Reporting from Canada #5: Gun Violence and Mass Shootings in Canada and the United States

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

The relative silence so far this year about mass shootings in the United States was broken yesterday, even though there have been over 250 so far. Yesterday’s shooting in midtown Manhattan, where 4 were killed by rifle shots and the perpetrator committed suicide, evoked wide news coverage. Earlier that day, there was also a much less noticed mass shouting in Reno, Nevada, where 3 were killed and the perpetrator was captured.

In Canada this morning, these mass shootings did not reach the same headlines. The scores of reported deaths and starvation in Gaza were just as prominent.

Preliminary information suggests that there were likely mental problems with the New York perpetrator, who drove straight from Nevada and left a suicide note related to football-related brain injury trauma. How he got his rifle, which he strode with while walking to the target building, is uncertain so far. In Canada, guns have availability, but with much more checking and limited use to hunting and shooting competitions.

Over so many years now, I have come to conclude that it is disingenuous to minimize the contribution of mental problems in mass shootings. They may tend not to be the full-blown paranoid psychosis exhibited by the perpetrator of politician Gabby Gifford years ago, but almost by definition and rarity, mass shootings are outside the range of normal behavior. Nor are they done by homeless individuals, who are more violence targets than perpetrators. Yet here we are recently with cutbacks in mental health care resources and no tightening of gun laws.

There is a terrible paradox that the numbers of deaths in our current global wars far outnumber the numbers of mass shootings, as tragic and traumatic as they may be. One explanation is that it is easier for us to emphasize with individuals rather than large groups.

Any of these violent deaths and injuries usually do not make it into clinical care, even with the ripples out to the public, though we still must check for possible violence tendencies in our patients. That means, to get more preventive attention, the social determinants of mental health and social psychiatry have to focus more on limiting the flow of potential violence much more upstream.

That focus must include governmental policies and actions that increase violent risks in society. That may include the model of violent rounding up of immigration targets, whether or not they have a violent history. It also must include our own professional priorities such as the so-called Goldwater Rule, which has seemingly silenced our expression of expertise publicly. We also still need a greater professional focus on peace in all its range, from families to countries. And, instead of trying to absorb Canada as our 51st state, it should be adapting the success they have in preventing gun violence.

Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He presented the third Rabbi Jeffrey B. Stiffman lecture at Congregation Shaare Emeth in St. Louis on Sunday, May 19, 2024. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.