Can the U.S. find consensus in better mental health access to curb gun violence?

One year after the Sandy Hook tragedy, violent acts like the latest shooting at a Colorado high school remind the nation that the gun debate is not over. Gwen Ifill looks at efforts to curb violence in the U.S. with Dr. Jeffrey Lieberman of the American Psychiatric Association and Paul Barrett of Bloomberg Businessweek.

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    Now to a debate that never seems to end. Every time a shooter goes on the rampage in a public place, the discussion turns to guns, mental health and even to violent video games.

    The FBI today said it helped disrupt or prevent nearly 150 shootings and other violent attacks in the past year, in part by directing potential attackers to mental health services. So there has been some progress, but there always seem to be new headlines.

    Friday's shooting at a suburban Denver high school was the latest violent jolt. Well-wishers left flowers today at a growing tribute to student Claire Davis. She was shot at point-blank range by a fellow student, 18-year-old Karl Pierson. Davis remains in a coma in critical, but stable condition at a local hospital.

    The latest shooting came as the nation was marking the first anniversary of the shocking attack in Newtown, Conn., that killed 20 schoolchildren and six educators. The massacre at Sandy Hook Elementary School revived the long-running debate over the causes and solutions for a mass shootings like it.

    It also prompted President Obama to say he would push for gun control legislation that wasn't a top priority during his first term.


    We can't put this off any longer.


    That appeal for congressional action came just after the new year. The plan called for overhauling the nation's gun laws while providing more treatment for the mentally ill.


    In the month since 20 precious children and six brave adults were violently taken from us at Sandy Hook Elementary, more than 900 of our fellow Americans have reportedly died at the end of a gun. So I'm putting forward a specific set of proposals. And in the days ahead, I intend to use whatever weight this office holds to make them a reality.


    Among other things, the president pushed Congress to bar the sale of ammunition magazines with more than 10 rounds, mandate background checks for all gun purchases, including online and gun show sales, and provide new funding for mental health counselors at schools and in communities.

    But most of that went nowhere. The gun control legislation in particular met stiff resistance in Congress. The National Rifle Association said the measures would do little to stem gun violence.

    The NRA's executive vice president, Wayne LaPierre:

  • WAYNE LAPIERRE, National Rifle Association:

    The only thing that stops a bad guy with a gun is a good guy with a gun. I call on Congress today to act immediately to appropriate whatever is necessary to put armed police officers in every single school in this nation, and to do it now, to make sure that blanket safety is in place when our kids return to school in January.


    Just four months after the shooting, any political support once again collapsed.

    President Obama expressed his frustration in a Rose Garden appearance.


    As I said from the start, no single piece of legislation can stop every act of violence and evil. But if action by Congress could have saved one person, one child, a few hundred, a few thousand, if it could have prevented those people from losing their lives to gun violence in the future, while preserving our Second Amendment rights, we had an obligation to try.


    Gun control activists shifted their effort to the state level, winning a high-profile fight in Colorado, where voters agreed to require background checks for private gun transfers and to ban magazines that could hold more than 15 rounds of ammunition.

    But they lost battles too. According to The New York Times, more than 1,500 gun bills have been introduced in state legislatures across the country since the Newtown shooting. Only 109 became law. Of those, 39 tightened gun restrictions. And, of those, 15 focused on helping the mentally ill. The other 70 laws actually loosened regulations on firearms.

    Last week, the White House marked the Newtown anniversary by pledging $100 million for improved mental health services and facilities.

    So, are we making any progress?

    For that, we turn to Dr. Jeffrey Lieberman, president of the American Psychiatric Association and chair of Columbia University's Department of Psychiatry, and Paul Barrett the author of "Glock: The Rise of America's Gun" and a writer for Bloomberg Businessweek.

    Welcome to you both.

    Dr. Lieberman, since Newtown, since Aurora, since Virginia Tech, since the Navy Yard shooting, in each of those cases, mental illness was traced on behalf of the part of the shooter. Is there anything that's changed in that time?

  • DR. JEFFREY LIEBERMAN, American Psychiatric Association:

    Well, you're right, Gwen. It has been like a tragic deja vu all over again, with the serial mass violence incidents occurring, and unfortunately involving disproportionately people with mental illness.

    But I do think there's reason to think this time may be different, because in the wake of these series of mass violent episodes, there has been a greater attention, a greater debate and more legislative action to try and address the root cause of the problem, which is the inadequacy and lack of quality comprehensive mental health care services.

    This is really the best way to stem many of the problems associated with the historic health care disparity in not providing good care to people with mental illness.


    Paul Barrett, is that the root cause?

  • PAUL BARRETT, “Glock:

    The Rise of America's Gun": Well, there are multiple causes to these issues. And we're really talking about multiple issues. The random mass shooter, the suicidal young man who wants to take out a lot of people as he goes down is one issue. Violent crime on the streets is another issue.

    But I certainly would agree wholeheartedly with what the doctor just said, that we should certainly hope that the Newtown massacre causes people to realize that, for years, we have actually been going in the wrong direction on mental health. The states have been cutting billions of dollars out of mental health budgets.

