The Cycle of Insanity: And Mass Shootings Continue

11/22/2014

We’ve got another one. Myron May, a lawyer and Florida State University alumnus, opened fire on students and employees in the Strozier Library on FSU’s campus. He managed to injure three people (one is still in critical condition) before he was killed himself in a gun battle with police. Since I did my internship at FSU, this one feels pretty personal.

Albert Einstein once said, “Insanity is doing the same thing over and over again but expecting different results.” With respect to mass shootings, the United States has been doing the same thing (e.g., nothing much) while expecting that mass shootings will stop. Perhaps we should start asking if we even want them to because it sure doesn’t seem that way.

In preparing to write this blog post, I went back and reread all the other blog posts I’ve written on this topic. Sadly, there were five that were Photo by Mike Licht - https://flic.kr/p/dBUdFVdirectly related and all of them fit with this latest tragedy as well. After the school shooting in Ohio, I talked about the mix of violent masculinity and guns and how the two don’t go together well. This latest shooting was perpetrated by a man armed with a semi-automatic handgun. Men and guns? Check.

After the movie theatre shooting in Colorado, I discussed the options we have for preventing violence and the need for greater community involvement when people seem troubled. May recently quit his job and broke up with his girlfriend. He complained to property managers that neighbors were laughing at him. He may have even had several stays in a mental hospital. Evidence of being troubled? Check. I also wrote about the nightmare inherent in having a child who is guilty of committing mass murder. May’s family in Ohio has yet to comment on the situation but rest assured that they are in distress. Family anguish? Check.

After the Newtown massacre, I explored the systemic factors involved in mass shootings. This tragedy had them all. Being male, having a gun, mental health issues? Check. After the community shooting in Tucson, I wrote another post about the increased need for mental health services. May reported to police in New Mexico police that he was certain there were cameras installed in his apartment and that he could hear voices commenting on his activities. He told people on Facebook that he thought an energy ray from the government was cooking him in his chair. So, although we will never know for certain what he was suffering from (schizophrenia, depression with psychotic features, or possibly a brain tumor?), he was definitely experiencing paranoia, delusions and hallucinations. Mental health problems? Check.

Are you bored yet? Because I sure am. In every single case of a mass shooting in the United States over the last few years, the same factors have been present: men, guns, and mental health issues. And yet we do little to address these things. There still are only a few voices even mentioning that men are the ones doing the killing, much less doing something to address that fact.

Gun regulation is still dead on arrival in most of the United States although there has been some movement toward gun control in some areas of the country. Washington recently became the seventh state to require background checks on all gun sales. Plus, two Democratic candidates – Colorado Governor John Hickenlooper and Connecticut Governor Dannel Malloy – who signed into law comprehensive gun-law reforms following the Newtown tragedy were re-elected. Yet despite these gains and strong public support for greater gun regulation, concealed weapon and open carry laws still exist and Congress refuses to act.

And then there is mental health. Despite President Obama’s mental health initiative and lots of talking heads nattering on about the need for improved mental health, the outlook for our mental health system seems pretty grim at the moment. Funding for mental health services continues to be cut, so places like Veteran Administration Hospitals and community mental health centers are struggling to get by with less staff and increased patient loads. It is a no-brainer to assume that when people are overworked and underpaid, treatment will suffer.

Private practitioners also are dealing with ever-decreasing reimbursement (which, let me be clear, was not high to begin with) and it appears likely that it will get worse. Although the Patient Protection and Affordable Care Act (aka Obamacare) will expand coverage for prevention and treatment of mental health issues, there is little in the bill that is encouraging about provider reimbursement. Thus, we in the mental health field are bracing ourselves for steep cuts in reimbursement and significant delays in payment. Medicare has already decreased payment for some mental health codes by as much as 21% of previous rates. Since Medicare often is the benchmark for reimbursement rates, we can expect other insurers to reduce payment as well.

If you follow this development to its logical conclusion, this probably means there will be fewer mental health providers in the field. After all, who wants to go through an extra two to six years of education and training while racking up a significant amount of debt only to be paid at a level commiserate with a college degree? That’s not even counting all the extra costs associated with supervision, licensure, malpractice insurance and continuing education. Factor in the fact that most of us pay for our own healthcare and you have hefty overhead costs coupled with a low salary. Who will be able to even afford to offer care? Thus, in a sad and ironic twist, the most likely outcome will be that coverage for mental health services will increase while accessibility of treatment will decrease. Ultimately this means that fewer people will receive the assistance they need.

So, we’re back to insanity as there has been no movement on the toxicity of violent masculinity, little movement on gun regulation and possible backsliding on the accessibility of mental health treatment. We’re doing the same things people, so there absolutely will not be different results. I don’t know what else to say. Can we at least acknowledge that we’re being insane? Because the first step toward seeking treatment is acknowledging that you have a problem.

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