The Objective Truth About Mental Health, Guns, and the Law

How, exactly, can mental health laws prevent gun deaths?  At a news conference on February 14, 2008, Florida governor Rick Scott suggested that Florida should modify its mental health laws at some unspecified future time to lessen the risk of gun violence:  “There’s a time to continue to have these conversations about how through law enforcement, how through mental illness funding that we make sure that people are safe.”  President Trump has echoed Governor Scott’s suggestions, promising to “tackle the difficult issue of mental health.”  This intention, of course, would be a significant shift from earlier in the week, when he submitted a budget proposal to Congress, which reduced funding for the Substance Abuse and Mental Health Administration by $665 million and slashed nearly half a billion dollars in funding from the National Institute of Mental Health.  Mr. Trump’s comments also represent a departure from a bill he signed into law in February of last year, which actually made it easier for people with documented mental health problems to purchase firearms.

February 14, 2018 marks the deadliest high school shooting in United States history. The perpetrator was 19 year old, former student, Nikolas Cruz, who murdered 17 people, at Marjory Stoneman Douglas High School, in Parkland, Florida.  Cruz had been “in and out of mental-health treatment,” as the Miami New Times reports.  He had been expelled from school — though not before the administration prohibited him from carrying a backpack because his behavior was so frightening.  There were 39 separate police visits to his home since 2010, with the Broward County Sheriff, Scott Israel, reporting that 20 of those visits over the past few years pertained to Mr. Cruz.  The Broward County Public Defender’s Office stated Mr. Cruz has been “suffering from significant mental illness and significant trauma” adding that “he has been experiencing and enduring mental illness his entire life. That has been an ongoing issue that he has been dealing with. That, coupled with the loss of his mother, the depression, and other issues…”  Cruz posted pictures on his instagram account of animals he had gruesomely tortured along with his burgeoning arsenal of weapons.  He described himself as an aspiring “professional school shooter,” in a comment he wrote on a Youtube video.  Other students grimly reported that they had anticipated he could be a school shooter.  The FBI had received two tips in four months that Cruz could perpetrate a school shooting, with the most recent tip dated January 5, 2018.

Mr. Cruz, despite his mental health concerns, purchased a Smith & Wesson M&P 15 .223 AR-15 style assault rifle in February, 2017.  An instant background check was performed at Sunrise Tactical Supply in Coral Springs, Florida.  Without a criminal record, Mr. Cruz passed the instant background check and the sale was legally consummated.

One might wonder, how, exactly, can mental health laws prevent gun deaths?  In fact, there are actually only two ways mental health laws can impact this problem.  The first is by denying people with mental health conditions access to a gun in the first place.  The second is by providing sufficient mental healthcare services to people to prevent them from going on to commit gun violence at some point in the future.  The answer quickly becomes quite a bit more complicated than it would appear at first glance….

For starters, it is important to understand that mass shootings are extraordinarily rare.  Since August 1, 1966 and including Parkland, Florida, 1,077 people have been killed in the United States in public mass shootings by 153 separate perpetrators.  In fact, mass shootings by people with serious mental illness represents just 1 percent of all gun homicides each year.

In contrast to these victims of gun violence, an estimated 33,000 people die every single year from guns.  Two thirds of these deaths are suicides.  Let that sink in.  Every single year, roughly 22,000 people will take their own lives with a gun in an action that is synonymous with the most tragic of mental health outcomes.

The next question to ask is:  does the United States have a higher prevalence of mental illness compared to the rest of the world or provide less mental healthcare than the rest of the world?  The answer to this question is actually ‘yes,’ or rather ‘slightly yes.’  According to a World Health Organization study, Americans do have the highest prevalence of mental illness although the rate is relatively similar to other industrialized countries.  Over the course of their lifetimes, 47.4 percent of Americans will experience a mental health disorder of some type.  In any given year, 27 percent of Americans will experience a mental health disorder.  This prevalence is tragically compounded by Americans having some of the lowest rates of treatment of any country.  In 2018, over 43 million Americans are currently experiencing a mental health disorder.  Of those people, 56 percent do not receive treatment.  However, since the passage of the Affordable Act more people are receiving care than were before the healthcare law was passed.  Lastly, 9.6 million people with a mental health disorder will experience suicidal ideations each year.

One particularly important question to ask is:  can we prevent people from purchasing guns if they have a mental health disorder?  The answer is somewhat jumbled.  Currently, federal law does bar someone who has been adjudicated to be “mentally defective” or “committed to a mental institution” from purchasing a weapon.  But this would only apply to a subset of people with relatively severe mental illnesses.  A majority of states supplement the federal laws by mandating mental health information be reported to the national background check system.  Of course, these laws only apply to licensed gun dealers; a person who did not wish to be subject to a background check (perhaps due to mental health status) could simply engage in what is called a “private sale” with an unlicensed gun dealer and the dealer would not need to provide a background check at all!  Requiring that all gun sales be subject to a background check would unquestionably reduce the number of gun sales to people who would otherwise fail a federal background check.

Worth noting is how Japan prevents people with mental health disorders from purchasing guns.  Japan requires would-be-gun owners to apply for a license, in which they would be subject to drug testing and mental health screening at hospitals.  The police would also interview their family members and neighbors before they would issue a license.  As of 2016, Japan has 210,928 licensed firearms in the country.  In 2014, Japan experienced just 6 firearms deaths (compared to 33,599 in the United States)!  The United States would be wise to emulate these types of background screening laws.

As far as prevention and treatment of mental health disorders in order to curtail someone’s propensity to engage in gun violence is concerned, the United States would be wise to simply increase funding and access to treatment.  Medicaid is the nation’s largest source of funding for mental health treatment.  The White House budget proposed cutting Medicaid funding by about $1.4 trillion over 10 years from projected spending.  Congress should, in fact, do exactly the opposite and increase funding for Medicaid if it is serious about addressing mental health.  Additionally, smaller programs such as the Substance Abuse and Mental Health Administration and the National Institute of Mental Health should similarly see their funding increased, instead of decreased, as the White House budget advises.

-Andrew Hennessy-Strahs

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