Dr. Gene Flick comments on the gun control position of the American Psychiatric Association.  

For a copy of their position statement, click here.

Dear APA,

Thanks for sending me the information regarding APA’s regrettable position on gun-control. I must admit to some confusion over what you sent me. The first article is clearly APA’s position statement on gun control, which as I read it, boils down to:

Murder rates are up, and

Murders are often committed with guns, and

Violence is philosophically a bad thing, therefore

No citizen should have a gun (or if they do, the guns should be strictly "controlled").

The second article appears to be an APA press release from some time last year, in which APA vice-president Paul Appelbaum comments that firearms background checks for involuntary commitment don’t make sense because "past mental illness doesn’t predict future violence." The article further comments that the National Mental Health Association (NMHA) supports gun control, but opposes having patients’ psychiatric records available to law enforcement because it "compromises the mentally ill’s right to privacy and to purchase handguns."

The second article concludes with a quote from Dr. Appelbaum: "The prospect that federal and state officials and gun dealers can look at an individual’s history of psychiatric treatment, however, will make people more reluctant to seek treatment. Once these national databases are established, their uses are endless."

Wow. Where do I begin? I suppose I’m most struck by Dr. Appelbaum’s closing statement. The APA feels we can’t trust the government to have a database of mentally ill patients, but we should trust them with a database of gun-owners? Which group poses the bigger threat to the power of government? The mentally ill, many of whom don’t even vote, or gun-owners, who have a history of political activism and the potential means with which to back it up? (Here’s a hint: President Bill Clinton ordered huge and costly IRS investigations of the NRA (which have found no evidence of wrongdoing, I might add) whom he held responsible for the House falling to the Republican majority in 1994. I don’t recall NMHA or NAMI (National Alliance for the Mentally Ill) enduring such investigations.)

Dr. Appelbaum also notes that once it becomes public knowledge that the government is keeping records, treatment for mental illness will be driven underground, or avoided altogether. But, the APA somehow believes that gun-owners (both legal and illegal) will simply register/surrender their guns and go away? It doesn’t think that gun registration will create an underground economy in firearms, such as we already see with illegal drug use? I don’t think anyone can claim that our "war on drugs" has been anything but a dismal failure. It’s not clear to me how the APA can believe that strict gun control will be any more successful.

I agree with Dr. Appelbaum’s remarks that past mental illness is a poor predictor of future violence, and shouldn’t necessarily influence gun ownership, but then again, 99.9% of America’s legal gun-owners have never committed a crime with their firearm, but the APA would like to disarm them. How is that consistent?

And then we come to the APA’s position statement on gun control. Point by point:

Yes, they are. And all data indicates that the more gun controls we impose, the higher go the rates of violent crime. New York, Los Angeles, and Washington, D.C. have the strictest gun controls in the country, and the highest murder rates. Cities such as Indianapolis, where concealed carry of a firearm is perfectly legal, have much lower rates of violent crime. John Lott’s studies have clearly shown a causal relationship between enactment of concealed carry laws, and a decrease in violent crime. And, as noted in my previous letter, now that Great Britain has outlawed handguns, violent crime rates have risen dramatically, and the English Bobbies have to carry firearms for the first time in their history.

Guns can cause death. Agreed. So can automobiles, swimming pools, and physicians, all of which cause more deaths annually than guns. However, our society has determined that cars, pools, and doctors also are responsible for many societal benefits, and so we tolerate the MVA’s, accidental drownings, and iatrogenic deaths. Unfortunately, the APA has apparently decided not to look at the societal benefits of widespread gun ownership, thus leading to its utterly mistaken conclusion that banning/controlling guns will result in lower "fears and stresses in crowded urban society." Ask the British about their fears and stresses now that armed thieves routinely kick in doors of occupied homes, safe in the knowledge that no one inside has a gun, and no one will call the police while being held at gunpoint. This is happening, and is well documented in the English press.

As I pointed out in my original letter, guns save 65 lives for every one they take; that’s 65 people who don’t need trauma care, rehab, and/or lifelong disability. The societal and economic benefits are clear to anyone who is willing to look, but I don’t think the APA Council on National Affairs made much effort to investigate.

I’m as opposed to needless violence as anyone, but I’m not sure our philosophical high-ground attitude will make any more of an impression on the common street thug than our injunctions against drug abuse and antisocial behavior. Based on my inpatient practice, I’m quite certain these folks couldn’t care less about our "sanctions." And like it or not, there are times when violence is necessary. You’ll recall that it was "violence as a social instrument" that led to our being a free nation. And if someone breaks into your home and is attempting to rape your daughter, I’m betting that you’ll have no problem resorting to "violence as a behavioral mode." I’ll concede on "violence as an adaptational pattern;" no need for that, but I’m puzzled as to how outlawing guns will stop it. If someone is using violence as an adaptational pattern, I suspect they’ll get by just fine with fists, bricks, ballbats, and knives. But if I run into one of those folks, I’d rather have a gun than not have one. I suspect the APA National Council, if they were honest, would agree.

Unfortunately, this "solution" has virtually no bearing on the problems cited by the authors, except perhaps to exacerbate them.

I hope you don’t mind my having taken this much space to refute the APA’s position. As I noted in my earlier letter, I’m never sure how much information to include. Too little, and I’m dismissed for lack of substantiating data. Too much, and I’m labeled a misguided zealot. I have noticed that anti-gun arguments tend to be brief sound bites based on emotional appeal. When rational arguments backed with objective data are laid out, gun control proponents all too often wander off to fight with someone less informed. As physicians and scientists charged with advocating for the health of our patients and society, we owe them more than sloppy science based on emotional appeal.

Perhaps it is time for the APA to re-examine its position on gun control. A lot of new data has emerged since 1993, and I would invite the APA to examine it with an open mind. If they would do so, I think they would be surprised at what they find. At the very least, I would like to see the APA stop advocating gun control. While I’m sure this would be a controversial decision, I doubt it will cause any more stir than removing homosexuality from the DSM. We weathered that one; I suspect we would weather this one as well.

I hope you will pass my messages along to someone at APA that has influence in this area. And should this message end up separated from my original one, I would refer the reader to http://www.cs.cmu.edu/ for an excellent review of the positive social aspects of gun ownership, written by physicians.

Sincerely,

Gene R. Flick, M.D.

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