Note: I delivered the following brief address today and was asked to post it here.
Who among us does not yearn when we hear the lyrics of John Lennon's song, "Imagine": "Imagine all the people living life in peace" and "Nothing to kill or die for.
In the nonviolent tradition of Dr. Martin Luther King Jr., whose birthday we celebrate today, and in the wake of the Newtown shootings, we search for ways to live in peace. But the intensity of the outcry about Newtown, which was undeniably a tragedy, also highlights the lack of outcry over decades about the gun violence that has led to the killings of enormous numbers of poor children and children of color.
The money and resulting power of the National Rifle Association (NRA) have gone far to distract us from what really would reduce gun violence: Reducing the availability of guns, especially those with the greatest power to kill. I have read that the rate of suicides by people serving in the Israeli Army led to that army's establishment of this rule: That when their soldiers went home on leave, they had to leave their guns behind. The suicide rate declined.
I am a clinical and research psychologist, so my brief remarks today are about not only the NRA's stupid claim that "Guns don't kill people. People kill people" but also about the widely acclaimed proposals since Newtown for the implementation of background checks on people diagnosed as mentally ill and more treatment of those so diagnosed.
To claim that people who are diagnosed as mentally ill need more help to prevent gun violence is a huge cash cow for the stunningly powerful and wealthy lobby groups for therapists, such as the American Psychiatric Association and the American Psychological Association, and the drug companies. Anyone who is suffering deserves help, whether it comes from therapists or from others, and I would never want to deny them that help. But would such background checks and increased therapy and drugs reduce violence? Let us look at the facts.
To begin with, people diagnosed as mentally ill are not statistically more likely to be violent. It is especially amazing that this is the case, because increasingly, when someone is charged with a violent crime, therapists are brought in to diagnose them as mentally ill, so there is an apparent but actually artifactual (alleged), increasing correlation of being diagnosed with committing violence.
The RAND Corporation -- not particularly known as a bleeding heart organization -- has made it clear after its staff reviewed the relevant research that a diagnosis of mental illness is not a predictor or correlate of violence, but what are are being male and living in a particular geographic region (http://www.rand.org/blog/2013/01/can-improved-mental-health-care-prevent...). In some regions, purchasing a gun is much easier than in others.
In the same report, the RAND staff said that it is wrong to assume that mental health professionals have treatments that reduce the likelihood of violence, when in fact they do not. My own review of the research about both predicting and preventing violent behavior is consistent with their conclusions. They say it is wrong to assume that mass killings would not have happened if only the killer's therapist had done some particular thing.
The RAND staff note that there is a "dramatic gulf between what people imagine mental health professionals can do to prevent gun violence and what the current science will support." As a trained clinician, I have been distressed to learn how often people assume that therapists can fix anything. Sadly, we cannot. It is naive and wrong to assume that background checks for potential gun purchasers to see if they have been diagnosed with a mental illness will help.
Huge numbers of people, as I have seen in my four decades as a psychologist, are upset, bereaved, frightened, etc., by life events but should never be diagnosed as mentally ill are given psychiatric labels. So singling out those with diagnoses to try to prevent gun violence gives the false impression that knowing that people have been diagnosed as mentally ill will tell us how to prevent them from committing acts of violence will not in fact reduce violence.
A few further points about psychiatric diagnosis are relevant here. One is that about half of the United States population will during their lifetimes be diagnosed as mentally ill. Imagine the enterprise -- the financial cost and the time and energy -- of doing background checks on 150 million people...and with no chance of using those checks to reduce violence. Another point is that I served for two years on committees that were writing the manual of psychiatric diagnosis, and there I learned that these diagnoses are not scientifically based, and giving someone a psychiatric diagnosis simply does not improve the outcome, does not reduce the person's suffering (Paula J. Caplan. 1995. They Say You're Crazy: How the World's Most Powerful Psychiatrists Decide Who's Normal). In fact, giving these labels can cause a vast array of kinds of harm. To give just one increasingly common example: People who have been devastated by going to war are regularly psychiatrically diagnosed, most often with "Post-traumatic Stress Disorder," which is officially a psychiatric condition. But being devastated by war is not itself a mental illness; it is a deeply human reaction. And we need to remember that psychiatric diagnosis is also very often sexist, racist, ageist, classist, and homophobic and heterosexist (Paula J. Caplan & Lisa Cosgrove [Eds.]. 2004. Bias in Psychiatric Diagnosis.).
A final point about being diagnosed with mental illness is that these days, hardly anyone gets such a diagnosis without being put on one or two or three or even many more psychiatric drugs simultaneously. Although these drugs do help some people sometimes, at least for awhile, research has shown that far more often, they do more harm than good (Robert Whitaker. 2010. Anatomy of an Epidemic). Most relevant for why we are here today is that it is well-documented that they increase the likelihood of violent behavior, including both suicide and homicide. It is a secret too well kept that most or all of the school shooters in recent years have been on psychiatric drugs.
Speaking of the question of who is mentally ill, I will close with some words from Dr. King, noting that in today's Presidential Inauguration, much was said about the importance of truly equal opportunity and respect for all, and that needs to include people diagnosed as mentally ill. Remember that the line between the so-called mentally ill and everyone else is too often drawn by the wrong people, especially those who gain financially or otherwise from drawing that line.
Dr. King said: "The saving of our world from pending doom will come, not through the complacent adjustment of the conforming majority, but through the creative maladjustment [my italics] of a nonconforming minority." He also said in a speech to the June 27, 1956, annual convention of the National Association for the Advancement of Colored People: "...there are some things in our social system that I'm proud to be maladjusted to, and I call upon you to be maladjusted to. I never intend to adjust myself to the viciousness of lynch mobs; I never intend to become adjusted to the evils of segregation and discrimination; I never intend to become adjusted to the tragic inequalities of the economic system which will take necessity from the masses to give luxury to the classes; I never intend to become adjusted to the insanities of militarism, the self-defeating method of physical violence." (Many quotations about this subject from Dr. King are available at the MindFreedom.org website)
To reduce violence, we cannot allow the money of the NRA, the drug companies, and the mental health lobby groups to dictate what we do.
© copyright 2013 by Paula J. Caplan All rights reserved