PsychiatricTimes Members: Login | Register
PsychiatricTimes SearchMedica Medline Drugs

Powered by SearchMedica

 
Risk Assessment
News
Current Issues
Blogs
Special Reports
CME
Conferences
Resources
Careers
Multimedia
About Us
 

Home » Blogs » Frances

Psychiatric Times.
 

Mass Murders, Madness, and Gun Control

By Allen Frances, MD | July 30, 2012

The US has averaged 2 episodes of mass murder a year for the past 15 years. And the odds are good that we will carry this sorry record forward forever into the future. Each tragedy provokes a predictable round of shock, grieving, soul searching, and finger pointing. Why would someone do something so crazy? Who missed what warning signs? Why weren’t the victims better warned or better protected? What can we do to prevent this type of awful tragedy from constantly recurring?

Everyone is intensely interested in the psychology of the killer. There is a presumption that if we can understand the mind of the mass murderer then perhaps we can prevent the mass murders. This is dead wrong. Psychiatry has no way of predicting or preventing rare and fairly random acts of senseless violence—it is simply impossible to find needles in haystacks. We must accept the fact that a small cohort of deranged and disaffected potential mass murderers will always exist undetected in our midst. The only questions are how often will these ticking time bombs go off and how much damage will they do when detonated. 

(MORE: Mass Murderer Psychobabble Misses Gun Policy Point)

The largely unnoticed elephant in the room is how astoundingly easy it always is for the killers to buy supercharged firearms and unlimited rounds of ammo. The ubiquity of powerful weaponry is what makes the US such a dangerous place to live. Guns do kill people and the number of people depends on the number of guns and the number of rounds that can be fired in a given period. Successful political scare tactics have buried open discussion of the most obvious of simple truths—that the wide circulation of powerful, semiautomatic weapons will inevitably result in a lot of preventable deaths. So don’t be at all surprised when there are a couple of mass murders every year—it is built into our current system. The US has one of the developed world’s worst statistics for mass murders and gun deaths because we have so many powerful guns floating around and gun laws that allow murderers easy access to them.

Add to the mix the egregiously vitriolic and verbally violent discourse of demagogic politicians and talk show hosts—egging on those vulnerable to physical violence and providing them with a seeming justification for their callous brutality. And I wonder about the collective conscience of those working in the video game and movie industry who have promoted a grotesque culture of violence.

There is no psychiatric solution for mass murder. Armchair analyses of the individual culprits are interesting (but harmful) distractions. We really have only 2 choices:
• Accept mass murder as part of the American way of life
• Get in line with the rest of the civilized world and adopt sane gun control policies

The smart money is betting on the gun lobby and Hollywood—and betting against the future victims and their families.  

 

Join the Conversation

Want to join the conversation? If you're a healthcare professional, we'd like to hear your comments. Just sign in or register today to become part of our growing, online community.

  • Oldest First
  • Newest First

by kimberly cay | August 02, 2012 12:02 PM EDT

I completely disagree wtih the author. Gun control laws are the reason that this horrific event happened. Colorado has some of the most strickt gun control laws in the nation. If just one person in that movie audience had had a hand gun on them the mandman who got his weapon ILLEGALLY could have been shot dead on the spot. SAVING many lives. We don't need to keep more sane, rational, honest citizens from being able to protect themselves, their families and their possessions from violent criminals with legal guns. We don't need to keep lawabiding citizens from owning high powered rifles that can be used for self protection as intended by our nations founders. We need to pay attention and get involved. Often many people know beforehand about the instability of the gunman but do nothing. We need to erradicate the culture of political correctness and out of place tollerence and get to know our neighbors. We as a society need to instill empathy and caring for our fellows instead of pitting one against anther for the advancement of a particular group at the expense of another group.
Kimberly Cay MSN, RN-BC

by Bruce Miller | August 02, 2012 2:18 PM EDT

It is true that there will always be those with a mental imbalance. We are a long way from understanding the complex factors that make up a dangerous personality let alone mental illness. However to imply that such people will always be a threat, is to opine that society will never be educated enough to look and reach out to such people and that they will (as individuals) remain helpless to protect themselves or stop such acts of violence.

In the distant past people were somewhat limited both in the ability to cause harm to others and to the numbers of people around them. Today with increased populations and the ability to procure means of destruction - both legally and illegally those with mental illness have more tools to wreck havoc. This is a fact of population increases and improvements in communication. Unfortunately the down side of this is that it also enables those with felonious intent.

Unfortunately, those that intend harm are not deferred by laws or restrictions on guns. This is well demonstrated by the suicide bombers (around the world), or those that flew airplanes into the World Trade Center. In fact a listing of the deadliest terrorist strikes around the world shows that in only 3 out of 10 did the perpetrators need guns to accomplish their deadly intent.

Thus your statement that the USA has the highest mass murder rate is ONLY true if you limit such acts to only guns - and ignores the many acts of terrorism around the world. In reality the USA is not even close to the most deadly if all acts are considered. Neither is the USA higher in overall violent crime - in fact England - with extremely strict gun control laws has almost FOUR TIMES the violent crime rate of the US (2009 statistics).

