I am a psychiatrist, and I live and work in Roseburg, Oregon, the site of the most recent act of mass murder by gun violence. We are yet again arguing over ways to reduce this senseless carnage. Some argue that we must change gun laws. Others say we must instead improve mental health care. We must do both.
The risk of gun violence -- both mass casualty and the more prevalent but less publicized individual gun deaths--can be reduced by more and better mental health care, increased access to it for those who want it, and stronger outreach to those who need it. This would be helpful by reducing the incidence of mental illness and being able to identify and take guns away from mentally ill people likely to kill or injure innocents. But there are significant problems in this. First, the individuals who commit acts of gun violence, even mass casualty violence, more often than not appear crazy only in retrospect. Although these acts of violence appear to be increasing, they are still extremely small in number in comparison to the number of people in this country. The number of lonely, angry, poorly socialized, often bullied young men--this being the profile of the men who commit these horrendous acts--is far and away larger than the number of them that commit violence. Together, these things make it is almost impossible to see violence looming in the future of any particular young man. Another problem is that some individuals will avoid contact with the mental health care system out of fear that their guns will be taken away if they are diagnosed with a mental illness. When I worked at the VA hospital as a psychiatrist, many suspicious veterans whose trust I had won asked me if just coming for help for PTSD and other psychiatric illnesses would put their gun ownership at risk. Thus, while improvements in mental health care would be helpful, they would not be enough.
I believe that in addition to improvements in mental health, we need to create gun laws that both respect Second Amendment rights to bear arms and lessen the likelihood that dangerous people will possess weapons with intent to harm others or themselves. Psychological and criminal background checks should be universal and mandatory. It is also necessary to alter current gun laws and HIPPA regulations to make it possible to at least temporarily disarm individuals who fit currently known psychological profiles predisposing to violence. An arm of the legal system needs to be created to allow such individuals to come under scrutiny if they fit that profile and legitimate complaints have been filed by individuals--such as family, coworkers, neighbor,s or law enforcement officials--in the position to know of increased likelihood that they might soon act in violent fashion. Such a complaint could trigger investigation and taking court-ordered custody of weapons if the risk is compelling. In some cases, that disarming should be permanent.
Another means by which gun violence can be reduced and rogue gun owners controlled is by returning to the sorely neglected words of the Second Amendment itself: "A well-regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed." That is, why not make gun ownership dependent upon membership in a well-regulated militia of fellow gun owners? This militia need not be controlled by Federal or even State governments. It could be formed and monitored by local, county governments. It could even be organized by groups like the NRA. Most important are groups of gun owners who can be responsible for each other. The vast majority of gun owners are responsible, civic-minded people. The militias could be organized and run as citizen's groups to provide service to the community in emergency situations, not unlike the National Guard. Membership and regular attendance of reasonably spaced meetings of such militias could be a fair and tolerable requirement for continued gun ownership. The members of the militia could monitor themselves and make certain that all of their members remain level-headed, responsible people. Members of the militias whose circumstances and states of mental health change for the worse could be spotted by other members of the militia, and steps could be taken to avoid escalation into gun violence. People unwilling to participate in such a militia, including the angry, antisocial individuals most prone to commit gun violence, would lose their gun rights.
This accelerating cycle of gun violence must end, and we must use every means at our disposal to do so. This means both improving mental health care and adjusting gun laws while still honoring the text of the Second Amendment to our Constitution. We must progress beyond this impasse. Innocent lives are at stake.