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Since the Sandy Hook shooting gun control has moved center stage. Biden is meeting with people / groups on both sides of gun control and is supposed to make recommendations soon about how to prevent another mass shooting.

Unfortunately I think the focus on gun control is misplaced because it is too narrow of a focus. Sandy Hook and other mass shootings aren’t purely a symptom of lax gun laws or the availability of high capacity magazines. There is much more to these mass shootings than even we know currently. Very generally mass shootings are going to involve individual factors, socioeconomic factors and legal factors.

At the individual level there is the obvious issue of mental health. Many are pushing for restrictions on the sale of guns to those with mental health issues. Personally I doubt this is even remotely feasable. First off it would require drastic changes to HIPPA, it would require that laws governing protected health information (PHI) allow information to be shared in order to screen individuals with mental health disorders. But that is unlikely to happen, how many people would want the state or gun dealers to have access to their personal health care records? I doubt many would want to grant others such an intimate view into our lives considering how protective of that information many people are. Second mental health is not an exact science, there is no way to predict if an individual is going to do something drastic or not. Most people (even with psychological disorders) are not going to go on a shooting rampage. Most people are not a violent threat to those around them. So that would leave us in the situation where if an individual has a psychological disorder we have to decide do we exclude them from gun ownership or not? In a majority of the cases there would be no harm in allowing that individual to own guns but in some cases it could be dangerous for them to own a gun. So do we take away the rights of 99 people in order to prevent 1 from doing something? That would seem to be the opposite of our legal system in which individuals are presumed innocent until proven guilty. Furthermore there is the question of whether we could even identify the high risk individuals. There have been shooting incidences in the military and those individuals are monitored to a much greater degree than civilians are. They have access to their health records when they need them, they can order psychological evaluation easier in the military, they can require treatment and much more. Yet they can’t identify potential shooters and prevent occurrences such as Major Nasan. If the military can’t identify potential shooters how would we expect the state or gun dealers to identify potential shooters. Then there is the issue of documentation. Even if we had a good method to identify high risk individuals and we required disclosure of mental health records we would have issues with preventing mass shootings. That is because a problem needs to be documented in order for it to come to light in a bureaucratic system. So if an individual never seeks treatment for mental health then there will be no record and thus no reason to deny that individual their right to bear arms.

Now we might be able to deal with all the mental health issues presented above if a psych evaluation was required prior to owning a gun. But that comes with it’s own problems. First off a method of identifying high risk individuals accurately would be a primary hurdle. I am personally doubtful that we could even develop an accurate test for the risk a individual poses to society if they were allowed to own guns. Then even if an effective test were created there would be major issues. It would be expensive to administer something of that nature, it would likely require a trained mental health professional and take at least a few hours. The cost would likely be hundreds of dollars, possibly even more than $1,000. That in itself would pose a problem as the constitutionality of such a measure could be challenged on the basis that the cost prohibits the exercise of one’s rights. Also there is the question of how often one needs evaluated. Mental health is not static, your status changes from day to day, from month to month, from year to year. So do you have to renew your psych eval to own guns? Or do you just do it when you purchase guns? Do you only do one then you qualify to own guns or do you get tested every time you buy a gun?

Now this is not to say that individual mental health should not be considered when trying to engage the issue of mass shootings. In fact I think it would be beneficial to invest more into research on individual who commit such acts. It would be good to develop a psychological profile of pertinent individual factors that might increase the propensity for somebody to go on a shooting spree. I am just skeptical of a predictive model for this type of occurrence, but any insight we can gain could be of benefit.

Next there are socioeconomic factors that play into the mass shootings. We know that social and economic conditions can directly effect an individuals mental health. That means issues like unemployment could play a role in a mass shootings. The stress from unemployment, under-employment, bankruptcy and other economic situations do have negative impacts on individual mental health. Thus when our overall economic situation in the US is worse then it would be reasonable to postulate that more mass shootings are likely to occur (though this needs empirically verified before it can affect policy decisions). If there is a true link between general economic conditions and the rate of mass shootings that could offer at least some potential solutions since improving the economy could improve this issue simultaneously.

Another social factor that plays a role is the perception of mass shooters. When one strikes their actions dominate the media for weeks. It is impossible not to see them everywhere. This causes a couple problems in itself. One there is a degree of aggrandizement of the shooters. They go down in a blaze of glory (if they die) or become a virtual celebrity (if they live). This could influence others to do the same thing. We know from psych research that highly publicized suicides can lead to copycat suicides in the areas where it received heavy media coverage. It is reasonable to suspect that a similar thing could take place with mass shootings. That could push an individual over the edge when deciding a course of action. That could influence them toward a mass shooting as opposed to a simple suicide. The other problem caused by media coverage is it’s influence on individual perception of mass shootings. Because they receive so much coverage people feel that they are a real true immediate threat when in fact the number of people killed in mass shootings is rather small. The probability of being killed in that manner is ridiculously minimal. Yet the media coverage leads people to believe that the danger is greater than it is. That causes people to be overly emotional about the issue which inhibits good well reasoned analysis of the root causes of the incident. It leads people to take action before thoughtful consideration of the solutions being proposed. It in general interferes with solving the problem.

