The Problem Is That I’m Not in an Institution

Well, well. This is something new. I’m used to people blaming mass shootings on mental illness because “Obviously there’s something wrong with those people.” I’m used to gross, proud ignorance of what constitutes mental illness and indignation over being asked to get it right before classing a large group as a menace to society.

What I’m not used to is a bunch of gun nuts telling us we can’t talk about gun control because we liberals were all in favor of deinstitutionalization. That’s the problem, you see. We no longer take away people’s freedom because their brains don’t work right all the time, so of course people are dying.

Nothing to do with the proliferation of guns and entitled attitudes toward them and incorrect beliefs about how they end up used. Nah, it’s because we don’t lock up all those crazies.

Ask pretty much any of the gun owners I’ve recently seen commenting on their friends’ and relatives’ Facebook posts for the first time in the last week.

As a “crazy” myself, I’ve got one or two things to say on the matter. It turns out that they all boil down to “Nope.” So here’s why these gun owners and whatever right-wing talking heads spread this meme.

By now, you’ve probably seen the argument that people who have a mental illness are more likely to be the victims of violence than its perpetrators. This is a robust finding when the topic is studied and in line with everything else we know about who is targeted for criminal victimization. People with mental illness make safe targets because they have more difficulties advocating for justice.

But what about mass shooters? Those must be different, right? Those crimes are inexplicable, so the perpetrators must be mentally ill!

Well, some of them are. That’s not surprising. With estimates of lifetime prevalence of mental illness usually placed somewhere around 20-25%, the surprise would come if none of the killers had any experience with mental illness. But the rates of mental illness among mass shooters is roughly equivalent to rates among the general population. In other words, mental illness makes people no more likely to shoot up a home, theater, or school.

Moreover, the reasons people give for killing a bunch of people rarely have anything to do with any mental illness. These reasons aren’t based in delusion. They’re generally based in dissatisfaction. “They fired me.” “They rejected me.” “Their politics will change the world in ways I don’t like.” “They don’t pay enough attention to me.”

These aren’t reasons you or I would find persuasive (I hope), but they’re grounded in some kind of reality. Unless we’re prepared to call everyone who makes decisions different from ours mentally ill, we have no business blaming these murders on mental illness.

Even leaving aside the question of what constitutes mental illness, however (though it’s vital to this discussion), people who blame these shootings on deinstitutionalization are dead wrong. Why? Because deinstitutionalization was never complete.

The argument for deinstitutionalization was that it served neither the interests of the mentally ill nor the state. It robbed mentally ill people of their liberty and self-determination without giving them anything compelling in return. Even those in institutions who were mentally ill (many were not) we’re only there because it served their families’ interests to have them hidden away. Their care could be delivered as well if not better in a community setting, and being deprived of freedom and social interaction hampered their progress.

We’ve arguably done a terrible job of delivering services outside an institutional setting as well, but this is why the change was made. But that’s the patients’ rights. We’re also discussing the interests of the state. Those came into play mostly in terms of who was released and who can be involuntarily institutionalized even now.

Oh, you did know we still lock up people with mental illnesses against their will, didn’t you? There are more limitations on the solution and more checks in place to make sure mentally ill people’s rights are considered, but we’ve never stopped institutionalizing people who want to be free. It’s just that, now, the only acceptable reason for doing so is that they have been judged to pose a reasonable danger to themselves or others by virtue of their mental illness.

That’s right. We already institutionalize the mentally ill people we’ve identified as being a risk to society. The only way we could reduce the risk further through institutionalization–which would, remember, put the risk below that from people without mental illness–would be to lock up people who have been evaluated but determined not to pose a realistic risk at this time.

In other words, we’d be locking up innocent people just so we didn’t have to mandate the kinds of checks and protections that all gun owners swear up and down to me that they already do. That’s what the gun nuts are asking us to do.

The Problem Is That I’m Not in an Institution