“Instead of arguing at the margins, politicians on both sides should be addressing the funding, access and quality of our mental health system …”
With the presidential campaigns in full swing, it is little surprise that President Barack Obama’s recent proposals on gun access have been met with political spin instead of objective analysis. Both sides are looking to make over-generalizations without looking at the practical numbers behind the real issue they should address: our mental health crisis.
Any conversation on gun violence should start with a basic set of facts in order to see the complete picture. Looking at the number of gun deaths, then moving to gun violence and mental health connections, and finally to where real bipartisan progress can be made in expanding access to mental health care can give depth to the otherwise shallow arguments made in today’s debate.
When looking at the actual occurrence of gun deaths in the United States, there is a very prominent role for those experiencing a mental illness, and it is not mass shooting settings. The point about gun access and suicide is clear in these statistics:
• More than 60 percent of people in this country who die from guns die by suicide.
• According to Harvard School of Public Health, in 2010 in the U.S., 19,392 people took their own lives with guns, compared with 11,078 who were killed by others.
• Over 90 suicides happen every hour, and 90 percent of these deaths are related to mental illness.
People are concerned that those suffering with a mental illness will gain access to a gun to kill others. In fact, they should be much more worried about this person having easy access to a gun used to take their own life.
As Matthew Miller, associate director of the Harvard Injury Control Research Center at Harvard School of Public Health, put it, “If every life is important, and if you’re trying to save people from dying by gunfire, then you can’t ignore nearly two-thirds of the people who are dying.”
What about those who are suffering from a mental illness? Aren’t they “dangerous,” as the political talking heads and media consistently assert. The Hogg Foundation for Mental Health recently hosted a forum about violence prevention and mental health at the Texas Capitol in February of 2015. Some interesting stats mentioned by Dr. Joel Dvoskin from the University of Arizona included:
• People suffering from a severe and persistent mental illness are 11 to 12 times more likely to be victims of a violent crime.
• If all violence related to mental illness were to go away, the overall reduction in violent crime would be only 4 percent.
• The odds of someone with schizophrenia killing someone is approximately 1 in 140,000.
The knee-jerk reaction to closely associate gun violence with mental illness completely misses the point in the current debate over gun access. Further stigmatizing mental illness by closely associating it with gun violence is perhaps the most prominent example of mischaracterization of a public health issue in the media today.
The population of people in this country that suffer from a mental illness are our friends, neighbors, co-workers and family members. And the system serving them has consistently failed to provide the needed medical care for their medical conditions:
• 1 in 5 people suffer from a mental disorder – more than cancer, diabetes or heart disease. Yet despite its prevalence, only 3 percent of the world’s health care budgets are directed at treating mental illness.
• 360,000 people with mental illness are housed in underequipped U.S. jails, only 35,000 in hospitals.
In mental health access, the media would be well-served to remember Texas ranks 49th in the nation for public funding for mental health (Kaiser, 2013). In Harris County, even with massive increases in the state budget in the last two legislative sessions, there is a striking gap of mental health access for residents. According to the 2015 report of the Mental Health Needs Council of Harris County:
• 142,930 adults had a serious mental illness in Harris County.
• 89,579 individuals with serious mental illness had no public (Medicaid or Medicare) or private health insurance and were exclusively dependent on the public mental health
service system for treatment.
• The Harris Center is able to treat between 11,000 & 12,000 per month, covering only a fraction of that population
Like clockwork, whenever the debate over gun control happens there will be questions around the mental health care system with calls to improve it. When enough time passes for the debate over guns to die down, the bipartisan calls for mental health care also fades from the headlines.
That’s how common sense bills like funding certified peer-support services, requiring PTSD coverage in Texas insurance plans, and expanded post-partum depression coverage get bogged down. All three had bipartisan support but failed to become law during the 2015 legislative session.
Instead of arguing at the margins, politicians on both sides should be addressing the funding, access and quality of our mental health system and not change the subject from the need for additional resources.
The biggest impact in reducing gun deaths in the United States is effective suicide prevention and improved mental health care, and that’s not debatable.
Bill Kelly is director of public policy & government affairs for Mental Health America of Greater Houston.