Point-Counterpoint: Gun Reform and Mental Health

By Leo Covis

David Jonas: Okay, let’s say your advising the President on gun reform. He wants something done, but he doesn’t have much of a stated agenda on the topic. What do you say to him?

Leo Covis: Mr. President, passing new gun laws is going to cost you A LOT of political capital and the results could be dubious. We may end up regulating illegal guns the way we regulate illegal drugs. The black market is going to be too powerful for us to make a real impact on gun violence.

Instead, if you’re interested in eliminating mass shootings like those in Newtown, Aurora and Columbine, spend your political capital on beefing up mental health services throughout the US. Right now, cops are our de facto mental health practitioners, and prisons are our largest mental health hospitals.

DJ: What would that look like? I’ve seen politicians of all stripes say that we need to focus on mental health. But what does a push on mental health look like?

LC: Great question Mr. President. I was hoping you would ask.

First of all, public school nurses should be trained in mental health diagnosis. Many times, people exhibit anti-social behavior early in life that could actually be a harbinger of on-coming sever mental illness. If nurses at public schools could tell the difference between growing pains and early signs of schizophrenia, we would have a good start.

Secondly, mental health treatment needs to be covered in Obamacare. We also need to require private insurance companies to include comprehensive mental health services in their policies.

Finally, we need more trained professionals. We should find ways to incentivize mental health treatment and facilitate the building of more mental health facilities.

Public mental health institutions existed before, but they were run poorly and were subsequently shuttered. We know now that we need public mental health facilities, but they need to be adequately regulated.

DJ: I’m not sure I see the link between these reforms and reducing gun violence significantly. Plenty of other countries have less-than-adequate mental health systems, but they don’t have the associated gun violence. How many fewer gun murders and suicides would be prevented by a complete mental health overhaul like the one you’re describing? Why not just put up more barriers to acquiring guns and ammunition?

DJ: You’re right that many other countries don’t have adequate mental health policies but still fewer mass murders and gun violence. The difference is, they don’t give their citizens the constitutional right to own a gun. Look here, in China a mentally-ill individual attacked children in a school. Unlike Newtown, however, he was armed with a knife. 22 children were hurt, none killed.

I’m afraid though that I don’t see us reaching that level of gun control here. Our constraints require us to focus on mental health rather than guns. If you like, you can also look at this report that suggests that stricter gun laws would have either no effect on illegal gun sales, or might even increase them.

Killers like those at Newtown and Aurora and other such mass killings exhibited dangerous behavior before they went on rampages. Had we been able to address their issues before hand, we may have prevented atrocities.

DJ: Okay, let’s say there’s a student in a school who’s exhibiting these tell-tale behaviors. What are the next steps? Are school health officials allowed to take this person out of class? What does this look like in practice? Because, I imagine, for every Adam Lanza, there are 10,000 kids who display the same symptoms.

LC: With all due respect, sir, similar symptoms, but not the same symptoms. I’m not qualified to tell the difference, but a trained professional would do better than me. I don’t think we need to give school officials more power than they already have. Teachers and administrators have the authority to temporarily take kids out of class to address behavioral issues. I’m suggesting only that they have the training to identify potentially serious problems versus normal coming-of-age issues.

If they identify someone who may be dangerous, then normal protocols would require informing the parents and then taking more action. Having adequate mental health facilities and trained professionals in them would give school administrators and parents and effective means to address problems before they become crises.

DJ: So what does this program look like? Is it a series of grants? Is it federally-mandated training?

LC: Mr. President, I think we need to require school nurses to be trained in mental health diagnosis. And I think we need to have well-equipped and staffed mental health institutions that can be accessed by anybody who needs them.

The way to do this is to mandate training for school nurses and providing grants through education funding for that purpose.

Requiring private health care companies to cover mental health will help to incentivize building the infrastructure to treat people who need help but can’t afford it now.

DJ: I agree, but I still don’t see how (structurally) a mentally-disturbed young man (they seem to range from early teens to late 20’s), even one who’s in treatment, is prevented from pulling off a massacre. Is this just about reducing the number of massacres, not making them structurally harder to perpetrate?

LC: You’re very perceptive, Mr. President. I see why you were elected.

Yes, this is about treating the problem at it’s source. I don’t think we can adequately address this by regulating guns, primarily because we can’t make guns illegal, and they will therefore always be part of American life, and unfortunately, part of American violence.

However, the people who have perpetrated mass shootings have had significant similarities that include mental health problems. If we can address the mental health, we can reduce, if not eliminate, the problem of mass shootings.

Here, to further strengthen my point, is the story of a man who used a legal gun with a 10-round magazine to commit a mass-shooting in Oakland, California. The reforms proposed by many advocates would have done nothing to save the lives of the people at Oikos University.

DJ: Last question. If we look at the Virginia Tech shootings in 2007, the gunman had received lots of attention from mental health practitioners, but by the time he was an adult, he could use medical privacy rights to prevent others from knowing it. And even when faculty noticed signs, there was little done on his behalf. How should schools and governments act in that kind of situation, where the student is a legal adult with certain rights that students under 18 don’t have?

LC: Virginia Tech is a good example. The Virginia Tech Review Panel suggested the following change to state law:

Virginia Health Records Privacy Act and Va.
Code 37.2-814 et seq., should be amended to ensure that all entities involved with treatment have full authority to share records with each other and all persons involved in the involuntary commitment process while providing the legal safeguards needed to prevent unwarranted breaches of confidentiality.

And Virginia responded by amending state laws in accordance with the review panel’s findings. Voluntary and involuntary commitment policies were changed, while disclosure standards were also changed, requiring practitioners to share information with other relevant parties.

This can work, Mr. President, and you can make it happen with less political capital than trying to eliminate assault rifles and high capacity magazines.


Leo Covis is a graduate public policy student here at the Goldman School. I asked him how he would advise the President on gun reform following the shootings in Newtown, Connecticut. Here’s a lightly-edited transcript.