Mental Illness in the US – How Policy Discourages Treatment

With yet another mass shooting incident, we will again hear the proclamations that guns must be kept from people “with mental illness.”


Indeed, we will be told that we must do more to screen individuals for mental illness.  Some will argue (as the President did after Newtown) that HIPAA rules must be changed because they present an “unnecessary legal barrier” to the states reporting of people with a history of mental illness.

On the other hand, these same people will argue for additional mental health treatment options.  They will argue that there should be additional resources devoted to finding and screening those with mental illness.  Perhaps they also believe that people with mental health should receive treatment in order to stabilize them.

Here is where policy goals have unintended consequences.  When a person or group says that it wants to identify a group in order to take away some of that group’s rights or privileges, it becomes a very big problem.  Take a look at airline pilots.  If an airline pilot suffers a bout of depression (for example, if the pilot’s wife died) then a diagnosis of depression is enough to ground that airline pilot.  In fact, a pilot would have top self-report that he is feeling down about the loss of his wife.

Trust me, there are hundreds or thousands of airline pilots each year who deal with some form of mental distress.  Yet, we are unable to point to any string of incidents that resulted from depressed pilots causing problems.  Nevertheless, when a German pilot deliberately crashed a passenger jet into the Alps earlier this year, it brought calls for increased scrutiny of airline pilots to undergo psychological testing or screening as a prophylactic measure.

Meanwhile, in England, there was a new approach.  England had a system whereupon a report of depressive illness resulted in a permanent grounding of an aviator.  The British realized that this system encouraged its pilots to deliberately avoid mental health care.  About five years ago, the British Civil Aviation Authority introduced new regulations that allowed a pilot to regain his or her medical certificate once the depressive illness had passed.

In the five years since the new regulations were adopted, it was reported that 350 pilots had self-reported a depressive illness.  Of this, more than 275 had been handed back their medical certificate, having shown that the depressive illness had passed.  They were free to resume their careers after receiving diagnosis and treatment.

But what is suggested in the US?  If a person suffered a major depressive episode and was involuntarily committed, that person is permanently barred from gun ownership and, no doubt, other things.  Due to the stigma associated with mental illness, and the punitive reactions, the US has created a policy that encourages the mentally ill to go untreated.  Treatment is available for them but they have a rational mind that understands that seeking treatment will likely come with a lifelong negative consequence.

Is it not time that we as a people stopped?  Do we want to blame someone?  Do we want to make a problem worse?  OR do we want to actually try to solve the problem by taking on an approach that encourages self-reporting and treatment?

Most mentally ill people did nothing wrong.  They did not ask for their affliction.  Let us show them that accepting help comes without strings attached.


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