Saturday, February 9, 2013


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?”


  1. The Swiss have more guns per capita than the US many of them "assault (fully automatic) rifles", with mandatory (male to age 50) and voluntary (female) training and yet have almost no gun crime; furthermore unique of European countries they have been free and independent since approx 1291 (yes, 1291). Perhaps the DSM needs a new diagnosis, "Swiss"?

  2. The Swiss have a culture that is quite different from the hodge podge collection of subcultures within the USA, and a topography to match. The highest their unemployment has ever reached is 3.9% And they are well off, so who needs to shoot anybody else? Switzerland is among the world's most prosperous countries in terms of private income. In 2007 the gross median household income in Switzerland was an estimated 107,748 CHF, or USD 137,094 at purchasing power parity. The median income after social security, taxes and mandatory health insurance was 75,312 CHF, or USD 95,824 at purchasing power parity.

    If you can remake the US of A to match Switzerland, go for it, I'm sure we'd all love it. One Quarter of the Swiss workforce is unionized.

    As for Jeff's comments in re the current batch of shooters seemingly being sane on the outside, I'd agree, and the latest one is a very smart, intelligent man, quite possibly driven to mad acts by a totally unjust system. It still does not excuse his acts.


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