Web Letters | The Nation

Why do we not hear about gun locks in the discussion?

In this complex issue, all methods that might reduce the abuse of firearms needs to be on the table. My husband and I are amazed that we hear no inclusion of the concept of gun locks in the conversations that are going on. Surely modern technology can be applied proactively and retroactively to secure guns in a manner that they can still be used for their recreational purposes while being protected from misuse. These days we have fingerprint recognition, retinal recognition and surely other methods that would reserve the ability to use the gun to the person who registered the weapon. The gun owner could be assured that the responsibility for keeping the weapon unusable by thieves, children and unqualified family members could actually be assured.

Why is this concept not being put on the table? There are millions of guns out there that could be made secure while preseerving the (abused notion of) Second Amendment rights. It is also a stimulant to a secondary industry rather than being an economic threat to the gun industry and a huge enforcement cost.

While I am mentioning that… When our Bill of Rights was being put together, having a gun was a life-or-death necessity for our pioneer forefathers. Beyond providing food for their tables and defense from frontier threats, if they were called up to defend our fledgling freedoms, they were required to provide their own gun if they wanted to be able to have one in a fight. The government wasn't providing them!

The survivalist notion that we are going to need weapons to defend ourselves from outer space invaders, the other last people on earth who want all we have, our own government… needs to be called out as far-fetched fantasy.

Keep up your good work, Ms. Harris-Perry. It is a pleasure to hear voices like yours speaking out.

Mental Illness and Violence: Assisted Outpatient Treatment

I agree with Ms. Harry Perry on much of what she said. But not all reactions to tragedies are knee-jerk. We have been working  for over twenty years to improve care for people with serious mental illness, but the only time the public pays attention—and the media want to report—are when there is an incident of violence that affects them. Policies we espouse to help the most seriously ill are ignored. So here they are.

First we need a definitive answer to “Are people with mental illness more violent than others?” The definitive answer is obvious, if you look at all studies, versus cherry-picking one that supports your view: It depends on who is mentally ill.

* Studies of the 40 to 50 percent of Americans whom mental health experts claim have some “diagnosable mental disorder” support the claim that “persons with mental illness are not more violent than others.” But the populations in those studies are disingenuously large.

* Studies of the 5 percent of Americans with the most serious mental illnesses—primarily schizophrenia and treatment-resistant bipolar disorder—who are receiving treatment also support the claim of mental-health experts that “persons with mental illness are not more violent than others.” But these studies prove only that treatment works, not that persons with mental illness are not more prone to violence.

* Studies of the 5 percent of subgroup of the most seriously mentally ill who are not in treatment and are psychotic, delusional or hallucinating, or are off treatment that has previously prevented them from being violent, are in fact more prone to violence than others.

When people ask whether the mentally ill are more violent, they usually mean this group of severely ill individuals and not their friends on Zoloft, Prozac, etc. There is a small group of these individuals who are so ill, they do not know they are ill. When you see someone under layers of lice-infested clothing, screaming at voices only they can hear, “I AM THE MESSIAH!” it is not because they “think” they are the Messiah. They “know” it. For this small group, and the even smaller group with a prior history of violence, we have to allow Assisted Outpatient Treatment (“AOT,” “Kendra’s Law” in New York; “Laura’s Law” in California). These laws are named after victims of persons with mental illness, because that is the only time those of us with loved ones who have mental illness are listened to. AOT allows courts after extensive due process to order this small group into treatment as a condition of staying in the community. It is more humane and less restrictive than the alternative: incarceration or commitment. Independent studies show with AOT:

1. Danger and Violence Reduced
55 percent fewer recipients engaged in suicide attempts or physical harm to self
47 percent fewer physically harmed others
46 percent fewer damaged or destroyed property
43 percent fewer threatened physical harm to others.
Overall, the average decrease in harmful behaviors was 44 percent.

