April 23, 2013

Mental Illness and Gun Rights: Some Hidden Traps?

Recent debates over gun-ownership have seen the pro-gun rights side reacting to calls for restriction with the counter-argument that what we really need is more attention paid to the mentally ill.

On its website, the National Rifle Association states, "The NRA has supported legislation to ensure that appropriate records of those who have been judged mentally incompetent or involuntarily committed to mental institutions be made available for use in firearms transfer background checks."

This seems like a good response to those politicians who want to turn law-abiding citizens into criminals with the stroke of a pen. We all agree that "crazy people shouldn't have guns."

But is there a hidden danger here? Who defines "mental illness"? The mental-health industry (drug makers, psychiatrists, clinical psychologists, and other therapists) keeps enlarging the definition.

The new fifth edition of the DIagnostic and Statistical Manual of Mental Disorders will have even more categories than the fourth edition had. And the DSM-4 already offered catch-all categories such as "adjustment disorder," which let a therapist medicalize any mild depression, etc., assign it a code number, and let patients submit claims to their insurance carries.

Now half the population will be conceivably coded as "mentally ill":
If we think of having a diagnosable mental illness as being under a tent, the tent seems pretty big. Huge, in fact. How did it happen that half of us will develop a mental illness? Has this always been true and we just didn’t realize how sick we were—we didn’t realize we were under the tent? Or are we mentally less healthy than we were a generation ago? What about a third explanation—that we are labeling as mental illness psychological states that were previously considered normal, albeit unusual, making the tent bigger. The answer appears to be all three.
A book review in the Chronicle of Higher Education also notes the multiplication of categories of mental disturbance:
Where [psychiatrist Jeffrey[ Kahn's book is a genial guide to American angst, [Edward] Shorter's How Everyone Became Depressed is a polemical, alarmist complaint about the psychiatric profession, the big pharmaceutical companies, and the changes within medicine about diagnosis and terminology. Shorter, a professor of history at the University of Toronto, who went down this road in Before Prozac (Oxford, 2008), argues that the overelaboration of symptoms in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the updated fifth edition of which will appear in May, has led to the multiplication of nervous syndromes. "Most clinicians, in their heart of hearts, thought anxiety and depression were really the same illness: It was only the DSM drafters who wanted to keep them apart," he says.
If you are not taking psychotropic medication yourself, you know people who are. And since not everyone metabolizes these medications the same way, perhaps you have heard stories of how a switch in medication caused the patient to become crazier, until they begged their psychiatrist to prescribe something else.

Furthermore, boys more than girls tend to receive psychoactive drugs. Making the connection, one writer notes, "It is simply indisputable that most perpetrators of school shootings and similar mass murders in our modern era were either on – or just recently coming off of – psychiatric medications."*

This is one aspect of school shootings that has not been examined enough. Could "Why did they do it?" have some connection with psychotropic medication?

So, gun owners, think about these questions:

• if you like the NRA's language about "involuntarily committed," do you think that if someone is placed on a 72-hour hold, the SWAT team should kick down the door and seize all firearms in the household? Even if that person is released subsequently with a pat on the hand?

• Do you think that a therapist who thinks guns are icky might get a patient to admit to owning one and then report that patient as a danger to society?

• Do you think that the gun-banners might seek to leverage the DSM-5 to make gun ownership more difficult in the name of protecting society from the "mentally ill"?

It's a culture war that we are in, not a disagreement over crime-fighting.

* I realize that WND tends toward the "paranoid style," but this issue of drugs and school shooters is worth looking at. Even a stopped clock is right twice a day.

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