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Violence is a Public Health, Not a Mental Health, Problem

We were all understandably shocked by the horrifying shooting in Tucson AZ this past weekend.  A Congresswoman was critically injured, and six people, including a nine year old girl, were killed.
Media commentators have asked an important question – are public officials safe from violence anymore?  As a former public official who received threats of violence, that's a question about which I care personally.
There’s a consensus answer to it.  In our vitriolic political environment, hateful rhetoric sometimes pushes disturbed, paranoid people over the edge.  If we dial back the rhetoric and keep a closer eye on disturbed, paranoid people, we’ll all be okay.
But there’s a more important question we’re forgetting to ask that leads to a far different answer.
Who points a gun at an innocent nine year old and coldly pulls the trigger?

Tim and Mayor Paul Gionfriddo,
Middletown CT Sidewalk Sale
1990, c.Hartford Courant 
The answer to the question doesn’t fit easily into the narrative of this tragedy.   This is because shooters of nine year olds aren’t usually stoked by hateful rhetoric.  And shooters far more often target innocent nine year olds, who trust us to protect them, than they do equally innocent public officials.  


Think about this:
·        A nine year old was shot dead inside his Washington DC apartment in November, 2009, when a gunman fired through the front door. 
·        A nine year old boy was shot and injured in Brooklyn NY in June, 2010, in a dispute over a stolen bike.
·        A nine year old boy was shot and killed in an affluent gated community in Dade County FL in March, 2010.  A family member was the first identified as a "person of interest.”
·         A nine year old girl, playing on the sidewalk outside her aunt’s home in York PA, was shot in the back and killed in a drive-by shooting on Mother’s Day in May, 2010.
·         A nine year old girl was shot and killed while jumping rope in her grandmother’s front yard in Chicago IL in August, 2010.  Her seven year old sister was also shot. 
·         A nine year old Baton Rouge LA girl was shot six times as she got ready for school, and her mother was killed, in a home invasion in September, 2010.
·         A nine year old girl was shot and killed in October, 2010 while sitting in her family’s minivan in a parking lot in Davie FL.
·         A nine year old girl in Hercules CA was shot and hospitalized in critical condition when she opened her front door in December, 2010.
These are just some of the nine year olds who were recently shot in our country.  How big would the list grow if we added a longer time period, more ages, and additional weapons?  It’s not hard to imagine, because we have the data.  In 2002 alone, homicides took the lives of 250 children aged 4-11.
The reasons for these crimes – vigilantism, gang violence, family feuds, retribution, theft – are as varied as the lives of our neighbors.  These and other environmental demons are far, far more often the reasons why nine year olds get shot than are the illnesses of our brains. 
People with mental illness are more likely to be the victims of violence than its perpetrators.  A history of violence, juvenile detention, and physical abuse are stronger predictors of future violent behavior than is mental illness, but media stories linking mental illness and violence have created the mythical “paranoid, violent, mentally ill person” for people to fear – a myth the weekend shooter happened to fit.  
The poor link between mental illness and violence is not just my opinion.  You can read about it in the Federal Substance Abuse and Mental Health Services Administration Center (SAMHSA) fact sheet Violence and Mental Illness: The Facts.
Violence is a public health problem in our country.  It makes our living environment more dangerous, and shortens our lifespan.  When violence leads to sudden death, most victims can be called innocent bystanders. 
No one deserves to be shot or killed – not a Congresswoman or a child, not six people on a sunny Saturday in Arizona, not the eight children listed above, not the 250 4-11 year olds killed in 2002, and not the 4,090 children and adults killed in 2008 alone in the sixteen states participating in the CDC National Violent Death Reporting System.
Our understanding of violence as a public health problem dates back only about thirty years.  Today, we need to understand that the threat of violence is much bigger than the threat posed by one gunman in a single time and place.
Until we appreciate that we have put nine year olds in harm’s way no matter where they live, learn, and play, we will fail to learn the real lesson from the weekend’s tragedy.  We are all responsible for this environment of violence, and we had better start working together to clean up our mess before more children die.

Comments

  1. I received this comment via email from Tommy Schechtman, MD:

    Agreed. As a pediatrician and strong advocate for children's rights; its time to address this public health threat to our nation's long term well being. Gun safety laws and funding for and access to mental health services should become a national priority for all, regardless of political affiliation.

    It incredible in this aftermath of the senseless Tucson tragedy, one of our State legislators in Florida would have the audacity last night to introduce a bill that would forbid a physician from inquiring from a patient (child) whether or not there are firearms in the household. Not only does this go against all doctor-patient privacy it prevents me from discussing the leading causes of death in teenagers. The leading causes at one time were infectious diseases (e.g., polio, chickenpox) but now accidents, homicides, suicides top the list. As a physician I am obligated to explore all health risks and provide lifestyle counseling for my patients whether it be obesity, high blood pressure, psychological/emotional issues or potential exposure to harmful environmental agents (cigarette smoke, guns). This type of legislation poses not only a public health risk but a real individual health risk for my pediatric patients.

    Tommy Schechtman, pediatrician in Palm Beach Gardens, Florida

    ReplyDelete
  2. Lynn Post-Anderson of MHA of Southwest Alabama, sent the following comment (via email)for posting:

    Dear sir All of those who perpetrate subjugation are the resource for this type of violence. This sad child wasn't (hopefully) born with a problem that wasn't recognized or was and hidden so she could grow out of it as the very ill person that killed her may have experienced. Her killers path probably was from his birth to her and so many others death and now the survivors mental trauma. There isn't one cure but one hope .... early intervention. Www.mhajust10questions.com

    Kindest Thoughts
    Sent from Lynn Post-Anderson's iPhone

    ReplyDelete

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