Gun Safety Revisited

July, 2022. As I write this editorial, in May, 2022, we are reeling from the mass shootings in Buffalo, New York and in Uvalde, Texas, and I hope there will not be others by the time of this issue’s publication in July. But given the odds, I fear that might not be the case. Much has been written about the epidemic of violent, lethal, mass shootings in our country. I am not a Constitutional scholar, but here’s what the Second Amendment of the US Constitution states: “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.” It does not say “the right of the people to keep and bear semi-automatic assault rifles shall not be infringed.”

I am personally appalled that, in my home state of Texas, an 18-year-old can legally purchase a semi-automatic assault rifle. In contrast, even in Texas, you have to be 21 to buy a beer or rent a car. We should be thankful for that. Substance use is well established as a risk factor for violence, and it would be irresponsible to allow teenagers to legally party hard, and then, with clouded judgment, to behave in ways that are illegal and potentially dangerous, such as driving under the influence. But the outrageous and utterly irrational statutes in Texas and in other states that make it legal for teenagers to purchase assault weapons are indefensible. An 18-year-old brain isn’t fully built yet, and the neurological brakes necessary to curb impulsive and dangerous behavior are not yet in full working order.

An editorial in the May 26, 2022 issue of Science, was entitled “We know what the problem is.” Editor H. Holden Thorp1 made the following point: “Although opponents of sensible gun control—the kind that prevails throughout most of the civilized world—continue to put the spotlight on the shooters’ motivations or unstable mental states, these are cynical diversions from the one obvious truth: The common thread in all of the country’s revolting mass shootings is the absurdly easy access to guns.” And he pointed out the fallaciousness of the argument that it’s not the guns but mental illness that’s the problem. “No doubt that mental health is a factor. But the rates of mental illness in the United States are similar to those in other countries where mass shootings rarely occur.”

Then there are those who say the problem is not easy gun access, or mental illness, but it’s the existence of evil (whatever that means). But these are all word games deployed to dodge responsibility, and in reality it’s all of the above. I last wrote about this in my editorial in November, 2021,2 where I emphasized the importance of gun safety rather than gun control. Responsible gun ownership can be persuasively defended, but no average citizen needs a semi-automatic assault rifle. And legal guns should be under lock and key, either in the home or elsewhere, accessible only to responsible adults. Then there’s the question about red flag laws to identify those potentially at high risk to carry out gun violence. These are important, but they are not foolproof, and they certainly should not target most individuals in treatment for most psychiatric conditions, who pose no greater risk of violence than the general population.

I recognize that there is not a single solution to this complex problem. But we can do better based on what we know. Let’s change the legal age to purchase guns to 21, an age when the neurodevelopment of the brain is approaching maturity. Let’s ban the sale of semi-automatic assault rifles. And let’s do a better job of identifying troubled youth (and, of course, adults) who need help, and let’s improve access to mental health treatment. As I mentioned in my previous editorial, take a look at the collection of columns by JPP’s Law and Psychiatry section editor, Hal Wortzel, and his colleagues (accessible on the journal homepage3) on therapeutic risk management for violence—a useful resource for all clinicians, as we collectively try to make our country safer. And as Science Editor Thorp said, we must not “sit on the sidelines and watch others fight this out …. Make protest signs …. Push lawmakers to finally break the partisan gridlock …. It’s up to us.”

Last but by no means least, on a happier note, let me congratulate Edison Leung and colleagues for their winning submission in our 2021 resident paper competition, “A retrospective study of the adjunctive use of gabapentin with benzodiazepines for the treatment of benzodiazepine withdrawal,” published in this issue of the Journal. Addiction issues remain in the forefront of our mental health challenges, and substance use, as mentioned above, is a well-established risk factor for violence. This study provides welcome guidance to counselors and clinicians to help people with this prevalent and highly addictive condition.

1. Thorp HH. We know what the problem is. Science. 2022;376:1027. doi:10.1126/science.add1854. 2. Oldham JM. Gun safety. J Psychiatr Pract. 2021;27:409. 3. Therapeutic Risk Management for Violence. Collection of articles published in the Journal of Psychiatric Practice. Available at: https://journals.lww.com/practicalpsychiatry/pages/collectiondetails.aspx?TopicalCollectionId=15. Accessed May 30, 2022.

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