history of the republic. Conservative NRA zombies in the media would have to renounce their core beliefs, radically reverse everything they believe about government, taxes, and deficits — in effect, they would have to have brain transplants.
Let’s look at what would be required if we took seriously what conservatives are hypocritically proposing:
- Pre-natal care: There is abundant evidence that pre-natal and perinatal insults and traumas can cause certain types of subtle brain damage often found in scans and autopsies of serial killers and mass murderers. Conservatives, then, should advocate for universal health coverage, pre-natal screenings, extensive maternity care, and a massive public education campaign about prenatal and especially perinatal health.
- Early dysfunctions in parenting: However genetics and biology contribute to temperament, it’s universally accepted that the “fit” between baby and caretaker is as important, or more important, in the eventual expression of those genetic and biological givens. Neglect, abuse, stress, and even a simple but deep lack of understanding of child psychology regularly produce huge reservoirs of depression, anxiety, aggression, and maladaptive behavior later on. But they’re treatable. San Francisco General Hospital, among others, pioneered a program in which young at-risk single mothers with newborns were treated with a psycho-educational and supportive approach by trained mental health experts who helped these mothers better understand what their child was feeling and why, and how to appropriately respond. Such treatment, often combined with house-visits, support groups, and comprehensive medical care all resulted in hugely positive mental health outcomes for these children, children who otherwise might be prime candidates for disorders of impulse control and violence. Thus, if they were serious, conservatives would be advocating for a massive public investment in these programs, not just for the poor, but for all new mothers.
- Headstart and other early education programs have been repeatedly demonstrated to contribute to greatly improved psychological and educational adaptation later in life. Obviously, then, conservatives should advocate for exponentially increasing funding for Headstart and kindred early-intervention programs, rather than be obsessed with cutting them.
- Special Education Programs: Children with cognitive, emotional, and physical disabilities, either those that are obvious or the softer ones, should get special care, and such care is extremely difficult to find. Adam Lanza was weird from an early age. One would not have had to be a psychic to identify a problem, and, therefore, wonder if Lanza could have been given special attention from early on. Such care exists and is effective. I’m waiting for the Right wing to take to the streets demanding massive increases in funding and training for special education programs and experts.
- Smaller class sizes and better teacher education: If class sizes were radically reduced, not only would children learn more, but teachers could observe and help individual students who are clearly having difficulties, not only in learning, but in their social adaptation. And if they were trained to identify psychologically troubled kids and had a wide menu of options available to them vis-a-vis assessment and treatment, these “first-responders” who interact extensively with our children every day could greatly improve early-detection. Therefore, one reasonable “mental health”-type approach to this type of violence would include education reform, increased school funding to allow smaller class sizes, better teacher training, and an increased emphasis on social and psychological functioning in addition to the three Rs. The silence from the Republican side of the aisle is deafening.
- Psychiatric Care: Given that there were signs of Lanza’s peculiarities from a relatively early age, he should have been offered good and intensive out-patient psychotherapy, affording him the chance to develop a relationship with a psychological provider who could have followed Lanza over time, acting in addition as a liaison between the school, Adam, and the Lanza family. Medications might have been helpful. If the family refused, pressure could have been brought to bear. But such resources are scarce, expensive, and usually outside the contractual purview of most insurance plans. I can just hear the clamor in Right wing circles for dramatic increases in funding for training mental health professionals and for underwriting massive increases in spending for mental health outpatient care.
- Group treatment programs: Buy the time Lanza got to high school and onward, his psychiatric symptoms were flagrant. He was withdrawn and paranoid. He needed to be in a caring and effective group home, half-way house, group-treatment program, or hospital. But anyone who has looked for such resources nowadays, particularly ones that allow and encourage long-term treatment at a high level, knows that they are both rare and prohibitively expensive. With the advent of de-institutionalization in the 1970s — a shift driven primarily by budgetary considerations — good long-term residential treatment facilities began to disappear. Can anyone imagine a conservative politician supporting a radical reversal of this trend?
These are just a few things that could be done to greatly improve our chances of identifying potentially dangerous and mentally ill individuals early on, and treating them before they go past the point of no return. The cost? Huge. The difficulties of radically reversing current trends in the funding, much less the understanding of the causes of mental illness and its prevention and treatment are even greater.
A broad liberal agenda, of course, would support all of these things. The very core of the conservative agenda, however, including its right-wing NRA faction, is antithetical to improving the very initiatives that their pundits deceptively and speciously advance. Not only are NRA-affiliated spokespeople ignorant about mental illness, but they deceptively use this issue to fool people into thinking that they aren’t simply pursuing the narrowest of self interest, but have broader and more human social concerns as well. When it comes to the psychiatric issues they urge us to consider, they lack complete credibility. In any real “national conversation” about the early detection and treatment of mental illness and violence, the NRA and its conservative proxies and talking heads would be mute.
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