Gregory K. Fritz: We need national response to school shootings

This past October President Obama spoke to the American people after yet another mass school shooting, saying, “Somehow this has become routine. The reporting is routine. My response here at the podium ends up being routine, as does the conversation in the aftermath of it. We’ve become numb to this.”
His comments reflected the widespread frustration in the U.S. that despite the mounting toll, nothing really changes. It appears to me that Americans want something to be done about school shootings — but that the solution has to be cheap, with little impact on our own life styles, and it can’t conflict with any group’s cherished ideals. And it should have immediate and guaranteed success.
My own view is that, given the complexity of the issues involved, and the magnitude of the problem, we should embrace every reasonable proposal that can plausibly have an impact. We should be mature enough to realize that there is no free lunch and we’ll have to pay for the solutions, with money and/or reasonable tradeoffs in some of the prerogatives we now enjoy. After doing all that we still have to accept that nothing can guarantee an absolute end to school shootings once and for all.
As a child mental health professional, I am sensitive to the likelihood of furthering the stigma of mental illness when our patients are equated with mass murderers. And if psychiatric records become government documents, the very patients who most need our help may avoid us like the plague.
It’s true that the vast majority of those with mental illnesses are not violent and that they are much more likely to be victims than perpetrators of violence. However it’s also true that virtually all school shooters have shown signs of serious psychological problems (preceding their attacks) that might well have been amenable to psychiatric/psychological intervention had they been identified and addressed earlier.
The problem is that children’s access to mental health services is woefully inadequate in our current system, stigma still keeps troubled youth from getting the care they need, and prevention and screening are just given lip service. Our country could change all that with just a fraction of the money that was spent on the Iraq war — but we apparently lack the will. To be fair, such an expenditure, even if it were highly successful, would not guarantee that a shooter would not slip through the cracks; the known risk factors are too non-specific and the events, while sickeningly frequent, are still extremely rare.
The other major topic of discussion in relation to school shootings is gun control, obviously a contentious issue that pits liberals against conservatives, urban dwellers against those who live in rural areas, and gun owners against gun haters. At first glance, gun control seems to be a simple and obvious solution: if there were no guns, there would be no shooting. Restrict access to guns and there will be fewer shootings. One has to just scratch the surface however, to see the complexity.
Gun ownership is a constitutionally protected right in America. There are currently more than 300 million guns owned by Americans, making for relatively easy accessibility even if all gun sales were stopped tomorrow. Restricting assault rifles and large capacity magazines would seem to be a reasonable reform, but the number of people killed by assault rifles compared to handguns is tiny, and the impact would be small.
Despite these complexities, I don’t see how it’s possible to reject commonsense gun control provisions unless one agrees that mass shootings are worth the price for unfettered gun freedom. As a lifelong bird hunter and owner of a number of well-worn shotguns, I nonetheless support gun registration, waiting periods, restrictions on assault weapons and background checks, (including medical record scrutiny). I hate to compromise the confidentiality of psychiatric records, but for those who wish to purchase a lethal weapon I believe it is a reasonable requirement (assuming the review process is appropriate).
It is true that these measures will disproportionately affect responsible gun owners compared with likely shooters — because there are so few in the latter category and they are extremely hard to identify.
The way to deal with school shootings is not via an endless “either-or” argument that always ends up as a stalemate. Rather we need to exercise our maturity and embrace an “and….and” approach. Then we need to mobilize our incredible national capacity and get something done.
Gregory K. Fritz, M.D., is academic director at Bradley Hospital and editor of the Brown University Child and Adolescent Behavior Letter.

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