Unfortunately gun control laws have proven that they are an abject failure - increasing not decreasing the risk to the population. Even ignoring the fact that Colorado is a gun control state, statistics prove that once a certain percentage of the population has the ability to protect themselves the violent crime rate drop drastically. (Murder and non-negligent manslaughter, forcible rape, robbery, and aggravated assault - FBI statistics 2011)

Furthermore despite the myth that gun restricted countries are safer the statistics prove otherwise! The USA is 13th from the top on the list of homicide rates per 100.000 people. Well below many countries with extremely strict gun control access.

It is also well known that people who feel in distress or danger do not reach out to others around them. Limiting a legal citizen's RIGHT to protect themselves - thus making themselves feel less secure will not increase their willingness to help or even recognize the distress of those around them. Instead it isolates them and makes them more vulnerable - individually and as a group.

Until and unless people take personal responsibility to both protect themselves AND to reach out to those with mental problems - to be caring members of society, such tragedies will continue to occur.

Narrowing your vision to blame gun laws is not just myopic but dangerous. It promotes the isolation of the individual when we should be educating and encouraging the public in ways that allow them to feel safe enough to help people in mental distress BEFORE they commit such acts - not blaming legal citizens and gun laws.

by Angelo Ferraro | August 02, 2012 2:50 PM EDT

Gun control was brought into Australia in the 1990s following the port arthur massacre. Since then, the number of mass murders (4 or more killings at once) reduced dramatically.
http://bit.ly/OzGJl1

by Stuart Twemlow | August 02, 2012 3:11 PM EDT

I agree 100%, although there are mathematical techniques that show promise in predicting very rare events, gun control will work as it did I think in canada when handguns were banned in the 1960's suicide & homicide went down
Stuart.W.Twemlow MD

by Ronald Pies | August 02, 2012 6:24 PM EDT

Thanks to Al Frances for his important opinion piece.

In my view, psychiatrists and other health care professionals cannot be credible advocates
for their patients' health and safety without also being proponents of reasonable firearm
restrictions. And, no--€"that does not mean confiscating guns, banning hunting, or repealing
the Second Amendment. It does mean taking sensible steps toward reducing the lethality
and availability of certain kinds of guns and ammunition. Furthermore, gun control goes
beyond the issue of homicide; it also touches on gun-related suicide, which is an enormous
issue for psychiatrists, ER doctors, and other health-care professionals. Of course,
increasing access to proactive mental health treatment-- including, in some cases, court-mandated
outpatient treatment--is also an important way of addressing the repeated instances of
mass violence in this country.

The right to self-defense is not at issue here--nobody needs a semi-automatic weapon with a
high-capacity clip to defend against a house break-in or any other reasonably likely case
in which a gun is required for self-defense. And nobody needs thousands of rounds of ammo,
available with a mouse click on the internet, in order to safeguard house or home. As for
the notion that the recent Aurora shooter could have been brought down by yet another
theater-goer with a gun: this is so implausible as to border on the absurd. Imagine a dark
room, filled with chaotic noise, where someone untrained in police or military tactics
is firing away, through a sea of bobbing, diving, lunging theater-goers, trying to hit
the gunman, while avoiding killing innocent patrons! I would like to see documentation of one
credible instance, within the last decade, in which such a "heroic second-shooter"demonstrably saved innocent lives. Of course, having an armed security guard on the premises of certain public venues,
well-trained in firearms use, is another matter, and one worth debating.

As I argued in my piece for Psychiatric News :

http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=108419&RelatedNewsArticles=true


"...According to research from the UCLA and the Harvard schools of public health,
homicide rates in the United States are nearly seven times higher than rates in other
high-income countries, driven by firearm homicide rates nearly 20 times higher.
In the population aged 15 to 24, firearm homicide rates are almost 43 times higher here
than in other high-income countries.

Moreover, contrary to some much-publicized but fallacious claims, both homicide and firearm homicide
rates in the United States are generally higher in areas with increased gun prevalence. Furthermore, permissive policies regarding carrying guns have not reduced crime rates, according to Dr. Garen Wintermute in the April 3, 2008, New England Journal of Medicine.

Suicide rates, according to the UCLA-Harvard study, were actually 30 percent lower in the
United States than in comparison countries--but the U.S. firearm suicide rate was almost six
times higher. Unintentional firearm deaths were also about five times higher in this country
than in comparison countries.

The UCLA-Harvard researchers, Erin Richardson and David Hemenway, have shown that
when we examine nonlethal crime and violence rates, the United States is comparable
to the other countries studied. The authors hypothesize that we are an "average" country
in terms of violence per se, but that our firearm-related crime rate may be driving up our
non-firearm-related homicide rate. For example, a drive-by shooting by one gang may
provoke retaliatory gang killings, using other means. Importantly, firearms make killing
extraordinarily efficient--€"especially when semiautomatic weapons with high-capacity clips
or magazines are involved, as in the Tucson and Aurora shootings. An attacker wielding
a knife simply cannot take down 20 people in 30 seconds.

