Wednesday, December 19, 2012

Mental Health, Check!

I have always been afraid of guns. I also am afraid of a man touching me on the back of my head. I might forgo that first fear for the second if any man ever lays his hands there - again. As the victim of violence and my right to resolve and even know was taken away from me the night of February 8th, I struggle with what it means to "feel safe".

I have never thought packing a pistol, let alone an AK-47 called the "Bushmaster" would offer warm comfort like a bath, a blanket or a hug. In fact not even cold comfort as a glass of Scotch might on a long winter evening. Somehow by the time I got the gun out, loaded, glasses on to see, prepare to ready, aim, fire I would be dead by the attacker at that point so why bother.

But the zeal to own guns in this country is uniquely American, the whole 2nd Amendment yada yada yada. I notice that we have 27, can you name say 25 others? We have not really gone that nuts updating that document since the first 10 and yet the other document held so hallowed, the Bible, has dozens of versions. Go figure.

As we search for explinations, justifications and reasons for why this uptick in violence occurs we go right for the usual assortment of band aids and quck fixes to what is an increasingly complicated problem.

I have theorized that its the "economy stupid" That with the rising and ever increasing divide in income and economics there is a rising tide of anger and resentment. And that anger is either turned inward or outward, neither are good.

The articles below discuss that the focus on mental health and propensity for violence is just another one of those smoke and mirrors our Politicians love to throw up rather than deal with what the real problem is - gun violence and ownership of weaponry most used in combat situations unnecessary for basic hunting or even home protection needs.

The other is an article by the very reliable Statistican, Nate Silver with regards to who owns guns in this country. His findings - party affiliation - that is the dominant factor, again not shocking. Mr. Silver doesn't try to conclude why and I am sure the Neuro-scientists will devise some cognitive theory that Republican's brains are hardwired for violence or whatever but I think its much like anything else - we cling to our history and our roots. And when you are strongly identified as one thing over another that is what defines you. My "Dadddy did it, my Grandaddy did it and his Grandaddy did it.." and so on. Same goes for party affiliation.

The American Unicorn Mythology clings to its guns, religion and more importantly their personal history. These are the same people who re-enact varying Civil and Revolutionary War battles for what reason? A different outcome?



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Party Identity in a Gun Cabinet

By NATE SILVER

An American child grows up in a married household in the suburbs. What are the chances that his family keeps a gun in their home?

The probability is considerably higher than residents of New York and other big cities might expect: about 40 percent of married households reported having a gun in their home, according to the exit poll conducted during the 2008 presidential election.

But the odds vary significantly based on the political identity of the child’s parents. If they identify as Democratic voters, the chances are only about one in four, or 25 percent, that they have a gun in their home. But the chances are more than twice that, almost 60 percent, if they are Republicans.

Whether someone owns a gun is a more powerful predictor of a person’s political party than her gender, whether she identifies as gay or lesbian, whether she is Hispanic, whether she lives in the South or a number of other demographic characteristics.

It will come as no surprise to those with a passing interest in American politics that Republicans are more likely to own guns than Democrats. But the differences have become much more stark in recent years, with gun ownership having become one of the clearest examples of the partisan polarization in the country over the last two decades.

In 1973, about 55 percent of Republicans reported having a gun in their household against 45 percent of Democrats, according to the General Social Survey, a biennial poll of American adults.

Gun ownership has declined over the past 40 years — but almost all of the decrease has come from Democrats. By 2010, according to the General Social Survey, the gun ownership rate among adults that identified as Democrats had fallen to 22 percent. It remained at about 50 percent among Republican adults.

The 2008 poll makes clear that gun ownership is deeply embedded in political identity, and vice versa. (Unfortunately, the question on gun ownership was dropped from the 2012 national exit poll.) Some other variables, like race or where a voter lives, also strongly predict gun ownership. But the differences between the parties remain even after accounting for these characteristics.

White voters were substantially more likely to own guns than Hispanics or blacks. But white Republicans were more likely to own guns than white Democrats.

And based on demographic inertia, the differences seem likely to grow over time.

About 35 percent of Democratic voters age 65 and older reported having a gun in their home, against about 25 percent of those ages 18 to 29. But gun ownership rates bore little relationship to age among Republican voters, and were constant at about 55 percent among all age groups. That might suggest that gun ownership will continue to decline among Democrats while holding steady among Republicans, further increasing the partisan gap.

Gun ownership rates are highest in rural areas, where guns are more likely to be used for hunting as well as personal protection. A slight majority of Democratic voters in rural areas said they had a gun in their home, according to the survey, although the rate was somewhat higher, 65 percent, among rural Republicans.

In urban areas, 40 percent of Republican voters said they had a gun in their home, while 20 percent of Democrats did.

The differences are most apparent in suburban areas. There, 58 percent of Republican voters said there was a gun in their household, against just 27 percent of Democrats.

Having school-age children in the household did not significantly affect gun ownership rates, either positively or negatively. A majority of Republican-voting parents of minor children had a gun in their home, while only about one in four Democratic-voting parents did.

