Improving mental health care is not enough


After the massacre at Uvalde, mental health care is enjoying a fleeting moment of attention. This ought to be a good sign, but it’s not. That’s because too many politicians and public commentators are conflating two issues that deserve separate attention, separate solutions. We need desperately to upgrade the social safety net for psychological services, but that would not prevent mass murders.

Politicians and pundits — especially those on the right — have promoted better mental health services as an answer to the problem of gun violence, but their arguments are specious. Improved psychological resources might help bring down the rate of suicides — it would surely help with the death rate from drug overdoses — but better mental health care is hardly the answer for keeping people with murderous intent from using firearms.

Psychiatrists cannot predict which among the many troubled Americans — angry, alienated, bitter, paranoid — will purchase battlefield weapons to take out their anguish on others. As academic psychiatrist Jonathan Metzl said in a PBS interview in 2019, “Most of the research shows that people with mental illness are actually less likely than the general population to go on to shoot somebody else or to commit mass violence.” Metzl noted that the general profile for mass murderers — “white male, angry, slightly paranoid, disaffected, isolated” — would fit hundreds of thousands of Americans, most of whom will never shoot anyone.

Yes, Congress ought to be able to come to a compromise to pass a national red flag law, which would give police and courts a path to temporarily prevent firearms purchases or seize firearms from a person exhibiting threatening behavior. That’s a modest enough step toward gun safety; most such restrictions expire after a year.

And they don’t always work. The shooter who opened fire on a grocery store in Buffalo had threatened mass murder about a year before he carried out his crime, a threat that led to a psychological evaluation. Still, New York authorities did not use the state’s red flag law to stop him from purchasing weapons.

The Uvalde shooter was reportedly an 18-year-old man from a dysfunctional home whose adolescence had been marked by alienation and bullying. He apparently showed many signs of acute psychological distress, frequently posting threats of violence on social media accounts. According to Texas Gov. Greg Abbott, he had posted on Facebook his intention to shoot his grandmother — which he carried out before his attack on the school. It’s deeply distressing that his threats weren’t taken seriously.

Perhaps his shooting spree would have been prevented if Texas had a red flag law. Perhaps. But the Uvalde police could not bring themselves to enter the schoolhouse once the shooting had started. Would they have roused themselves to prevent the shooter from buying weapons?

Cowed by the gun lobby, conservative politicians have abandoned logic and jettisoned common sense to overlook the key factor in the nation’s plague of gun violence: guns. Gov. Abbott has mandated “unannounced, random intruder detection audits on school districts” to determine whether strangers are able to sneak into schools unnoticed. Measures designed to deter “random intruders” will inconvenience parents and other legitimate visitors, but they won’t stop a determined killer with a gun.

Of course we should have a serious, rational discussion about improving mental health services. Given the epidemic of teen suicides, that discussion is overdue. The United States is a wealthy country, but we don’t use our wealth to shore up the social safety net or promote the common good.

Our medical care system is a profit-based scheme that poorly serves those without deep pockets. Mental health care is especially skimpy; even those with health insurance can expect to have to shoulder much of the financial burden should they pursue routine therapeutic care. Laws mandating that insurance companies provide parity with physical health care haven’t managed to change that dynamic. We can do much better to serve those who need mental health resources.

We can also do more to keep firearms from the hands of murderers. The way to do that is to require background checks and waiting periods for gun purchases — for everyone.

Cynthia Tucker won the Pulitzer Prize for commentary in 2007. She can be reached at [email protected]



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