The Stigma of Mental Health and the Shooting in Tuscon

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The horrible shooting in Tucson one month ago left 14 people – including Rep. Gabrielle Giffords – injured and six innocent people dead. One victim was just 9 years old. How does a mentally unstable, recently rejected US Army applicant go and buy a gun, and magazine clips of ammunition with only a cursory background check when many people suspected that he was mentally unstable?

Apparently many people suspected that this young man had serious problems. But no one stepped up. People that perhaps should have raised red flags stayed silent. Or maybe it was privacy laws that prevented them from passing on knowledge, that if known, may have saved lives. It’s not just gun laws and carry restrictions that need another look; it’s also our mental health system.

According to the Vera Institute of Justice “people with severe mental illnesses are more likely to be violent than individuals without mental illness, with the important qualification that this increased likelihood is largely driven by substance abuse” various media reports say that Jared Loughner’s parents, some of his friends, and administrators at the community college he attended, suspected that there were issues. Making it worse was the fact that he was supposedly a frequent user of various drugs – including salvia and marijuana. Salvia, which is legal, can closely imitate psychosis and cause intense hallucinogenic effects. Many psychosis-inducing drugs can either hide mental illness or make it worse.

Loughner never got a formal diagnosis. But the signs were there. He grew more disconnected from reality, more isolated from friends; and he began seriously acting out in class, prompting campus police to come and remove him. These were just some of what were apparently several red flags. According to Alison Pratt, PsyD., a psychologist in Floral Park, NY, there are many signals that someone may have mental health issues and need help: “The biggest thing I’d say is a change in typical behavior. Other signs might include an obsessive interest in guns and violence along with paranoid thinking, seeing themselves as a victim, history of trouble in school and/or not being able to hold a job, while also being a perfectionist in other areas.”

Dr. Pratt said that often, people like Loughner are very rigid in their thinking and see the world in terms of absolute rights and wrongs. “You can’t get much more black and white than the military. It would have appealed to his personality.” They may also accuse others of having it in for them and lack any sense of empathy. “There may also be one final trigger, such as a romantic rejection or loss of a job, that finally sets them off. That rejection turns violent due to perceived humiliation and anger.”

Would things have been different if he acknowledged he needed mental health treatment? Perhaps. On the other hand, there are also supposedly sane individuals that just snap and begin a shooting spree – at a post office, a former place of employment, or around a neighborhood, park, or school.

Why does mental health still carry such a stigma? If someone has heart disease, or diabetes, or cancer, it’s acknowledged, treated, and dealt with in an open manner. If someone is thought to be mentally unstable, people seem to be afraid of saying anything. A study conducted last year by Columbia University and Indiana University found that the ignominy about mental health still strong, and seems to be getting worse.

The National Alliance on Mental Illness says “When tragedies involving mental illness occur, it is essential to understand the nature of mental illness — and to find out what went wrong.” This group is working to change the public – and media – perceptions of mental illness and bring the issue out of the shadows and into open and candid discussion. According to NAMI, one in four people in the US experience a mental health disorder in any given year and 1 in 17 live with a serious mental illness such as major depression, bipolar disorder or schizophrenia.

Fortunately, federal law now mandates parity for mental health and addiction treatment by insurance companies. Help is also available for little or no cost from many non-profits, federal, state and local agencies.

Could earlier diagnosis and intervention for his mental disorders have prevented Loughner from injuring and killing so many? We’ll never know. But until this stigma about the issue goes away, unfortunately he probably will not be the last mentally unstable person to legally purchase a gun, rounds and rounds of ammunition, pass a background check, and fire at will.

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