Lay That Pistol Down

How Gun Laws Enabled Jared Loughner

“I have a Glock 9 millimeter, and I’m a pretty good shot,” Congresswoman Gabrielle Giffords told the New York Times last year. Alas, so did, and was, a deranged fellow Arizonan named Jared L. Loughner. Just what the Congresswoman hoped to accomplish with her semiautomatic pistol—beyond showing her support for an individual right to bear arms—remains uncertain. But Loughner’s intentions were made horrifically clear in the mass shooting in Tucson last week.

Several among those killed had government connections, as is frequently the case when lunatics start shooting. It’s difficult to imagine what insane animus Loughner bore his other victims, including the nine-year-old girl. The available information suggests that he was troubled for quite some time before becoming frankly psychotic in 2010. His behavior then became so eerie that fellow students and a teacher at Pima Community College were seriously afraid of him. He was expelled and informed that a “mental health clearance” was required before he could return. News accounts to date, however, make no mention of any effort to accomplish such an evaluation.

Nonetheless it’s unsurprising that responses to the tragedy have included calls for a more authoritarian approach to psychiatric patients. Some commentators believe we need not just more custodial care of the severely mentally ill and more scrupulous implementation of existing laws and guidelines, but a rewrite of the relevant statutes with probable implications for constitutional law. “We need legal reform,” exhorts the political philosopher William Galston in an article making a case for reforming our laws regarding “involuntary commitment” (January 11). “Those who acquire credible evidence of an individual’s mental disturbance should be required to report it to both law enforcement authorities and the courts, and the legal jeopardy for failing to do so should be tough enough to ensure compliance.”

Give us a break, Mr. Galston. At a minimum, 1 percent of the American population suffers from a major mental illness. What are the police and the courts supposed to do with those 3 million reports?

For over forty years as a practitioner and as chief of psychiatry at a large community hospital, I’ve been acquiring very credible evidence of people’s mental disturbance pretty much every day. Triage clinicians are called to the emergency department round the clock to evaluate psychotic cases, and the large group practice I belong to sees one hundred new patients every month. But so many patients certainly would not seek us out if we ran tattling to the police every time an irrational person said something menacing.

When we do sense imminent violence, however, the law poses no problems.  I don’t know about Arizona, but in Massachusetts virtually any psychologist or psychiatrist seeking to restrain a dangerous person just completes a simple form known colloquially as a “pink paper,” and faxes it to the police. They transport the patient to a hospital where he can be held for at least three days on the admitting doctor’s say-so. During that time, if the patient continues to be adjudged dangerous, the hospital requests a commitment hearing. The patient is then detained for as long as it takes—never less than a week—and provided with a lawyer. A judge is brought to the hospital. At that point the patient’s right to due process is honored.

The system for dealing with violent patients is fraught with problems, but not because of the law. It is nonviolent patients and their families who suffer most from the libertarian tenor of the laws on involuntary treatment that concern William Galston.

The great obstacle to proper involuntary treatment of the violent is that nobody wants these patients. Would you? They are uncooperative, devious, hostile, almost always frightening, and often dangerous to other patients and to staff. And of course they’re typically uninsured. The director of any inpatient unit to which too many of them are admitted will soon seek another line of work. The criminal-justice system, recognizing irrationality, naturally pushes them toward the mental-health system which, recognizing danger, pushes back. The Massachusetts Department of Mental Health, like that of many other states, has largely abandoned provision of direct patient care. Bridgewater, Massachusetts’s facility for the criminally insane, has room only for the egregiously violent and a disproportionate number of sex offenders. So the staff member in charge of psychiatric triage pounds the telephone in her emergency department through the long night hours, trying to find a place for the likes of Jared L. Loughner. It’s not the law that’s defective; it’s the system.

What the law really fails to provide for is the involuntary treatment of the nonviolent. I think of a fellow who, after a couple of widely spaced episodes of moderate depression, not nearly severe enough to require hospitalization, suddenly became manic. And this episode was severe. Delusionally grandiose, awake all night, talking constantly, spending absurd amounts of money, making dreadful scenes at work and at home, he began rapidly to destroy his career, his estate, his reputation, his marriage, and his relationship with his children. As usual in cases of manic psychosis, evidently no one could persuade him even to consider treatment. No one could tell him anything, in fact, because he wouldn’t stop talking. It was obvious that only involuntary hospitalization could prevent his ruin. But, “Hold it right there!” said the law. “Is he an immediate physical danger to himself or anyone else?” Immediate yes; physical—well no, not really. “Then,” our law declares, “he has a right to his ruin.” Had the law empowered me to get a bit of lithium into this poor chap a happy outcome was probable.

