I often hear people talk about how we have to keep guns away from the mentally ill. A judge friend recently said it quite bluntly, "What's the issue with guns and the mentally ill? They shouldn't have them." A cousin posted a link to a story about a man who killed his family and then himself. Cousin commented, "We have to find a way to keep guns from the mentally ill." The article mentioned nothing about a history of mental disorder or psychiatric treatment or distress in the man who killed his family and himself; people were shocked, there was no clear motive, the gun was owned legally. Granted, by the time you kill your family and yourself, there may well be a mental illness leading you to this, but people say "Keep guns from the mentally ill" as though they wear signs indicating who they are. Sometimes, the first clear indicator that mental illness is present is an act of violence, often a suicide attempt or worse, a completed suicide. It's all awful.
So I thought I would help here with some guidelines as to how to identify those with mental illness so we actually can do a good job of getting their guns. Here would be my criteria for labeling people so that we could prevent mass murders and other atrocities:
~Anyone who has a been civilly committed to a hospital for a suicidal or violent act.
~Anyone who has been civilly committed for threatening such things/ saying them/ or thinking them.
~Anyone who has been voluntarily in a psychiatric unit, even if not acutely dangerous right now, there is clearly a mental disorder present.
~Anyone who has seen a psychiatrist or therapist. To get reimbursed for these services, you need a DSM code to submit, so all these folks are mentally ill.
~Anyone on Social Security Disability for a psychiatric reason.
~Anyone who has gotten a psychotropic medication from a primary care provider, a psychiatric NP, or any other prescriber. Purchase of any psychotropic medication should immediately trigger notification of the FBI. Remember, some anti-convulsants are prescribed for psychiatric reasons, so prescriptions will need to show clear indications for the medications. The pharmacists will have a dedicated line.
~Anyone who has taken a sleeping pill, because sleep problems are often secondary to other psychiatric conditions, plus they slow reaction times and can cause cognitive issues. We don't think people under the influence of sleep medications should be operating guns, do we?
~Anyone who purchases over-the-counter sleep medications, or any medication that can induce drowsiness. If you need to be drugged with something that warns against operating heavy machinery, the FBI needs to know and you don't need to be pointing a gun at anyone. Plus, do we really want people who are sleep deprived to be handling guns? They can be very cranky.
~For the same reason, anyone who takes narcotics for pain, coughs, or recreation. Or amphetamines for that matter -- they make people jumpier, not a good mix with a gun. And testosterone makes people more aggressive, so that should be a no-no. Need a mood supplement: St. Johns Wort or SAM-e? The government needs to know.
~Anyone who tells a health professional about mood changes, feeling sad or stressed. This could be a warning sign that a mood disorder is present and you never know when someone might swing to being a killer.
~Because many people with mental illness never seek treatment, we need a list of psychiatric symptoms to be made public, and all teachers and employers should be required to report when they hear of, or observe, any of these symptoms. Voices, paranoia, moodiness, irritability, anxiety? There should be mandatory reporting with stiff criminal sentences for any health care provider, teacher, coach, or employer who does not report the name of anyone with psychiatric symptoms to a federal gun database.
~Google searches should be monitored for those looking up mental disorders or psychiatric symptoms. Facebook/Twitter/Instagram posts should also have identified phrases that are associated with mental illness. Those teens who post song lyrics about existential angst or the end of the world -- the government needs to know.
~Substance abuse is a mental illness, and guns and alcohol/drugs don't mix. They are a recipe for disaster. Liquor stores should have a threshold amount for purchases, along with requisite questionnaires to determine who is drinking too much. Case of beer for the Superbowl? List the names and addresses of who those who will be sharing with you and the predicted number of beers/person. Unused portions along with accountability charts need to be returned so those who over-imbibe can be identified.The government needs to know.
~Reclusive and weird: absolutely no gun. The government needs to know about anyone who isn't out of their house by 9 AM on weekdays. Special dispensations could be issued for people who work at home or have unusual hours, provided they do leave their house for enough hours/week and have a threshold number of social contacts.
So if you look at it this way, it becomes pretty easy to identify the mentally ill. You target treatment settings, medications used for their treatment, and observed or stated symptoms of psychiatric symptoms. We still will miss a few people, but if we can identify these folks, and keep guns out of their hands, I guarantee the rate of gun violence will go down. It's a sure fire thing.
(Of note: Satire alert)