    And so the relatively modest increases we have seen in the last year are only beginning to make up for that fact. We have 90 percent fewer in-patient psychiatric beds today than we had in the 1950s. So there is a long distance to go even to get back to even.


    So let me ask you both this…



    Go ahead, Dr. Lieberman.


    I was going to say, this is absolutely true.

    What we have taken are only baby steps in terms of trying to remedy this problem. If you look at all violence in the United States, the mentally ill contribute a very small proportion, only 4 percent, but if you look at these civilian massacres, these mass violent incidents which seemingly have no rhyme or reason, mentally ill persons are disproportionately affected.

    And if you look at all of these individuals, virtually all of them, they have been individuals who have not received treatment or who have dropped out of treatment. And that's because we have a fragmented and an inadequate mental health care system and policy in this country.


    So, Paul Barrett, has time been wasted on gun control, something which seems to freeze up in Washington, or — and have people been focused on the wrong solutions?


    Well, I don't know about whether time has been wasted.

    But I certainly think that gun control proponents have tended to go back to the same solutions, perhaps not terribly productively. For example, the relentless focus on particular weapons — you know, many — often, we have been focusing on so-called assault weapons — I think has proved to be very unfruitful over time.

    And focusing on things like access to weapons, narrowly focusing on that issue, whether it's through improving the background check system or it's improving the identification of potentially violent mentally ill people and then making sure they get into treatment, those are access issues.

    And I think if we focus more on the access to guns, you might be able to defuse the Second Amendment complaint that someone in Washington wants to come around and collect everyone's guns.


    But, Dr. Lieberman, does this raise the — I don't know, is there a stigma attached to the mentally ill that they are more likely to be violent than someone else?


    Well, there definitely is a stigma, because violence committed by people with mental illness frequently doesn't conform to our understanding of passion crimes or robbing for money or even a disgruntled employee who comes back to shoot up his supervisor in the office.

    With mental illness, it's totally irrational, unpredictable. How do you explain a young man like Adam Lanza walking into an elementary school and killing little children who he had no relationship with? It makes no sense. And this is what scares the public. But this problem has been a long time in coming.

    It really stems back to Present John F. Kennedy's Community Mental Health Act, which attempted to provide a more civilized and humane level of care to people in the community, as opposed to keeping them in the silence. Now, that vision was never realized, because our policies and commitments to making it real was never fulfilled.

    And what we see in these violent crimes is the tip of the iceberg of that. But the other elements of the iceberg are the 40 percent of the homeless who are mentally ill, the 30 percent of prison inmates who have mental illness and have been laundered through the criminal justice system.

    And the violent crime is simply the extreme consequence of this failed policy.


    Paul Barrett, where should this be addressed, at the state level, at the local level? Is it prevention that needs to be addressed first?


    I think it's all of the above.

    I think prevention is certainly a big part of this issue. I think trying to separate out the radioactive Second Amendment-related debate from the potentially more specific and not necessarily specifically gun-related issues of mental health that we're talking about here this evening would be a huge step forward.

    I think that's an area where a lot of consensus could be found. And I think it has to be addressed at all levels. It has to be addressed at federal level with funding. State and local agencies are the ones that will ultimately carry it out, and even nonprofit and private organizations that are part of the picture as well.


    Dr. Lieberman, help me with something. I read today that mass shootings are up, the rate of mass shootings has increased, but the rate of gun homicides is actually down.

    How do those two things coexist? How can that be?


    Well, I think law and order has been a great success in many of our cities. Crime in New York, where I live, is at historic lows.

    And this has been a great success of our police force and our system of law enforcement. On the other hand, though, our treatment of mental illness has not gotten any better. And over half of the mass killings that have occurred in the last five years have been from untreated people with mental illness.

    But I think there has been some forward movement. The president and the administration are to be applauded for their focus on mental health care. Vice President Biden has become very much engaged. Congressman Tim Murphy of Pennsylvania introduced historic legislation this week on the anniversary of the Newton tragedy to try and reform how mental health care services are delivered.

    We need to have comprehensive and proactive mental health care services, and with a particular focus on youth, because youth is really the breeding ground for mental illness.


    Paul Barrett, what do you see about the distinction between mass homicide — I mean, gun homicides and mass shootings?


    Well, I think this is a crucial point.

    I think a lot of people who are mystified by why gun control proposals at the national level have not fared well over the last dozen to 15 years ought to look at our overall crime rates. Let's set to one side the aberrational school shootings just for a moment. That horrific phenomenon set to one side, this is a much safer country today than it was 20 years ago.

    Violent crime rates are down by 50 percent since 1993. That is very, very significant. And that has destabilized the traditional liberal argument that more guns just equals more crime in a very simplistic relationship. It's more difficult to say that today, because compared to the early '90s, for example, we have more guns, but overall less crime.

    So we need to think about this in new ways. We need to look at places like New York City, where crime rates are down drastically, ask what has happened in those communities, and how can we replicate those anti-crime programs, while simultaneously going after the mental health issues we have been talking about this evening.


    Well, as I said at the beginning, this is a conversation that is never going to end.

    Paul Barrett, the author of "Glock," and Dr. Jeffrey Lieberman of the American Psychiatric Association, thank you both so much.


    Thank you.


    Thank you.