So, although I find that Massachusetts law does not impede adequate care of violent psychiatric patients, with regard to the nonviolent I share Galston’s concern that libertarianism does more harm than good.

In every nation on earth, however, no matter how wisely drafted its laws, the impulsively aggressive, the violently drunk, the desperate, the fanatical, and the insane will always be with us—mostly out and about. One wishes they weren’t so fond of firearms.

Since I began my training in psychiatry in 1965, a great deal of my work has been in hospitals. There, for one reason or another, from time to time I’ve taken a phone call running something like this: “Dr. Gault, this is X over in the Y department. I hate to disturb you, but there’s a (patient, visitor, staff member) creating a disturbance, and we hoped you could come over and lend a hand.” I believe this happened as often as once or twice every three years or so over a period of almost forty years. So let’s say, conservatively, twenty times. Only once, if I’m not mistaken (and I’m not), did the caller add, “and we think he has a gun.” Now, I’ve heard the gun-lover’s slogan, “It’s not guns that kill people; people kill people.” If that’s true, why was I so unafraid to lend a hand those other nineteen times? I’m not an especially courageous person, but when no gun was mentioned, I answered the call without any anticipation of dying. I’ve never heard anyone say, “It’s not atomic bombs that incinerate people, it’s aviators.”

The Glock pistol that enabled Jarod L. Loughner to become a celebrity has a magazine that holds more than thirty rounds. He didn’t waste them; more than half his shots hit somebody. Many solid citizens love to go hunting. If it’s birds or very small game he’s after, he uses a shotgun; for bigger game, a rifle. But pistols are for shooting people. Desperate souls like Loughner understand that perfectly. I’m told that pistols enable citizens to protect themselves. I understand the theory, but why does this so seldom occur in practice? Many Arizonans, after all, have taken the trouble to acquire and become competent in the use of a handgun, but none of the many dozens on the scene was prepared to deal with the madman in Tucson as he squeezed off thirty rounds. It was in Texas in 1966 that Charles Whitman sniped away from the university tower for an hour and a half before several brave police officers—not a pistol-packing undergraduate—finally dealt with him. Were there no self-defensively armed civilians within earshot who could have run up those tower steps and stopped Whitman before he’d shot forty-eight people, killing sixteen? Whether it’s Colorado or Oklahoma, Arkansas or Massachusetts, whether it’s a day-care center, a post office, a shopping mall, or a school, where the hell are those citizen sharpshooters when we need them? No, pistols do infinitely more harm than good. They always will.

Even if we enacted Galston’s impractical and Draconian precepts, innumerable desperate souls would remain at large among us. Must they have such easy access to automatic weapons?


Related: Sick Minds, by Cathleen Kaveny
Will We Ever Have Sane Gun Laws? and Tragic Prophet, by E. J. Dionne Jr.
Killings in Tucson, by the Editors
Forward Motion, by Joseph D. Becker

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Ridiculous circular logic. You were doing fine until the last couple of paragraphs, probably because you knew what you were talking about vis avis law and involuntary committment. [Though in most states it isn't anywhere near so easy as you make it out to be.]   Clearly you know very little about firearms, and equally clearly you come from an anti-gun sociocultural background, as is often the case.  Pistols needn't be fired to be used for self-protection.  And they are used this way multiple thousands of times a day, every day. It isn't rare, and it isn't insubstantial. Like seatbelts, they serve a purpose even on the days you don't get into a car wreck, because you never know what day that might be.

Pistols do infinitely more good than harm, contrary to your statement.  As do many other potentially lethal pieces of hardware that we can't keep out of the hands of mentally deranged people. Knives, cars, airplanes...  Weapons are morally nuetral, used for good and bad.  Any realistic comparison of the number of weapons in this country and the amount of crime-related use proves they are used more for good than bad.

Just as the legal system can convict innocent people, and psychiatrict professionals can committ sane people, all through error and imperfect systems and standards, so is it impossible to prevent firearms from falling into the hands of the mentally ill.

Its a price we pay for freedom, and many Americans are totally, irreversibly unwilling to lose those freedoms becasue of your fears.  The Second Amendment is a Constitutional roadblock that prevents even a mjority from disarming citizens...try and nullify it if you can.  The day you can actually get a Constitutional amendment to do so is the day you spark civil war.  But I doubt you can get the American people to support such a change.

