Can we borrow terminology to help identify—and address—the mental issues associated with gun violence?
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In the gun violence debates, mental illness inevitably comes up as a possible contributing factor. Research seems to suggest that mental illness, or mental disorders per DSM terminology, will only increase the risk of committing gun violence if it is a diagnosable disorder without effective treatment. Otherwise, as the June 1, 2022, “Statement from the American Psychiatric Association on Firearm Violence” states: those with mental disorders are more at risk to be victims rather than perpetrators.
However, there is a whole middle ground on the spectrum between so-called normality and DSM 5 disorders that seems to be left out of these discussions. Almost by definition, those committing gun violence other than self-defense must have some sort of mental abnormality. Borrowing terminology from the field of meteorology, I would use the term mental disturbances, as disturbance is commonly used in weather forecasting to describe a change in atmospheric conditions or patterns. And, at its worst, these disturbances can end in a disaster.
In psychiatry, the disturbances between normality and official disorders can include many possibilities, potentially enough for a classification of their own. Among others, they can include the perpetrators and/or victims of: gun violence, inappropriate hate, criminals, burning out, xenophobias, racism, terrorism, domestic abuse, and cults. Obviously, many of these are connected to potential gun violence. All of these will usually have some degree of symptoms and impaired functioning, although they may not reach the threshold for a psychiatric diagnosis.
There are interventions that can address such mental disturbances, even if it is not formal psychiatric treatment. In gun violence and burning out, for instance, our systems need to change for the better. Coaches, ranging from life coaches to spiritual coaches, and a wide variety of counseling services, have likely evolved in part to help this middle ground of mental well-being.
Due to the range and prevalence of such psychopathology, these problems should not be medicalized, and psychiatrists do not need to be extensively involved. However, the field should consider adding such mental disturbances to our public mental health concerns. After all, we ourselves have the highest prevalence of burning out, which also adversely effects the outcomes of our patients.
Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism. He serves on the Editorial Board of Psychiatric Times™.