GUNS DON'T KILL PEOPLE, MENTALLY ILL PEOPLE DO!

Well of course that is only a very small part of killings with guns in the world. It just gets a whole lot more attention from the media.  A recent killing rampage in California by Elliot Rodger has led to more calls for the involuntary comittment of the mentally ill as Elloit's recent and past behavior suggests that he was mentally ill. This is commented upon in an opinion piece in the June 3, 2014 NY Times by Joe Nocera.  Mr. Nocera does not believe that locking up the mentally ill who are agitated and yet not making specific threats to individuals, and who can function independently, is the answer. Mr. Nocera ends his opinion piece wondering if the focus should be on making it harder for anyone to get guns, not just the mentally ill. 

Well, that idea suffers from being too logical and effective in signifantly reducing gun related deaths. It requires that we as a country take responsibility for the suffering and loss that are insistence on the right to arm ourselves has caused. We are now moving toward defining our right to bear arms to include carrying concealed weapons on college campuses (according to the National Conference of State Legislatures website seven states have laws permitting this). I have blogged before about the problem of access to weapons and all the deaths, including children, related to this. As I've mentioned, "guns don't kill people, but people with guns do!"

Getting back to potentially violent people suffering from mental illnesses, I have two points to make. The first one is that Elliot Rodger's parents reported that Elliot was severely bullied as a child. I have blogged a couple of times about the damage that bullying can do and the deadly reactions that can occur, including suicide and homicide. My second point is that it might be time to take seriously general threats made online and in other settings. It seems prudent and reasonable to consider these threats a crime. This could have led to Elloit getting help.  Finally, people who are bullied will sometimes cope by bullying others. Another reason to work to reduce bullying and provide more help for those who are bullied and even for the bullies!

AFTER BEING BULLIED, IT STILL HURTS TEN YEARS LATER

The most recent AACAP News summarized an article by Copeland, etal., in JAMA Psychiatry 20:1-8 that looked at children and adolescents who were bullied or the bullies 10 years later.  This was a follow-up from the Great Smoky Mountain Epidemiological study that was done in wesern North Carolina.  They found that both those who were bullied and those who did the bullying continued to suffer.  Those who had been bullied were still at high risk for several anxiety disorders and depression.  In addition, suicidal impulses were very increased in males who had been bullied and agoraphobia was very increased in females who had been bullied.  For those who had done the bullying, the only increased risk for any psychiatric disorder was for antisocial personality disorder.  

It is important to also mention that the increased risk for psychiatric disorders was related to the bullying and not to genetic or other environmental factors.  This points out the serious consequences of being bullied and also the consequences for the bullies as well.  It is possible that the continuing suffering is related to the development of Post Traumatic Stress Disorders [PTSD] and ongoing symptoms related to the PTSD.  The PTSD is treatable and yet must be recognized as PTSD to help the treatment to be successful. I have treated a number of children and adolescents in the hospital who developed suicidal behavior related to their being bullied.  

I hope that increasing awareness of the severe consequences of bullying will help efforts to stop bullying and treat it as a serious problem that often leads to longterm suffering.  We have zero tolerance for threats of violence in our school systems.  Maybe it is time to have zero tolerance for bullying as well.