This is a classic case of overreaction to a highly publicized tragedy, and everyone goes wandering off looking for some kind of rationale or explanation.  Here's a news flash; there isn't one.  That's why we call it "senseless".  Now get over your fears, and be an adult.  It isn't preventable unless we hand over all our freedoms and independence to state authorities, who frankly have proven themselves to be more incompetent and corrupt than the average American.  I refuse, and I don't care what laws you get passed.  If you don't like our freedoms, leave.  They aren't negotiable.

BTW, the semi-auto Glock used in the Tucson shooting comes with 15-round magazines (10 in California).  The extended magazines he used were for a different automatic model made for the Austrian government.  Just happens to be interchangeable.

 

I worked as a nurse in Northampton, Mass back in the 80's when Ronald Reagan decided warehousing people in mental health institutions cost far too much money. He was going to cut costs and demonizied the very institutions that kept people safe, calling up the movie "The Snake Pit" starring Olivia De Haviland as a buzz word for abuse. What we demonized was not replaced with improvements, only chaos. This chapter in Arizona brings it home as one of a cluster of alarms that should be going off in healthy rational heads across the country. Back in the 1980's, as the good physician here well knows, Northampton State Mental Hospital dumped out hundreds of people who had lived entire lives in their own protected world. It wasn't just us being protected from them---they likewise were protected from us. I saw bewildered patients coming in our hopsital doors because they had no place else to go and today, I can only imagine that the Loughner family might have felt equally as helpless while watching their son sink into a madness they couldn't understand or get help for. There is no place for these folks to go. In my work as a psychiatric nurse, it is near impossible for a family to committ inpatient unless they have been threatened with death by their loved one. Why do we allow such violence in the home? Because mental health law gives far too many 'rights' to patients who have broken thinking. Unlike an arm or leg, the process that allows them to give consent does not work, their thinking is impaired, the brain is broke, so what is a family to do but look hostile to them, placing their own lives many times in danger? There is no place to go for care by a family unless we allow a downward spiral to occur. Once they hit bottom, hopefully without violent actions, then we can committ them. And once in the system, you are not assured of a long treatment stay there, as the physician also knows. A mere three days is not sufficient time for anyone's mental illness to turn around. You are not treating with antibiotics or surgery. It takes weeks, sometimes, months to see results in mental illness and that is just not fast enough for insurance companies and their parameters. If you have no insurance, you may be better off in jail. Even with an involuntary committment by a judge, you can be back out on the streets within a week if you smile often enough and play ball well with the staff. Things such as Arizona, might never have been able to be prevented, just as life is always messy, imperfect and filled with unpredicatable risk. But why not try?  Instead, I have patients that tie up valuable resources of police, 911 services, ER visits for fear and anxiety, and i simply can't believe that's better for them or more cost effective for the community. Is this legacy of Reagan something we truly wish to live with? My patients live as members of a community within a community. Many are still unable to live without a well structured enviornment that helps to tap down their levels of fear and anxiety at the prospect of being alone. For whatever the reasons, community welfare also is a right, for my patients to feel safe in it from violence outside them and for the general community. It is a reciprocal relationship. When I think of everyone carrying a gun, I trust my police who are well trained in  knowing how to use a gun but I wouldn't feel safer being around someone who is a weekend user. No thanks! In the meantime, we need to provide safe places for those living with mental illness, safe laws that protect them, even from themselves and safe communities where those who live with MI can enjoy the fruits of a supportive community.

I agree witht the psychiatrist who wrote this article that guns should not be acessible to any person diagnosed with a mental illness. The action of the use of semi-automatic weapons allows the person to kill or injure many people from a distance whereas a knife etc. requires more direct contact and the violent person could be subdued easier before an escalation of damage could occur.

Unfortunately...many "violent" people do not seek psychiatric help because they don't "feel" anything is wrong with them.. Most are sociopaths who have no conscious. People who have mental illness are very stigmatized because of these "loose canons". A very great majority of the mentally ill are NOT violent ! And it is a pathetic shame to include them in on the list of "killers".

I myself have Bipolar I and am NOT a violent person. Although I was suicidal...a crime against myself. I have been manic quite a few times and my "Psychosis" was a peaceful event related to praying for world peace...a return to the Garden of Eden scenario. Of course that type of behavior in public outside of a church is not condusive to societal norms. Therefore I was hospitalized and even my therapist said I experienced a "shamanic crisis". But I am medication compliant and still remain docile.

