The Kitchen Shrink

Psychiatry, health care reform, and parenting.

They Chose Guns Over Mental Health Care

Gun Control Is Not Enough

The Newtown, Tucson and Virginia Tech “shooters” all chose guns over mental health care.

 

As the nation strives to prevent further mass tragedies, we look to gun control. But a true solution must involve a serious examination of our mental health system. Even if Adam Lanza, Jared Loughner and Seung-hui Cho had no access to guns, they still would have been seriously mentally unstable and dangerous.

 

From the time of asylums, safety has been a primary purpose of psychiatric institutions. Treatment of mental illness was secondary, as antipsychotic and antidepressant medications were not invented until the 1950’s.

 

Why is our psychiatric system now failing to keep our communities safe?

 

It’s not that treatments today don’t work. Medications for serious mental illness are better today than ever. In fact, they are so user-friendly that atypical antipsychotics (Seroquel, Abilify, etc.) outsell any other class of medication including antibiotics, anti-hypertensives, and even cholesterol-lowering drugs.

 

The problem is that citizens in need often can’t access mental health care, or they look at the mental health system, and choose to avoid it.

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The only true solution will occur when mental health care is more accessible—and more desirable—than the alternative of getting a gun.

 

Yet here’s what happens before a patient gets to a psychiatrist. First, he must navigate his insurance company to figure out which psychiatrist his insurance will cover. Next, he must find a psychiatrist who will see him in a timely manner.

 

Once he gets to a psychiatrist’s office, he is confronted with a tome of paperwork regarding privacy, and commitments to pay. He may be nervous about signing these contracts—but if he doesn’t, liability and malpractice concerns will keep the psychiatrist from seeing him. If he finally makes it into the shrink’s office, the patient may only get a diagnosis and pills. Or, as some patients put it—“I’ll be told something’s wrong with me, and not the crazy world.”

 

All the while, in the course of seeking relief from his emotional torment, he is likely to hear many phone recordings directing him to 9-1-1 or the nearest emergency room.

 

This kind of “caring” has put our nation as a whole into a state of emergency.

 

Here’s a solution.

 

Caring and compassion have been the foundations of medical care since ancient times. They work far faster than pills—and they just might make mental health care more attractive than guns.

 

Yet in today’s health care system, a doctor must devote one-third of his/her time to bureaucracy. The doctor-patient relationship may last one session, if at all.

 

Let the recent tragedies remind us that any community is only as stable as the least stable citizen among us. Then let’s ponder the numbers. One percent of any population is schizophrenic. That makes approximately 3-million citizens among the US population of 300-million. Another one to two percent, or 3- to 6-million Americans suffer serious bipolar disorder. That is not counting citizens with addictions, other mental disorders, and people who are just plain crazy.

 

How much can gun control do?

 

Dora Wang, M.D., is the author of The Kitchen Shrink: A Psychiatrist's Reflections on Healing in a Changing World. She is a psychiatrist based at the University of New Mexico.

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