We have a mental health problem in the United States, and no small part of which is the fact that we only talk about mental health after mass shootings. When we finally get the guts to talk about an issue this complex, we usually stigmatize the mentally ill under the guise of compromise for gun control. So, as long as we’re talking about mental health, we might as well address the real issues surrounding mental illness rather than using people with illnesses out of their control as a cop out for substantive action on gun violence.
Much of the stigma surrounding mental health comes from a deep seeded belief that only people who can’t pull themselves up by their bootstraps are mentally ill, and that oneself, and one’s hardworking friends, and family members could not possibly be mentally ill. According to SAMHSA, about 42.5 million Americans have a mental illness (nearly one in five); chances are that some of those who claim that gun control is only a mental health issue have friends, or family who are mentally ill, or are even mentally ill themselves. Keeping this in mind, would the same pundits, and politicians feel the same way when advocating for the denial of firearms to the family, and friends that they go skeet shooting, or hunting with simply because someone close to them has a documented history of mental illness?
One of the most problematic implications of legislation being proposed by those who want to divert gun control legislation to mental health legislation is the sharing, and disclosing of confidential mental health information. In the New York State Assembly, I encountered proposals for legislation of this nature that can be seen in similar forms in states across the country. The essential argument is that mass shootings will be prevented if documents concerning a patient’s violent, suicidal, or otherwise vaguely problematic thoughts can be released to the proper authorities who can then act upon what was believed to be shared confidentially to a therapist, or psychiatrist during an appointment. This poses two major problems: one that creates a slippery slope, and the other being a pragmatic problem in preventing mass shootings.
However prevalent the slippery slope fallacy may have been in one’s intro philosophy class, the notion that one’s private thoughts shared with a mental health professional can be released to the state under the condition of any threat of violence nonetheless sets a dangerous precedent. Mental health providers already have the authority to disclose information about violent, or dangerous plans revealed in therapy to authorities. With legislation such as HR 3722, almost everything said in therapy would become eligible for disclosure, and thus effectively non-confidential. Under the guise of preventing mass shootings, this kind of legislation would effectively nullify the confidentiality that is central to the effectiveness of mental health treatment.
The second major problem posed by most mental health legislation concerning gun control stems directly from the first problem. If confidentiality no longer exists in treatment, and if prospective patients are made aware of this, then there is little to no incentive for them to disclose their true thoughts, and feelings, nor is there any incentive for them to get any help at all if all of the information they disclose to their therapist, or psychiatrist can later be used by the state against them. It would therefore become nearly impossible to achieve the intent of this legislation, which is to prevent mass shootings by effectively eliminating confidentiality because the trap would not work.
As far as mental health legislation goes, there are far more important things to focus on, such as mental health parity, and addressing the ridiculous amount of mentally ill people who find themselves in prison in this country—or even worse, in solitary confinement. Senator Chris Murphy of Connecticut has a bill in the Senate—S. 1945, otherwise known as the Mental Health Reform Act of 2015—that could drastically improve outcomes of mental health treatment by providing more resources to mental health providers who provide care that is either inadequate, or far too expensive for the vast majority of patients. Although imperfect, this bill would be a step in the right direction for a country that has a severely ineffective mental health care system.
A bill that ought to be passed at the federal level is a version of New York State’s “Boot the SHU” (sponsored by NY Assemblyman Jeffrion Aubry of Queens) bill that aims to divert, or remove prisoners with serious mental illnesses from solitary confinement (known as Special Housing Units) to residential mental health treatment units. The New York State Assembly also passed a bill–A. 1346-a— in June that aimed to prevent putting anyone with a mental illness, developmental disability, or any juveniles in solitary confinement. Unfortunately, the bill was stalled in committee in the Republican controlled Senate, and never even made it to the floor, and much less, to Governor Andrew Cuomo’s desk.
With over 4,000 inmates in solitary confinement, and with no limits on how long they can be kept there, New York State still has a long way to go, and I hope to continue my work in New York State politics in this arena, rather than working as a pawn of the NRA to divert attention from the epidemic of gun violence in this country by stigmatizing the mentally ill. If we are actually serious about preventing mass shootings, and addressing mental health in the United States, we must understand that passing legislation that makes treating mental illness more difficult than it already is only serves as a convenient distraction for the NRA, and the gun lobby as a whole. Real change will come from comprehensive legislation that addresses both issues holistically, and not from using one as an excuse for inaction on the other.
Lahut is a member of the Class of 2017.