Gun control is necessary for ALL in this now hostile,paranoid society. The "right to bear arms" is outdated as we are not living in the 18th century when the U.S. Constitution's Bill of Rights was drafted. We must protect ALL citizens from SOCIOPATHS!!!  The mentally ill are victims of SOCIOPATHS too !!! 

 

Ms Allen,

Ypur comments highlight precisely why stiffer gun control laws won't work:  We don't have the eady ability to define "mental illness" in a way that allows for competent screening.

Gun control won't make soiopths go away.  It'll only make the rest of us all the more vulnerable to others' insanity.

 

Sorry, that shoud be "ready" ability.  Typing w two fingers (due to a paper cut) is more difficult....

Mr. John ?,

I know that it is difficult at best to screen for those who are sociopaths....different from those who suffer from diagnosed mental illnesses. But guns in the hands of "vigilantes are even more dangerous than ALL of the sociopaths combined ! Guns are meant for only one thing...to kill! I shudder at the thought of "untrained" citizens toting guns as if this country was still in the wild west days ! Leave the need for protection up to law enforcement ! They are well trained...maybe we need more instead of cutbacks in cities.!

By your profile name... I am guessing you live in a rural area. I do too. The odds that a sociopath will knock on the door and harm you and your family are really low...in other words...safety for a lone sociopath finding you are almost non-existant.

By the way...I have heard that Elmer's glue (non-toxic of course) is great for paper cuts ! ;)

Will someone please explain to me how allowing virtually anyone to carry a weapon - licensed or unlicensed, openly displayed or hidden - has anything to do with "forming a well-ordered militia?"  How exactly is returning to a frontier weapon culture anything near a "well-ordered militia?"

As seen from various comments this is a complicated issue. Barry Gault's article made some good points, but I must take issue with his comment that "nobody wants these patients" because they are "uncooperative, devious, hostile...." etc. This is seen as the main obstacle to treatment. May I suggest that what psychiatrists often see as denial and resistance to taking medication is in fact anosognosia (DSM-IV) in many cases......a lack of awareness/insight as a symptom of mental illness. Why would anyone "co-operate" and agree to take anti-psychotic meds with all the potential side effects if they honestly believed they were OK? This is a huge challenge for mental health professionals. But until the problem is recognized it will be difficult to engage these patients in sustainable treatment. Draconian methods are neither practical, ethical or compassionate. However we do need a way to regulate the procurement of automatic weapons. It is not only the mentally ill who use them for violent acts.

Barry Gault, Michelle M. Allen, Jimmy Mac and anyone who agrees with this article, needs to read John Lott's book More Guns, Less Crime. There is monumental evidence that having the citizenry armed reduces violent crime. Yes, Mr. Gault, handguns are for shooting people although they can and have been used for hunting as well. They have been used in battle by our soldiers to shoot other humans in order to defend and keep our freedon as well as other more defensless citizens of other countries. Law enforcement officers use them to stop violent criminals when they cannot stop themselves. And countless civilians have stopped crimes from occuring to them, or if a violent crime has already begun against them or others, have used handguns to defend themselves and prevent further injury or violence against them.

It's pretty rediculous to think that we could or should carry long guns around. They are impractical for close quarter defense. Besides, a round from a rifle will most likely pass through and keep going and possibly hurt an innocent person.

I'd like to see every handgun owner receive competent training and be able to make all the right decisions when the time comes to use those skills. However, not everyone who cares about defending their lives, is also able to attend training - should only people who can afford it be able to defend their own lives? Close quarter skills and accuracy aren't necessary to stop or scare off someone intent on harming you. I applaud the Korean War vet who recently shot an intruder in his home, after first being shot at by the intruder His family was also in the home. This occurred in the Chicago area where all handguns are banned. Now he is in trouble. Does that seem right to you?

Recall the scene from Raiders Of The Lost Ark, when the big guy that is going to fight Indiana Jones is swinging a big sword around with obvious skill. Then Jones pulls out a gun and shoots him. Fair fight? Nope. But where do people get this romantic idea that when you are being attacked, you should try fighting hand-to-hand, or use a kitchen knife, or call the police who will be there in a flash, or if you do have a gun, you should shoot the intruder in the arm or leg? These are unbelievably naive, hollywood style notions. Real violence against innocent citizens needs to be stopped as quickly as possible with great force.

Some ignorant quotes:

"Pistols do infinitely more harm than good." Wow. Where is there any evidence of this? To the contrary, there is a wealth of evidence proving exactly the opposite. Again, read John Lott's book (although I doubt you will even take the time.)

