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Tue Dec 25, 2012, 06:28 PM

 

“Mass Shootings and the Ethic of the Open Heart” Medscape Today (Dec 20, 2012)

http://www.medscape.com/viewarticle/776427_5
The reality is that mass murder cannot be "predicted" as such, particularly by persons outside the perpetrator's social circle. Any hopes of prevention must rely on various approaches acting together to provide a widely cast safety net. Yes, it's rare, but the fallout is profound, devastating, and long-lasting. I conclude that it is society that must first decide whether it cares enough to take meaningful action. I will forever advocate for better mental health services and improved access to care. However, at the present time, measures such as screening for prior psychiatric treatment (often in the distant past) among individuals who want to legally purchase firearms represents no meaningful intervention.

Here I refer to the Brady Handgun Violence Prevention Act and relevant portions of the National Instant Criminal Background Check System (NICS). At the present time, this system is an inconsistent patchwork across the country, with different states handling the issue quite differently. There are many other problems with the NICS system, but they are beyond the scope of this article. However, suffice it to say that pouring precious resources into a system that evaluates anyone with a history of involuntary hospitalization (sometimes 20 years prior) who is also honest enough to go buy a firearm legally does not seem to me to be a meaningful intervention.

Experience has shown us that, at this point in time, the higher-yield interventions are:
• third-party reporting of concerns or leaked intent;
• sensible gun control laws; and
• media responsibility.

Having already addressed the issue of third-party reporting with the example of Lammers' mother, I now turn to the perennial and contentious subject of gun control in the United States. It turns out that countries with less stringent gun control laws have been observed to have a higher risk for mass murder than countries with stricter laws. In contrast, consider an Australian observational study done in the wake of a highly publicized 1996 mass shooting in Tasmania. The study compared mass murders before and after Australia enacted gun law reforms that included removing semiautomatic firearms, pump-action shotguns, and rifles from civilian possession. In the 18 years before the gun laws, there were 13 mass shootings in Australia. In the 10.5 years after the gun law reforms, there were none.

* * * * * * * * * * * *

As a psychiatrist, I desperately wish that improved psychiatric care and access to treatment could save the day. I have little doubt that over the years, unsung mental health heroes have averted possible mass murder tragedies. Yet, it seems all too clear to me that this is simply not a problem that psychiatry can solve on its own. No one should expect psychiatry to do the impossible -- it already has its hands full with the possible. Therefore, I am suggesting 3 additional methods of prevention that should be seriously considered if we wish to confront the tragic phenomenon of mass murder: careful reflection on gun control laws, responsible media reporting, and acknowledging the heroism of individuals such as Tricia Lammers with the hope that more will follow her compassionate, responsible example.

Please read and contribute to my thread "IMO the problem is "self-defense" and "group-defense" and a solution must satisfy both."

Please no insults and ad hominem attacks.

If you aren't part of the solution, you're part of the problem.

As my friend Forrest from Bayou La Batre said "That's all I have to say about that."

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Reply “Mass Shootings and the Ethic of the Open Heart” Medscape Today (Dec 20, 2012) (Original post)
jody Dec 2012 OP
jody Dec 2012 #1

Response to jody (Original post)

Wed Dec 26, 2012, 04:05 PM

1. Kick for comments. nt

 

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