Archive for December 18th, 2012

Run For Cover

December 18th, 2012

Lawmakers and other politicians have been ducking and running for cover from the NRA and gun lobby for more than a decade. Perhaps after the slaughter of first graders in Connecticut—many little feet trying vainly to run for cover from an assault rifle—that may change.

In the shooting’s aftermath, I heard pundits and politicians call for better “mental health screening.” Say what? We have no valid instruments to predict which mentally ill people are likely to erupt in random violence. Unquestionably, we can improve our system of care for people with mental illness. Outpatient commitment laws can use judicial powers to assure a higher rate of adherence to treatment for many at-risk individuals. And state systems are sorely in need of more funds and better leadership, with accountable management and best practice standards.

But we really need better gun laws. Semi-automatic assault-style weapons, with high-capacity ammunition clips, make no sense for sport or self-defense. Background checks and other restrictions will help. An angry or psychotic person can wreak havoc with a baseball bat or knife, but rapid-fire firearms can kill and maim large numbers of defenseless innocents in seconds.

Monday is my clinic day. This week it followed the Newtown killings by three days. A mother of young children, whom one of my residents treats for an anxiety disorder, feared sending her kids to their elementary school and was considering home schooling as safer. A woman in her 70s re-experienced dormant grief. A mother of a disturbed youngster felt anticipatory guilt, as she identified with the shooter’s mother. Patients with PTSD felt re-traumatized, with resulting recurrent symptoms.

The residents and I did our best. We consoled, offered advice and perspective, suggested limiting exposure to continuous television scenes of carnage. We counseled on ways to explain the events to children.

We helped our patients grieve. And along with our own families, friends, and colleagues, we grieved. Many tears have been shed since last Friday’s senseless loss of life. How many more children must die before our state and federal governments take reasonable steps to enhance public safety?

-Alan J. Gelenberg, M.D.
Editor, Biological Therapies in Psychiatry
Shively/Tan Professor and Chair, Psychiatry, Penn State University
Editor-in-Chief, Journal of Clinical Psychiatry