President Trump was asked about gun violence following the two horrific attacks in El Paso and Dayton. Any time there is a mass shooting we here about gun control. Rarely do we hear about it when individuals are murdering each other.

“We’re looking at the whole gun situation. I do want people to remember the words ‘mental illness.’ These people are mentally ill. And nobody talks about that.”

He got that right! When we do, we tend to spread fear of those of us who live every day with a mental health issue.

It appears that some of the people who have committed these mass shootings have been diagnosed with a mental illness or looking back, they showed signs of a brain illness. But keep in mind, fewer than 5% of the 120,000 gun-related killings in the U.S. from 2001 to 2010 were perpetrated by people diagnosed with mental illness, according to data from the Centers for Disease Control and Prevention.

“I think we have to start building institutions again,” he added, saying that mental institutions were closed in the 1960s and 1970s and “the people were just allowed to just go onto the streets ― that was a terrible thing for our country…We have to open up institutions ― we can’t let these people be on the streets.”

He is right about that. We cannot and must not let people with mental illness languish on the streets.

He also said the public don’t want “insane people, dangerous people, bad people” owning guns.

First, I give credit to the President for saying something few want to say. Too many people with mental illness are not receiving the care they deserve and far too many are on the streets.

Homelessness began with deinstitutionalization.

Deinstitutionalization is the name given to the policy of moving severely mentally ill people out of large state institutions and then closing part or all of those institutions; it has been a major contributing factor to the mental illness crisis. Deinstitutionalization began in 1955.

The magnitude of deinstitutionalization of the severely mentally ill qualifies it as one of the largest social experiments in American history.

Most of those who were deinstitutionalized from the nation’s public psychiatric hospitals were severely mentally ill. Between 50 and 60 percent of them were diagnosed with schizophrenia. Another 10 to 15 percent were diagnosed with manic-depressive illness and severe depression.

Thus deinstitutionalization has helped create the mental illness crisis by discharging people from public psychiatric hospitals without ensuring that they received the medication and rehabilitation services necessary for them to live successfully in the community. Deinstitutionalization further exacerbated the situation because, once the public psychiatric beds had been closed, they were not available for people who later became mentally ill, and this situation continues up to the present. Consequently, approximately 2.2 million severely mentally ill people do not receive any psychiatric treatment.

President Jimmy Carter’s Commission on Mental Health said this ideology rested on “the objective of maintaining the greatest degree of freedom, self-determination, autonomy, dignity, and integrity of body, mind, and spirit for the individual while he or she participates in treatment or receives services.

Self-determination. Wow, Sounds wonderful. Except people with severe mental illness, people suffering from deep depression, do not have self-determination. They cannot think clearly.

This deinstitutionalization is a prime example of feeling-based decision making. And that one decision placed far too many of our most vulnerable people on the street. Turning to drugs and alcohol to self-medicate. And for those of you who have trouble understanding why people with mental illness turn to drugs and alcohol;they blot out the fear and anxiety.

Today, homelessness is a severe problem for those living with mental illness. About a quarter of a million Canadians will experience homelessness a year and about a third of them, 85,000 live with mental illness.

In America  25 percent of the homeless—140,000 individuals—were seriously mentally ill at any given point in time. Forty-five percent of the homeless—250,000 individuals—have a mental illness. Mental illness was the third largest cause of homelessness for single adults (mentioned by 48% of cities).

“Lack of treatment for the most seriously mentally ill causes the kind of delusions and bizarre behaviour that makes living alone or at home with families untenable. As a result, many become people with untreated serious mental illness become homeless and communities are forced to bear the cost of that.”

So let’ talk about mental illness!

First, people with mental illness rarely kill others. We tend to kill ourselves. Which does not mean that people with mental illness do not kill.  Dr. James Alan Fox, a criminologist at Northeastern University has studied and written about mass murderers.

“For the purely random attackers, that’s where you find psychotic thinking…The more indiscriminate; the more likely there is serious mental illness.”

Dr. Peter Delany in a 2011 report published by the U.S. Centers for Disease Control and Prevention said “These are real people that have very serious problems…The data should be helping us think through how we want to approach helping them get services that they need.” In all cases, family, friends and sometimes medical people who knew something was wrong but didn’t do anything.

Remember Adam Lanza and Sandy Hook?

Mass murderers are too often suffering from a mental illness. But please, Mr. President do not refer to the mentally ill as insane and dangerous.  We are neither. But I understand that sentiment. We hear it over and over again. Here, in Canada, we try and connect actions of terrorists with mental illness. Terrorists are responding to evil ideologies. They are not mentally ill. And when we connect terror with mental illness we increase stigma.

Mental illness continues because of stigma. Investigators have found that social stigma against mental health treatment is strongest amongst youth, men, members of ethnic minorities, and people in the military and health sectors. Sarah Clement, a co-investigator on the King’s College study says that social stigma — rather than mere cost — still impedes progress on improving population health.

“Our study clearly demonstrates that mental health stigma plays an important role in preventing people from accessing treatment…We found that the fear of disclosing a mental health condition was a particularly common barrier. Supporting people to talk about their mental health problems, for example through anti-stigma campaigns, may mean they are more likely to seek help.”

So here I am, again, waiting. Waiting for lots of tweets about mental illness and stigma and how we are all going to put an end to the homelessness…and nothing.

Just the President is talking.

 

From the Ethics of the Fathers: “Rabbi Tarfon used to say, it is not incumbent upon you to complete the task, but you are not exempt from undertaking it.”