DSM5 in Distress

The DSM's impact on mental health practice and research

Gun Control Can't Work If Restricted to the Mentally Ill

Guns kill people; assault guns kill lots of people.

The bad news is that it takes recurring tragedy to restore interest in a sane gun control policy. The worse news is that any meaningful legislative relief remains very much a long shot. Hypocritical politicians are likely to do nothing at all or find cosmetic excuses to avoid the hard choices necessary to protect us and our kids from this epidemic of avoidable violence.

Perhaps the easiest way out for the politically timid will be to limit themselves to gun control for the mentally ill. This is long overdue, but won't help much and doesn't go nearly far enough—kind of like applying a band-aid to the gaping wound inflicted by an expanding, high impact bullet.

We must go much further. No civilian—mentally ill or not—ever needs or deserves access to a military-style assault weapon that is capable of killing dozens of people in a few short minutes. The pleasure that some gun enthusiasts seem to take in owning and firing these weapons is not an inalienable constitutional right deserving second amendment protection.

I challenge even hunt-happy Justice Scalia to make the case that the constitution requires allowing the de facto militarization of one portion of our civilian population when doing so presents such a clear and present danger to the rest. We have successfully outlawed these ridiculously powerful weapons in the past and must now do so again.

There are five reasons why targeting only the mentally ill will have little effect in preventing homicides:

•While they are somewhat more prone to violence than the general population, the mentally ill account for only a small percentage of homicides.

•It is impossible to predict in advance who is likely to become violent and when.

•The mentally ill most likely to commit violence often avoid mental heath contact and likely won't leave a computer trail to alert authorities.

•It is impossible to guarantee security once the gun is sold. The Newtown killer used weapons purchased legally by his mother. If enough assault weapons find their way into American households, some will inevitably wind up in the wrong hands and repeated mass murders will be the unhappy result.

•The boundary between mental illness and normality is fuzzy and arbitrary, providing no practical way for deciding how much restriction should be applied to whom.

The biggest benefit of better gun control for the mentally ill would be a reduction in firearm suicide, not homicide. This is beneficial, but not enough.

Gun control advocacy groups have previously endorsed efforts that targeted the mentally ill on the theory that this was all that could be accomplished given the political climate and that some gun control was better than none. This was reasonable then, far too unambitious now.

The goal now should be to restrict everyone's access to military grade weapons and also to regulate gun show distribution channels.

The NRA is stubbornly doubling down—making the ludicrous suggestion that we continue to allow wide access to military-grade offensive weapons, but establish a defensive perimeter around and within our schools to protect against them. The radical ideologues who control the NRA would encourage a continuing arms race that will result in even more murder, mayhem, and shootouts. This is the path of madness.

Politicians, now is the time to declare your fealty. Do you care more about the safety of kids or the campaign contributions of the NRA? Our country must not continue to be held hostage to this deadly plague.

Allen Frances, M.D., was chair of the DSM-IV Task Force and is currently professor emeritus at Duke.

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