There is a lot of interest in civil commitment these days, as a possible tool to fight two big health problems. As we continue to watch the rates of opioid-related deaths climb, and in the wake of an unfunded emergency declaration by President Trump, some policymakers are looking to involuntarily commit overdose survivors for drug treatment. On the gun violence side, experts like Jeffrey Swanson have argued for applying gun-access restrictions that now cover people subject to long-term civil commitment to those subjected to short-term civil commitment.
With those kinds of ideas in the air, it is important to recognize how little modern data we have on commitment and its effects. In a recent article in the Washington Post discussing commitment for opioid treatment, Michael Stein and Paul Christopher emphasize how little we know. I entirely agree on the need for more research, and offer a couple of things to help.
The first is the Policy Surveillance Program’s LawAtlas dataset that maps civil commitment laws across all 50 states and the District of Columbia. If we’re going to examine these laws and their impact, this is the place to start. We also put out the call to anyone interested in studying this to work with us not only to update this data through 2017, but also to make sure we’re mining these laws and their characteristics for the right information in these circumstances — Are we asking the right questions? Continue reading →
In recent years, there have been a multitude of state- and federal-level discussions about how to use law to minimize gun violence as active shooter events increase. During these deliberations, one point that has repeatedly been debated is whether people with mental illness should have their gun possession rights limited.
Typically, we would avoid such a shameless plug for our researchers — we’d be a little more subtle. But, we can’t help it this time. This book is the best $10 you’ll spend all year.
A little less than a month ago, Johns Hopkins University convened more than 20 of the world’s leading experts on gun violence and policy to summarize their research and recommend policy changes. This 282-page book features empirical research from the leading experts in the field covering the topics of mental health and gun violence, gun law enforcement, high-risk guns, international case studies of responses to gun violence, the Second Amendment, public opinion on gun policy, and concludes with a summary of the recommendations for reforms to Federal policies.
Chapter 3, “Preventing Gun Violence Involving People with Serious Mental Illness,” features research conducted by Jeffrey Swanson, PhD, and his team of researchers based at Duke University. The research presented was funded by PHLR and the National Science Foundation.
I was in India when the tragic news hit; 26 people dead–20 of them children in a massacre at Sandy Hook Elementary School in Newtown, Connecticut on December 14, 2012. In India, NGOs struggle with ending violence against women and children. Acid tossed in the faces of women by scorned boyfriends is not uncommon nor the increasing, random acts of slitting women’s throats on trains. Sensational it may seem to us; but very real for women in Mumbai and Bihar. In fact, the day before learning of the tragedy in Connecticut, Delhi officials announced the hiring of thousands of guards to deploy at 548 elementary schools in South Delhi amid reports of rapes and molestations of little girls who are followed, harassed, and in too many cases harmed on their way home after leaving school. The government’s response comes on the heels of parents threatening to remove their daughters from school.
In that country and others, broad scale violence is understood as more than a national problem; it is a social and public health problem. In cases of sexual violence and the externalities that result, including sexually transmitted diseases and pregnancies, the public health component may be more visible to those of us in the West. However, the public health indicators extend physical health problems; violence causes emotional and psychological trauma. The mental health component of public health must be better understood. Americans who live in gang infested communities, where violence seems almost endless and difficult to escape, understand this all too well as their kids experience anxieties closer to post traumatic stress disorder as part of their daily lives.
The Newtown shootings offer a moment for reflection on the lives lost and also our nation’s first principles and commitments. Perhaps this will be a time to consider gun control beyond a very divided constitutional law debate to also understand its public health dimensions. Who benefits from current policies? Who are those harmed? Physical wounds do heal, but the mental health traumas, grief, and anxieties often take a lifetime to manage and overcome.
Federal and state efforts to restrict firearms access to potentially dangerous people with mental illness have focused in recent years on extending the reach of states’ reporting to the National Instant Criminal Background Check System (NICS). In August, in response to the Colorado movie theater shooting, Mayors Against Illegal Guns released a report tallying the number of mental health records each state has submitted to the NICS and ranking each state’s reporting performance. Nearly five years after Congress enacted the NICS Improvement Act, only about half the states have submitted more than a negligible proportion of their mental health records.
The Mayors’ report mentions the “mentally unstable man” who shot President Reagan and his press secretary, Jim Brady, for whom the Brady Handgun Violence Prevention Act was named. It recalls the deadly rampages at Virginia Tech in 2007 and in Tucson in 2011. It includes an interactive map titled Fatal Gaps: Can dangerous people buy guns in your state? The not-so-implicit message here is that states’ spotty reporting of mental health records to the background check database is partly to blame for the senseless deaths in mass shootings.
It is easy to say there’s a problem with our gun laws or their enforcement by pointing to isolated cases where mentally disturbed mass shooters were able legally to buy guns. That is probably true. Unfortunately, there is no evidence yet available to suggest that filling the NICS with more records of people with gun-disqualifying mental health histories would have any measurable impact in reducing firearm violence in the population.
A study underway at Duke University, funded by the National Science Foundation and the Robert Wood Johnson Foundation’s Public Health Law Research Program, may soon provide some answers to that question. Whatever the study finds, though, the results will hinge on whether two assumptions underlying our gun prohibitions turn out to be true: that there is a strong causal relationship between serious mental illness and gun violence; and that our extant gun-disqualifying legal criteria can accurately identify the subgroup of mentally ill individuals at risk.