2. Consumer Outcomes Improved
74 percent fewer participants experienced homelessness
77 percent fewer experienced psychiatric hospitalization
On average, AOT recipients’ length of hospitalization was reduced 56 percent from pre-AOT levels.
83 percent fewer experienced arrest
87 percent fewer experienced incarceration.
49 percent fewer abused alcohol 48 percent fewer abused drugs

3. Consumer participation and medication compliance improved
The number of individuals exhibiting good adherence to medication increased by 51 percent.
The number of individuals exhibiting good service engagement increased by 103 percent.

4. Consumer Perceptions Were Positive
75 percent reported that AOT helped them gain control over their lives
81 percent said AOT helped them get and stay well
90 percent said AOT made them more likely to keep appointments and take medication.
87 percent of participants interviewed said they were confident in their case manager’s ability to help them
88 percent said they and their case manager agreed on what is important for them to work on.

5. Effect on mental illness system was positive
• Improved Access to Services. AOT has been instrumental in increasing accountability at all system levels regarding delivery of services to high need individuals. Community awareness of AOT has resulted in increased outreach to individuals who had previously presented engagement challenges to mental health service providers.
• Improved Treatment Plan Development, Discharge Planning, and Coordination of Service Planning. Processes and structures developed for AOT have resulted in improvements to treatment plans that more appropriately match the needs of individuals who have had difficulties using mental health services in the past.
• Improved Collaboration between Mental Health and Court Systems. As AOT processes have matured, professionals from the two systems have improved their working relationships, resulting in greater efficiencies and,ultimately, the conservation of judicial, clinical and administrative resources.

There is now an organized process to prioritize and monitor individuals with the greatest need;
AOT ensures greater access to services for individuals whom providers have previously been reluctant to serve;
Increased collaboration between inpatient and community-based mental health providers.

No one will write on this, absent an act of violence. But next time there is one, perhaps these links will help:
Kendra’s Law Research
List of supporters (NY only)

Thank you. I am the executive director of Mental Illness Policy Org.

After Newtown, Beware Fear-Driven Policymaking

We need more analysis like this

MHP is on the mark. Thought and analysis, not mere emotional reaction, is necessary to deal with the issue of guns and gun violence. Two points requires greater attention. First—not dealt with here—is the role played by the business and industry of guns, and their diffusion and influence throughout society. But second is the complexity of the community dynamics seen in communities such as Newtown. The New York Times article “In Town at Ease With Its Firearms, Tightening Gun Rules Was Resisted”—which ran a couple of days after the killings and was buried immediately thereafter—confounds the ready kneejerk reactions presented in the media and from the pronouncements of politicians of all stripes. While we are understandably sensitive to the losses of so many families, little attention has been directed to the complexity and contention within the community itself that fostered a culture of guns.

After Newtown, Beware Fear-Driven Policymaking

Let us reason together

I wish to thank the author of this article for cool, clear level-headness. In the wake of such a tragedy as we saw a week ago, people tend to be very easily led to a conclusion. Let’s place strict gun controls, says the president. After that there come many that want to take away our Second Amendment rights.

I came to this publication to blast the editor for remarks made elsewhere about control of guns. Looking at the list of articles, I saw this article. This author makes a good case for all Americans.

This type of dialogue is just what is needed at times like this. I didn’t expect to see this here. If all Americans would use this logic, our country would be well on its way to healing. The two parties would begin to work togather.

As all Americans know logically, a gun doesn’t kill. People kill. It’s not fair to take away guns from the millions that enjoy shooting for whatever sport they choose. Legally owining a gun is part of our history. Without gun ownership, we wouldn’t have been able to win our independence. It was the gun owners that beat back the enemany long enough for our young country to get the money and equip an army, to take over the defense of our nation.

It would not be proper to blame cars for the deaths that drunk drivers cause. Each year about 30,000 people die of gunshots. Each year about 40,000 people die in auto accidents. A good number of people killed in autos, are by drunk driver, but it wouldn’t be right to place controls on cars.

You could go on and on with this compairson. The fact that the author chose to use a level-headed approach impressed me. Thank you, and keep up the good work. We do need to try to stop some of the violence in our country. My belief is we need to make the parents responsible for part of this. If the parent can’t control the child, then we need to have a system in place to help them