Suicide rates in the United States are slightly lower than average compared with similar
countries, but the profusion of guns here increases the lethality of many suicide attempts .
The UCLA-Harvard researchers opine that U.S. suicide rates would likely be even lower,
relative to other countries, if firearms were not so readily available.

Some insist that limiting the availability of firearms will merely result in suicide by
other means. But appropriate firearms restrictions may buy valuable time, particularly when
the suicidal individual impulsively seeks to buy a gun. Thus, Andrew Slaby, M.D., writing
in the August 2001 Psychiatric Services, recounted the story of a suicidal man in New York
state who tried to buy a gun in a sporting-goods store, only to be told that it takes six
months to obtain a gun license. Temporarily put off, the man found his way into psychiatric
treatment and subsequently improved. Finally, numerous case-control studies in the United
States have shown that a firearm in the home increases the likelihood of both suicide by
firearms and overall suicide, for everyone in the household.

Placing sensible restrictions on firearms is not a "liberal" or a "conservative" position.
Such restrictions have been advocated by groups as diverse as the American Psychiatric Association
and the International Association of Chiefs of Police. Psychiatrists are sometimes called "ambassadors of reality." It is now time for us to become ambassadors of responsibility. We must become advocates
for reasonable limitations on firearms and ammunition sales.

Ronald Pies MD

(The author wishes to thank Becca Knox, M.P.H., M.S.W.; David Hemenway, Ph.D.; and
Garen Wintermute M.D., M.P.H., for their helpful comments and references on my article in
Psychiatric News)

Article Comment Pages: 1 2 Next


Related content

POINT: The Case for Gun Control

COUNTERPOINT: Gun Control and the Second Amendment

Mass Murderer Psychobabble Misses Gun Policy Point

Mass Murders, Madness, and Gun Control






 
TOPIC INDEX

Addiction Medicine
Alzheimer Disease
Anxiety Disorders
ADHD
Bipolar Disorder
Child & Adolescent Psychiatry
Dementia
Depression
DSM-5
Geriatric Psychiatry

 

Health Care Reform
Major Depressive
Disorder
OCD
Personality Disorders
Schizoaffective Disorder
Schizophrenia
Sleep Disorders
Somatoform Disorders
All Topics

 


 
MOST POPULAR
  • Most Popular
  • Most Emailed
  • Most Recent
  • Developmental Psychopathology Comes of Age
  • Grief and Depression: The Sages Knew the Difference
  • The Moral Struggles of Practicing Psychiatrists
  • Update on Mental Health Benefits and Substance Use Disorder Services Under the Affordable Care Act
  • Psychiatry and the Myth of “Medicalization”
  • Grief and Depression: The Sages Knew the Difference
  • Developmental Psychopathology Comes of Age
  • Psychiatry and the Myth of “Medicalization”
  • Synthetic Cathinones: Signs, Symptoms, and Treatment
  • Journey of the Traumatized Hero: Kerouac’s On the Road and Gandhi’s Railroad Ride
  • DSM-5: Where Do We Go From Here?
  • Suicidal Behavior: A Separate Diagnosis
  • New Insight Into the Neurobiology of Depression
  • Cultural Psychiatry and the 'No-Chicken' Doctor
  • Benefits of CAM Therapies for Dementia
Click here to subscribe to our newsletter
 
COMMENTS
  • Most Commented
  • Most Recent
  • Psychiatry and the Myth of “Medicalization”
  • Grief and Depression: The Sages Knew the Difference
  • Is it Time for a Treatment Manual to Complement DSM-5?
  • Diagnosis and its Discontents: The DSM Debate Continues
  • Lamotrigine for Major Depressive Disorder Is Inappropriate
  • Psychiatry and the Myth of “Medicalization”
  • Parity Laws: Powerful Weapon—or Pipe Dream?
  • The Moral Struggles of Practicing Psychiatrists
  • DSM-5 Won’t Solve the Overdiagnosis Problem—But Clinicians Can
  • NIMH vs DSM 5: No One Wins, Patients Lose
Click here to subscribe to our newsletter


 
CAREER CENTER

  •   Featured Jobs  
  •    Resources   
  • Psychiatry and Nurse Practitioner Opportunities
  • Associate Medical Director - Psychiatrist Delray Beach, Florida
  • Retiring Child Psychiatrist Seeks Replacement August 2010 or Before
  • Chairperson, Dept of Psychiatry Needed
  • FT Staff Psychiatrist - Excellent Benefits
  • BC Adult and Child Psychiatrits - PT and FT Positions Available
  • Managing Risks When Practicing in Three-Party Care Settings
  • 12 Tips for Making Your Practice Greener
  • Keys to Avoiding Malpractice: Standard of Care in Psychiatric Practice
  • Take This Job and Shove It
  • Merging Administrative and Academic Careers in Psychiatry


CancerNetwork | ConsultantLive | Diagnostic Imaging | Musculoskeletal Network | OBGYN.net | PediatricsConsultantLive |
Physicians Practice | Psychiatric Times | SearchMedica | Medical Resources

© 1996 - 2013 UBM Medica LLC, a UBM company
Privacy Statement - Terms of Service - Advertising Information - Editorial Policy Statement - UBM Medica Network Privacy Policy