"Guns in the hands of vigilantes are even more dangerous than ALL of the sociopaths combined" Again, no evidence would ever find this true, but huge leap here to equate concealed carry with vigilantism.

"Guns are meant for only one thing...to kill!" Tell that to all the gun owners who regularly shoot targets.

"I shudder at the thought of "untrained" citizens toting guns as if this country was still in the wild west days!" Nice image, but not based in reality. Concealed carry holders are trained, responsible citizens who don't tote them out in view of others.

"Leave the need for protection up to law enforcement!" Law enforcement sometimes will protect you, but more often is there after the crime of violence has occurred. When seconds count, the police are only minutes away.

"When I think of everyone carrying a gun, I trust my police who are well trained in  knowing how to use a gun but I wouldn't feel safer being around someone who is a weekend user" Why do have the image of police being the only ones who know how to use a gun. There are many well-trained citizens, who are ex-military, ex-law enforcement, avid hunters, or simply gun enthusiasts who are also capable of safely using a gun.

"the violent person could be subdued easier before an escalation of damage could occur" And who is going to be doing this subdueing? Are you confident anyone standing by could physically subdue someone with a knife or even no weapon? Violent people are violent and will violently refuse to be subdued.

"Gun control is necessary for ALL in this now hostile, paranoid society" Contradiction? If society is more hostile, then how can you also say we are being paranoid. Society is getting more violent, which is all the more reason why innocent, law-abiding citizens should more more prepared, and more more willing to defend themselves by whatever means necessary. Gun control laws only serve to enable the criminals to more easily take advantage of those who follow the laws. Criminals DO NOT pay attention to gun control laws.

"The "right to bear arms" is outdated as we are not living in the 18th century when the U.S. Constitution's Bill of Rights was drafted" Geez, I hope defending yourself never becomes outdated. You probably don't like much else about the constitution either. Just a bunch of old guys making up stupid rules, who had no idea what this country would be like 200 years in the future, right? They were more concerned about protecting each individual's rights at that moment, and for future generations than you realize. I am so thatnkful that they had the foresight and strength to fight against the ignorance, arrogance and naiveity that they knew would be around 200 years after they were gone.

Oh, and to Phyllis Townley:

"However we do need a way to regulate the procurement of automatic weapons"

First of all, the shooting of Gabrielle Gifford had nothing to do with automatic weapons.

Second, There already ARE Federal laws regarding procurement of automatic weapons. They rarely issue permits to purchase those, and they are tightly managed. Anyone found with an automatic weapon without the proper permits faces federal prison time.

Lastly, there are countless laws on the books in every state regarding gun control. We don't need more laws. Creating more laws that limit the law-abiding private citizen from posessing guns does just that, but it doesn't prevent a criminal from possessing a gun and using against an unarmed victim.

Jimmy Mac:

"Will someone please explain to me how allowing virtually anyone to carry a weapon - licensed or unlicensed, openly displayed or hidden - has anything to do with "forming a well-ordered militia?"

"How exactly is returning to a frontier weapon culture anything near a "well-ordered militia?"

In both cases thay don't, so why are you mixing the two? Creating Straw-Man arguments to knock down is a waste of time. You make false arguments and then arrogantly try to topple them without even supporting them.

However, I will explain the differences. The premise "allowing virtually anyone to carry a weapon" is silly. In the first place, you say weapon, but I'm sure you are referring to guns. Not a single state is like this. And no one is talking about returning to a "frontier weapon culture." Every state has rules about who can and can't own and carry a weapon. Most states require that if you do want to carry a gun, you attend training, pass a test, apply for a permit, get fingerprinted, legally purchase a firearm, and carry it responsibly. Owning a firearm is a right. Carrying it is a priveledge in a civilized society. There are those that will argue that we should have the right to carry openly without all the other hoops to jump through. That's another story. However, the well-ordered militia is in regards to being able to defend yourself against an oppressive government. Our founders saw that it was possible for the goverment to get out of control, and to oppress and rule over the citizens without fear of reprisal. Well, they wanted to make sure the government knew that if they tried that, they would not face an unarmed citizenry. It was a way to not allow the power to only remain with those in power, but to give us the right and ability to remain free if there was no other way. BTW, you might want to study Hitler. Before he began killing all the Jews, he confiscated all the guns. He is not the first or the last to try to take away the power to defend yourself in order to oppress you.

Trained and Armed and Anonymous ... All of these conditions are based on fear.

ed gleason, Your fear of facts is irrational. Try to get over it.

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About the Author

Barry Gault is a psychiatrist in private practice in Newton, Massachusetts.

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