TO CONTROL GUN VIOLENCE, LOOK BEYOND MENTAL ILLNESS

Even the AMA has been saying many years that gun violence in America is a public health issue. Seeing it as such plugs it usefully into the subject of mental health. Unfortunately--and surprisingly--though, that's something we don't have a practical handle on. Plenty of us are way off the beam but not diagnosable under present standards.

Those who are frankly psychotic actually aren’t responsible for much violent crime. In all our gun massacres, few shooters had ever been designated insane. They were odd, alright, but not enough for anyone to summon the white coats. After they finally exploded, neighbors uniformly commented, “Well, he was a little strange. Kept to himself, got angry easily, and oh, yeah, he had a lot of guns.”

One endemic oddness these days combines anti-social isolation with fear. How many Americans are coiled in terror this very moment, eager to strike out in protection? How many will shoot relatives or harmless visitors as suspected intruders? How many of us, fearing any social confrontation, will homicidally “stand our ground?”

The soon-to-be-published fifth edition of psychiatry’s bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), won’t feature diagnoses like “doesn’t get along well with people,” or “frightened enough to own an armory, but not full-on paranoid.” Some other country’s DSM might consider these conditions abnormal, but here they’re arguably the norm.

We don’t need laws that address mental health as much as we need mental health itself. We can start by asking why Americans own one gun per capita, ten times the world average. As Gandhi asked armed-to-the-teeth Khyber tribesmen, “What are you so afraid of?”