Showing posts with label Mental Health. Show all posts
Showing posts with label Mental Health. Show all posts

Thursday, January 24, 2013

Misguided Moralism From Both Sides of the Gun Debate


Many have questioned why it took the tragedy at Sandy Hook to jump start the debate on gun control, a massacre so horrific that even some staunchly pro-gun politicians have started to suggest that perhaps some new regulations might be in order.
"The Suicide" Edouard Manet, 
This outpouring of support for tighter gun control was due largely to the fact that the Sandy Hook massacre involved the slaughter of “innocents.” Young school children are seen by many as the most vulnerable, unsullied and worthy members of our society (unless you include unborn fetuses and the rich, whose worth to society is unquestioned).

This distinction between worthy and unworthy victims has permeated the discourse on gun control on both sides of the issue, with the focus being on how to make our schools safer (i.e., protecting the “innocents”) rather than how to make society safer or how to cut the overall social costs associated with gunshot wounds and deaths.

Yet, as tragic as it is for children to be gunned down at school, school shootings make up only a tiny fraction of the total annual gun deaths (less than 300 since 1980, or less than 10 per year). The sad reality is that tens of thousands of Americans die each year from gun violence, primarily due to suicide. In 2010, there were 19,392 gun-related suicides, or 63.6% of the total gun-related deaths, according to Wikipedia. In contrast, there were 11,078 gun-related homicides, or 36.4% of the total. Very few of the homicides occurred at schools or other public settings. Nevertheless, President Obama promised on January 16 to make our schools safer by keeping guns out of the wrong hands and improving mental health surveillance and services. Like his sanctimonious colleagues in Congress and the media, the focus is on the “innocents,” while the bulk of gun victims are ignored.

Biggest Bang for the Buck: Depression or Psychopathy?
In one sense, the discussion of better mental health monitoring and treatment is welcome. For too long mental health services have been inaccessible or unaffordable to many who need them, while prejudice and shame prevent some from attempting to obtain these services even when they are accessible.

The problem is that this aspect of the discourse has focused on almost entirely on psychopathic rampages, which account for very few gun deaths, while virtually ignoring depression, PTSD and other conditions that lead to suicide, which accounts for the overwhelming majority of gun deaths. From the perspective of cost effectiveness, it would make a great deal of sense to improve mental health access and services for everyone who needs it—not just those who are seen as potential homicidal maniacs.

Another problem with the mental health “solution” is that it tends to be discussed in essentially moralistic and prejudicial rather than rational terms. For example, Obama’s call for schools to become “more nurturing” implies that mean teachers or impersonal schools are somehow responsible for school shootings. His call for more mental health workers in the schools to curb “student-on-student violence” (rather than to treat all student mental health conditions) suggests a distinction between the worthy but rare victims of school rampages, and the less worthy but abundant victims of depression, anxiety, and stress (conditions which, if left untreated, could lead to suicide). His call for more police on campuses sends the message that school shooters are bad guys who must be punished or killed, rather than troubled youth in need of help. Yet there is no clear evidence that school safety officers have any effect on reducing crime or violence at school.

Moralism is also behind the lynch mob demanding a national registry for the mentally ill and the denial of their second amendment rights. The assumption is that because some crazy people have committed shooting rampages, that all crazy people are untrustworthy and violent and therefore need to be carefully monitored and controlled. Yet statistically, crazy people are no more likely than anyone else to commit acts of violence. Thus, identifying them and preventing them from buying guns should have only a nominal effect on the total number of annual gun deaths. On the other hand, the implementation of a national registry could scare away many people who need mental health services from seeking help, thus putting themselves (and possibly the public) at greater risk.  

A Rational Person in the Asylum? (Or Not)
One would think that mental health practitioners would take this unique opportunity to talk about depression, PTSD, and other problems that can lead to suicidal thoughts, now that the media has latched onto the idea that the government might do something to improve access and affordability of mental health services. Yet when the media interview mental health experts about the role of mental health in reducing gun violence, the experts rarely mention suicide. They, too, seem to be caught up in the moralism and hysteria (or perhaps they were told in advance to avoid mentioning suicide since it is a downer, far less titillating than massacres and therefore bad for advertising). 

Of course those who commit suicide rarely take out large numbers of “innocents” in the process. They simply shoot themselves, often when no one is watching. Furthermore, they have made their own decision when and how to die, in contrast to the “innocents,” whose choice was made for them by their murderer.

Yet suicide, like school violence, has significant social costs, including the loss of income and the emotional trauma for surviving family members (including the “innocents” they leave behind). Suicide can require emergency services, often at the taxpayers’ expense. It is disruptive to colleagues who must pick up the slack at work as they mourn the loss of their workmate and friend; and to their bosses, who must suddenly find a replacement; and to landlords, who lose rental income while their bloodied apartment is being cleaned.  

What About Gun Control?
Gun enthusiasts like to point out that during the 10-years assault rifle ban, there was no reduction in gun fatalities in the U.S. However, the ban was pretty leaky, with loopholes that allowed the purchase of numerous high powered weapons. It also did nothing to reduce the 270 million guns circulating in the U.S. (close to nine guns per every 10 people).

However, it is hard to imagine how a total reduction in circulating guns (rather than temporary bans on the sale of certain types of guns) could not reduce gun fatalities. Consider that slightly more than 50% of suicides in the U.S. are committed with firearms. When guns already exist in the household, they provide a quick and highly efficient means of killing oneself. Since other methods are less reliable, more painful, or more difficult to plan and carry out, reducing access to guns should reduce the number of suicide attempts, as well as the success rate. 

