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Mark - while your statistics about the co-ocurrence of mental illness and mass shootings is true, it ignores the fact that the other underlying characteristics - obsession, narcissism, domestic abuse, etc. - are hallmarks of personality disorders and other decreased mental functioning. They may not have classic mental illness - bipolar, depression, schizophrenia - but mass shooters are not in a healthy frame of mind. Personality disorders are notoriously difficult to diagnose and treat, but that does not mean that the president is incorrect. Virtually all mass shooters have some type of mental state for which medical or counseling treatment would be beneficial. Reading the literature closely is important. One must note how people write about mental illness vs. mental conditions. The former is exclusive to bipolar, schizophrenia, depression, while the latter includes anxiety disorders and personality disorders.

Further, the discussion about the necessity of mental institutions must consider the needs of the chronically homeless, for which mental illness co-occurrence is significant. In fact, the increase in the number of mentally ill homeless on the street coincides with the closure of mental institutions in the 1980's. You and I agree that the institutions that were closed were rife with abuse. But that does not negate the need for institutional treatment and support for so many people who currently do not receive it. If community-based, voluntary care has not been effective, then perhaps it is important to consider again mandatory, institutional-based care.

Mark, with all due respect: if any of the recent mass shooters (any mass shooter, really) stated their desire to engage in a mass shooting and their reasoning behind it, all of them would have been committable to a psychiatric ward for inpatient observation/medication/therapy on the spot. Just because only 25% have been diagnosed with a mental illness before the shooting, it does not change the fact that post-shooting virtually all are diagnosed (whether alive or living) with the kind of behavior and traits indicative of mental illness, esp. schizoid breaks with reality. In fact, the kind of mental break with reality that causes someone to think, "it's okay if I go kill 5, 10, 20, 40 people" is an evaluative factor in diagnosing someone with mental illness! By definition, mass shooters are mentally ill.

The president is correct to say that mass shooters need help and that our current system is not helping them.

Mark, your comment that news reports are not trustworthy indicates your position on this issue. When I read that I hear you saying, "I don't trust news reports that report information that contradicts with my preferred narrative". I have no reason to not trust that media validly report on the issues surrounding these catastrophic events. It's going to be difficult to continue this line of dialogue if you are not open to the possibility that others have different - and valid - perspectives from you.


Keeping in mind the community guidelines, let us agree to disagree and cease this line of discussion. Please receive this in love. I share your desire to provide loving, appropriate care for those with mental health needs (which includes those who have a psychotic break with reality that causes them to inflict harm on others). But having worked in the field, I recognize the need for institutional care - up to and including the ability of the government to commit those who refuse to seek help voluntarily if they present a danger to others.

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