[Ed: I wrote the following reply 9/18/19 to an article by Liza Gold, MD, “Gun Violence and Mental Illness: It’s Time to Change the Status Quo” (8/29/19). (BTW, Dr. Gold told me she’d heard of us.) Psychiatric News editor, Cathy Brown, referred my response to their executive editor, Jeffrey Borenstein, MD, who has declined DRGO’s input in the past and did again, without comment. However, it’s always worth responding. Occasionally one gets published, which is a win. If not, publish the exchange elsewhere so the biases are recognized.]

To the Editor, Psychiatric News

I read with interest Dr. Gold’s August 28 Psychiatric News article “Gun Violence and Mental Illness: It’s Time to Change the Status Quo”. Last week, I had the great pleasure of meeting her when she gave a talk to the Genesee Valley Psychiatric Association here in Rochester, New York, about her other area of expertise, sexual abuse.

Dr. Gold’s main points are extremely well taken about how shocking and unacceptable are any violent deaths, and even more, mass murder; and that people with psychiatric problems are inaccurately and unfairly stigmatized as responsible, when only about 4% of all violent crime perpetrators had identified, treatable mental illnesses. We have a major responsibility as psychiatrists, along with our patients, to combat that stigmatization every chance we get.

Other matters are not so cut and dried. In fact, on a per capita basis, whether measured against population, the number of gun owners, or the number of firearms legally possessed by civilians here, the United States is one of the safest countries in the world. The idea that the presence of firearms in a household dramatically raises the risk of harm to family members is a canard dating back to Dr. Arthur Kellerman three decades ago.¹ In fact, any such “risk” to others can be eliminated by owners’ wise decisions about storage and access.

National Instant Background Checks (NICS) have long been required for all commercial gun sales, along with state checks in many places. Many states also require them at gun shows (as does mine, New York). Requiring background checks for all purchases at all gun shows would be doable, but requiring them for private, 1:1 individual transactions is impossible and would highly complicate personal life for those who complied. Dr. Garen Wintemute found that California’s long-time universal background check requirement has had no impact on “gun deaths”, ² nor did repeal of those in Indiana and Tennessee³, or establishing them in Colorado, Delaware and Washington.⁴ Too many jurisdictions inconsistently report prohibiting conditions to the NICS, allowing too many purchases by otherwise ineligible buyers. At the same time, most NICS’ denials may be false positives, wrongly denying legal purchasers.⁵

There would be almost nothing gained by banning “military-style assault weapons”. Retrospective analyses by the Department of Justice of the 1994-2004 ban could not “clearly credit the ban with any of the nation’s recent drop in gun violence.”⁶ Less than 2% of shootings employ any rifle (not just this subset)—that’s less impact than mental illness. And “assault weapon” is a made-up misnomer—these are simply semi-automatic firearms with features that make them easier to use, not more dangerous. They have become the most popular rifles of all since their appearance in the 1950’s).

Critically, overwhelming non-compliance with any bans must be assumed: in New York, Connecticut and California ((MSRs); Vermont and New Jersey (“bump stocks”); no more than 15% (and mostly less than 5%) of estimated pre-ban supplies were turned in or registered.⁷ These only criminalize erstwhile legal, responsible gun owners while not touching criminals at all, who obtain their firearms via theft or straw purchases and from each other.

Finally, Extreme Risk Protective Orders are a hot topic, being used or considered in many states already, with some Congressional interest in promoting them. They may have utility in forestalling some suicides,⁸ although their value, beyond anecdotes, in preventing murder (mass or otherwise) is uncertain. It is known that police killed one man because of the ERPO they attempted to serve on a man surprised and angered him.⁹ As thus far constituted, ERPO’s have many serious, inherent deficits: they deny initial due process for the uninformed subject; any action permitted to reverse the ERPO comes at the convenience of the court and at the cost of the accused, who is considered guilty unless he proves his own innocence; and like domestic abuse allegations, ERPO’s are easily abused by angry acquaintances.

We may well learn from court challenges that ERPO’s constructed in these ways are illegal and unconstitutional. Doctors for Responsible Gun Ownership wrote a position paper¹⁰ detailing what is necessary for fair, effective ERPOs, and is working with lawyers in the public interest toward promoting legislation that addresses these and other problems with them.

Overall, laws restricting legal ownership and bearing of firearms come up short. The very best recent nationwide study of trends in homicides and violent crime versus relative stringency of state gun laws shows no correlation between them.¹¹

Plenty needs to and can be done to reduce the toll of violent deaths and injuries in the United States without barking up these wrong trees. What we can do and why would require another article, so I’ll limit this communication only to responding to these aspects of Dr. Gold’s excellent article.

Sincerely yours,

Robert B Young, MD

Associate Clinical Professor of Psychiatry, University of Rochester School of Medicine

Distinguished Life Fellow of the American Psychiatric Association

Executive Editor, Doctors for Responsible Gun Ownership

.

.

— DRGO Editor Robert B. Young, MD is a psychiatrist practicing in Pittsford, NY, an associate clinical professor at the University of Rochester School of Medicine, and a Distinguished Life Fellow of the American Psychiatric Association.

All DRGO articles by Robert B. Young, MD