A reduction in the number of guns in circulation also ought to reduce accidental gun deaths (which average around 600 per year). Though statistically rare compared with suicides and homicides, slightly more than half of the accidental gun deaths involve children, and thus account for far more deaths of “innocents” than do school rampages. However, the otherwise upstanding adults whose negligence or irresponsibility contributed to these accidents are far more sympathetic (and formidable, when it comes to threatening their right to bear arms) than are crazies like Adam Lanza (the Sandy Hook killer).

Poverty is Violence
Since the pundits and politicians have taken suicide off the table, let’s talk about homicide, because even here there is a lot of moralism and prejudice in the public discourse. Certainly it is scary to imagine oneself or one’s child the victim of an armed robbery, rape, terrorist attack or school massacre. But for most Americans this fear is exaggerated. In the majority of homicides, the victim is poor, with a prior criminal record.

One might justly wonder why the left isn’t calling for “economic justice” or programs to help ex-cons integrate back into society, in addition to gun control and improved mental health access, since this could help reduce the number of gun deaths. But then again, ex-cons and the poor, in general, are not considered worthy victims. If we really wanted to reduce their unnecessary deaths, we would have to provide housing to the homeless so they didn't die of exposure. Employers would have to slow down the factories and provide sufficient safety equipment so their low income employees would stop dying on the job. They'd have to provide healthcare so they could keep their employees' diabetes and hypertension under control, and increase their pay so they had less stress and material insecurity (which contribute to their elevated rates of hypertension, diabetes, cancer and heart disease).

Lastly, a significant fraction of the homicide victims are women who were killed by their partners. In 2000, according to the Violence Policy Center, 1,342 women were shot to death by their partners (about 50% of the total domestic violence deaths). But why worry about a thousand dead women (some of whom left behind orphaned “innocents”) when there are ten innocent school children who need protecting? 

Monday, December 13, 2010

Seasonal Affective Pedagogue Disorder


Depression Drags You Down, by Ianuiop
As winter break approaches, teachers across the land begin to fall into a seasonal funk that is unique to teaching and distinct from the more generalized depression afflicting the rest of the country that results from relentless familial obligations, winter colds and flu, financial woes, seasonal affective disorder and overdoes of Christmas commercialism.


This peculiar teacher malaise is caused by the weariness of toiling for months to keep kids engaged, stimulated and well-behaved, combined with ongoing harassment by parents, politicians and pundits, and the sad realization that, despite all the hard work, we still have large numbers of failing students. For those unfortunate enough to teach in districts where finals occur after winter break, there is the added bummer of knowing that some kids will fail because of family vacations that extend past the end of the semester.


By the end of spring we are exhausted, but at least we can look forward to the long summer vacation ahead. Additionally, by second semester, many of the students who failed first semester have figured out how to do their work, or dropped the class, so the total number of Fs is lower. Spring is also graduation time. Students are more excited and optimistic. I receive my most positive feedback in the spring, when students and parents thank me for sticking with them and ask me to sign their yearbooks. I’ll never forget my first year teaching, when one boy introduced me to his father on graduation day, explaining that he would be the first in his family to graduate from high school, and then attributed it all to my confidence in him. 


The Bowl Curve

I suspect that Seasonal Affective Pedagogue Syndrome is more common in low income and low-performing schools, which tend to have a disproportionate number of students who begin the year without many of the prerequisite skills necessary to succeed at their grade level (e.g., reading, math, organization). As a result, they often fail to complete assignments and do poorly on exams, thus bringing down class averages to depressing lows. I have so many of these students that my class statistics (both overall, and for any given exam) more closely resemble lopsided bowls than traditional bell curves, with more students earning Ds and Fs than As, Bs and Cs.
The really sad thing about the bowl curve phenomenon is not just that there are so many Ds and Fs in one class or school, which is depressing itself, but the deplorable social conditions that contribute to it. The majority of my students who fail are reading below grade level. Most of them are low income. Many of them haven’t the slightest idea how to behave academically, routinely showing up without pens, their binders chaotically stuffed with random papers. Some have GPAs of less than 1.0 by the time they are seniors. Many are homeless, or have one or both parents looking for work, or in the hospital, or in jail, or deported, or dead. I have Iraqi refugees and students who’ve lost parents in the war.


It’s really quite remarkable that some of these kids make it to school at all. For others, it’s the only sane and structured part of their day.


Student Malaise

It’s not just the teachers and disadvantaged youth who suffer this seasonal depression. Even privileged students are burned out from all the homework, projects and testing. Many have tuned out by December. Frustrated, I went to a colleague for support. “I’ve been reviewing for finals with my students, but no one seems to know the answer to anything anymore, not even topics we covered yesterday.”


My colleague told me not to take it personally, that it was just the time of the year, and that we’re all experiencing the same thing. She told me she got so frustrated that she told her class, “I’m not going to stand here and ruin my voice asking review questions if you won’t take the trouble to think or look up the answers.”


Nevertheless, the problem seems worse this year than in previous years. I suspect that the economy has something to do with it. We have far more unemployed parents than usual. The stresses of living in poverty or even in a struggling middle class family can have profound effects on children. Worried parents, arguments over finances, privation and sacrifices, all cause stress and can affect children’s sleeping and eating habits, cortisol levels, immunity, and ability to concentrate in class.


On A Bright Note

Attendance is up and tardies are down, so at least my kids are making it to class. Very few kids have been rude to me this semester and interactions with self-entitled parents have been minimal, which has kept my stress levels low. Best of all, I will soon have two weeks to eat, read, relax and pee when I want to, unencumbered by bells and regulations.