Next there is the access to and perception of mental health treatment. There is a definite bias against seeking mental health services in this country. There are many who consider psychological counseling to be little more than snake oil. And even among those that don’t share such a negative view many still are adverse to mental health treatment. Some don’t want to admit they have a problem, some don’t want others to know they have a problem, some don’t believe therapy or medications can help them. There are many reasons to avoid seeking mental health treatment. I think that as the overall perception of psychology / psychiatry improves then the rates of seeking treatment will improve. That in turn will allow more people to get help and should help reduce the prevalence of mass shootings. But as is, the stigma of having a psychological disorder is a barrier to the prevention of mass shootings since it is a barrier to treatment.

Another barrier to mental health treatment is access to care. Mental health treatment has never been taken as seriously as physical treatment. States fund less care for mental health than physical health. Insurance companies fund mental health and often require higher copays or offer fewer visits. Additionally mental health services are quite expensive if you pay out of pocket. That means even if an individual is open to seeking mental health treatment they may not be able to get treatment. On the plus side this will be mitigated to some degree. Part of the Affordable Care Act required that insurance companies treat mental health services like medical services in terms of coverage. That should expand access to care for millions of individuals.

The final issue is the legal system. Say we implement increased gun control, would that actually help prevent mass shootings. Well that depends on how we implement it. If we ban high capacity magazine but grandfather in all existing ones then we have functionally done nothing. The magazines would still be available just there wouldn’t be any new ones being produced. So yeah it might be a bit harder to purchase but that isn’t really a barrier. Same goes for restrictions of certain types of guns. It doesn’t matter if we ban production of them if there are thousands already floating around and people are allowed to possess them legally. For any gun restrictions to work even mildly it would require that existing items are not grandfathered in. Though an outright ban on some weapons would not mean they would disappear. It would take a lot of enforcement to try and get those items off the streets. Beyond that, if an individual is planning a mass shooting I doubt that the legality of their weapons would be a major deterrent. They are already preparing to commit a heinous crime so buying a gun illegally would not stop them. My point here is that any gun control is only as good as it’s implementation. If there are flaws in how it is implemented then gun control legislation serves no purpose. The same idea applies to mental health requirements in order to own a gun.

Also we have tied our hands in some respects. The ATF is not allowed to maintain a computer database of guns. So tracking guns requires a lot of leg work when it could be an instant search in a database. Also firearms dealers can’t be required to take inventory of their stock yet more than 100,000 guns are missing from dealers shelves. And firearms dealers can only be inspected once a year. That creates a system where we as a nation don’t want to track firearms sales to ensure that guns don’t end up in the wrong hands. How are we to implement any form of gun control if firearm dealers don’t have to track their inventory and the federal government can’t look up firearms in a database?

Note: The previous paragraph came from an interesting article from NPR.  http://www.npr.org/2013/01/08/168889491/gun-control-advocates-say-atfs-hands-have-been-tied

In conclusion, my biggest problem with the discussion surrounding the recent mass shootings is it’s scope. The focus is narrowed down to just gun control. But the problem is not that simple. Gun control alone is not likely to change anything. Even if we successfully eliminate high capacity magazine and assault weapons we will not stop mass shootings. An individual can do a lot of damage if they want to with or without guns. Gun control at best will minimize the damage but can’t stop it. There is no way to take away all weapons from people if they want to cause harm to others. Just look at prisons where people are extremely restricted and can still kill one another. Look at inpatient psychiatric institutions where people can still commit suicide despite all the precautions taken. Instead of focusing purely on gun control we need to focus on broader more complex causes of shootings like this.

But before we can really focus on any solution we need more knowledge. We need to invest into greater research into this area. We need to develop psychological profiles of the mass shooters along with features that can distinguish them from other individuals which are not a threat to society. We need to identify personal history factors, social factors, economic factors and other general aspects that seem to play a role in mass shootings. That could help develop solutions or identify areas or individuals of high risk. Next we need to evaluate barriers to mental health treatment because if individuals can get treatment before going down the path of destruction then we can prevent the damage caused. Then we need in-depth analysis of gun laws and practices which could inhibit mass shootings. But this must be done by looking at how the guns were acquired for numerous shootings. That way any gun control changes are based on what conditions could have prevented prior shooters from acquiring the firearms they used.  If we research these aspects of the shootings we may be able to develop a solution to prevent future mass shootings.