Today President Obama signed 23 Executive Actions on Gun Violence, called Now is the Time (the .pdf of this document can be found on CNN.) Part of the plan talks about mental illness "even as we acknowledge someone with a mental illness is far more likely to be a victim of a violent crime than a perpetrator," says President Obama.
Now is the Time has quite a long plan for dealing with mental illness including encouraging doctors and other mental health care facilitators to report "direct and credible threats of violence to the authorities." It states the government will "Launch a national conversation to increase understanding about mental health: The sense of shame and secrecy associated with mental illness prevents too many people from seeking help. The President is directing Secretaries Sebelius and Duncan to launch a national dialogue about mental illness with young people who have experienced mental illness, members of the faith community, foundations, and school and business leaders." The government will also seek to ensure coverage of mental health treatment and provide more mental health services to children and youth since the majority of mental illnesses appear before the age of 24.
I am glad that mental illness is getting more attention and there will now be a national discussion on what good mental health care should look like. I am sad that this had to come about after a shooting when in fact, as the President said, people with mental illness are more likely to be the victim of a crime than a perpetrator. Having the conversation come about in this way just makes the stigma worse. The Presidents plan at least mentions the fact that the stigma against mental illness is high and we need a conversation around that so people can get the help they need. I would like to have faith that with more education the public will not equate violence with mental illness, but I doubt that will happen.
I think we have to face the fact that what really happened today is we have inadvertently greatly increased the stigma against people with mental illness.
I am not saying we should not be doing the things this document suggests, I just see the realities of what this means for people with mental illness since we tied better mental health care to a violent tragedy in our society.
In terms of reporting people with mental illness to the authorities, the document says to report "direct and credible threats of violence." To me this seems pretty clear that they will have some good guidelines on what is a direct and credible threat. Hopefully such things as cutting, thoughts of violence but no plans, even recurring violent nightmares will not be things that the government encourages to be reported. These are all things that do not actually indicate a violent person and are well taken care of in treatment. For instance, people with PTSD or even severe anxiety may see recurrent violent images in their mind, sometimes from an incident they saw in the past but do not really remember, incidents they do remember, or things they are afraid will happen. I could see how someone with these issues would not want to mention them because unless you have a really good mental health provider who understands mental illness and how the brain works, someone could completely overreact. This means less people will get help and they will be living with these scary images without learning how to resolve or diminish them.
What sounds even more concerning to me though are other laws like New York States new gun control law which "requires physicians, psychologists, nurses or clinical social workers to alert local health officials if a patient 'is likely to engage in conduct that would result in serious harm to self or others.' After an evaluation, the health officials would pass on the person's information to law-enforcement agencies that would be authorized to seize any firearm owned by the patient. If a person is found not to own any firearms, the patient would be added to a statewide criminal background check database, marking a significant expansion of who would be made ineligible to legally buy a firearm."
This is more of an issue for me because "serious harm to self or others" is not a very clear definition. What is "serious harm?" Also, even if you do not want a firearm and will never apply for one, you will now be added to the criminal background check database which could seriously affect your ability to get a job if this part of the background check that is accessible to employers. If it is, now your background check will forever state that you have a mental illness and no matter how stable you are, all employers will see is that something came up on your background check, not who you are. Again, this will lead to less people seeking treatment. As it stands right now, 60% of people with mental illness do not seek treatment due to stigma. This number will rise.
These are just some of the issues I see in this preliminary discussion of gun control and mental illness and I am interested to see where this goes. As someone who does not want a gun, I really don't care if I get on a list that says I can't have one. However, there are great police officers and military personnel who should be able to get treatment for their mental illness and not risk loosing their job. Also, it just makes me sad that I could be tossed on a list of "violent" people just because I have an illness which most people, even many mental health professionals, don't understand. No matter how we define all these terms of what is "violent," "serious harm," and a "credible threat," the fact is people are scared of those of us with brain disease and they will scapegoat us and overreact instead of trying to help and heal.
My best suggestion is that those of us with mental illness who can speak up, do. Tell our stories and show another side of the illness that is not all about relating the need for better health care to violence, but to the need that we create a community that helps people thrive.