In other respects, the profile of gun owners defies some of the stereotypes that urban liberals might assign to them. For example, despite President Obama’s comments in 2008 about voters who “cling to guns and religion,” the two qualities are not strongly correlated. Slightly more than 40 percent of voters who said they attended church weekly or more often reported having a gun in their home, about the same percentage as among those who attend religious services just a few times a month or a few times a year. And gun ownership rates are highest among the middle class, rather than the poor. Households making $50,000 to $100,000 per year were slightly more likely to own guns than those that made a little bit less or a little more. (However, gun ownership rates are inversely correlated with educational attainment

Perhaps last weekend’s mass shooting in Newtown, Conn., will serve to diminish the partisan split in attitudes toward guns; early polls on Newtown find relatively modest differences between Democrats and Republicans on what they see as the causes of the shooting. Then again, following the initial aftermath, the partisan divide in attitudes toward guns has seemed only to accelerate after similar past events, as at Columbine High School in 1999.

It might seem strange that ownership of a single household object is so strongly tied to voting behavior and broader political attitudes in America. But America is an outlier relative to other industrialized nations in its gun ownership rates. Whatever makes this country so different from the rest of the world must surely be reflected in the differences in how Democrats and Republicans see the nation.





In Gun Debate, a Misguided Focus on Mental Illness

By RICHARD A. FRIEDMAN, M.D.
Published: December 17, 2012

In the wake of the terrible shooting at an elementary school in Newtown, Conn., national attention has turned again to the complex links between violence, mental illness and gun control.

The gunman, Adam Lanza, 20, has been described as a loner who was intelligent and socially awkward. And while no official diagnosis has been made public, armchair diagnosticians have been quick to assert that keeping guns from getting into the hands of people with mental illness would help solve the problem of gun homicides.

Arguing against stricter gun-control measures, Representative Mike Rogers, Republican of Michigan and a former F.B.I. agent, said, “What the more realistic discussion is, ‘How do we target people with mental illness who use firearms?’ ”

Robert A. Levy, chairman of the Cato Institute, told The New York Times: “To reduce the risk of multivictim violence, we would be better advised to focus on early detection and treatment of mental illness.”

But there is overwhelming epidemiological evidence that the vast majority of people with psychiatric disorders do not commit violent acts. Only about 4 percent of violence in the United States can be attributed to people with mental illness.

This does not mean that mental illness is not a risk factor for violence. It is, but the risk is actually small. Only certain serious psychiatric illnesses are linked to an increased risk of violence.

One of the largest studies, the National Institute of Mental Health’s Epidemiologic Catchment Area study, which followed nearly 18,000 subjects, found that the lifetime prevalence of violence among people with serious mental illness — like schizophrenia and bipolar disorder — was 16 percent, compared with 7 percent among people without any mental disorder. Anxiety disorders, in contrast, do not seem to increase the risk at all.

Alcohol and drug abuse are far more likely to result in violent behavior than mental illness by itself. In the National Institute of Mental Health’s E.C.A. study, for example, people with no mental disorder who abused alcohol or drugs were nearly seven times as likely as those without substance abuse to commit violent acts.

It’s possible that preventing people with schizophrenia, bipolar disorder and other serious mental illnesses from getting guns might decrease the risk of mass killings. Even the Supreme Court, which in 2008 strongly affirmed a broad right to bear arms, at the same time endorsed prohibitions on gun ownership “by felons and the mentally ill.”

But mass killings are very rare events, and because people with mental illness contribute so little to overall violence, these measures would have little impact on everyday firearm-related killings. Consider that between 2001 and 2010, there were nearly 120,000 gun-related homicides, according to the National Center for Health Statistics. Few were perpetrated by people with mental illness.

Perhaps more significant, we are not very good at predicting who is likely to be dangerous in the future. According to Dr. Michael Stone, professor of clinical psychiatry at Columbia and an expert on mass murderers, “Most of these killers are young men who are not floridly psychotic. They tend to be paranoid loners who hold a grudge and are full of rage.”

Even though we know from large-scale epidemiologic studies like the E.C.A. study that a young psychotic male who is intoxicated with alcohol and has a history of involuntary commitment is at a high risk of violence, most individuals who fit this profile are harmless.

Jeffery Swanson, a professor of psychiatry at Duke University and a leading expert in the epidemiology of violence, said in an e-mail, “Can we reliably predict violence? ‘No’ is the short answer. Psychiatrists, using clinical judgment, are not much better than chance at predicting which individual patients will do something violent and which will not.”

It would be even harder to predict a mass shooting, Dr. Swanson said, “You can profile the perpetrators after the fact and you’ll get a description of troubled young men, which also matches the description of thousands of other troubled young men who would never do something like this.”

Even if clinicians could predict violence perfectly, keeping guns from people with mental illness is easier said than done. Nearly five years after Congress enacted the National Instant Criminal Background Check System, only about half of the states have submitted more than a tiny proportion of their mental health records.

How effective are laws that prohibit people with mental illness from obtaining guns? According to Dr. Swanson’s recent research, these measures may prevent some violent crime. But, he added, “there are a lot of people who are undeterred by these laws.”

Adam Lanza was prohibited from purchasing a gun, because he was too young. Yet he managed to get his hands on guns — his mother’s — anyway. If we really want to stop young men like him from becoming mass murderers, and prevent the small amount of violence attributable to mental illness, we should invest our resources in better screening for, and treatment of, psychiatric illness in young people.

All the focus on the small number of people with mental illness who are violent serves to make us feel safer by displacing and limiting the threat of violence to a small, well-defined group. But the sad and frightening truth is that the vast majority of homicides are carried out by outwardly normal people in the grip of all too ordinary human aggression to whom we provide nearly unfettered access to deadly force.








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