What problem are we solving? – Guns and Mental Illness Part 3

This post is part of a series.  Part 1 is here. Other links will be added to Part 1 as they’re published.

Before we go too far down the road of targeting mental health as a means of solving gun violence, perhaps we should investigate whether it’s actually the root cause.  From everything I can tell, it’s not.  It’s a tautology to say that *something* has gone wrong in the head of someone who commits mass murder, but that doesn’t mean they have a mental illness.  It’s equally possible for them to simply be a selfish, or angry, or violent person who is perfectly sane.

While there are mental health issues that can mean a person should not have access to a gun, that doesn’t mean that everyone with a mental illness is a danger. In fact, people with mental illnesses are more likely to be victims of violence than to perpetrate it, and when they do, it’s mostly suicide. (I’m all for preventing suicide, but we have to acknowledge that the dangers are different.)

Mass shooters are pretty much uniformly white males, the demographic group with the best access to mental health services. The ones with the worst, black women, aren’t out there shooting up schools and concerts.

Following along with that, mental illness exists in Japan, Australia, Great Britain, and all these other countries who don’t have mass shootings.

We need better mental health care, and we should take steps to make sure that people who are actively homicidal or suicidal can’t access guns. *But* scapegoating mentally ill people not only harms an already marginalized group, but it also ignores large parts of the problem.

So, once we’ve kept guns out of the hands of mentally ill people, many of whom have never and would never hurt a fly, what are we doing about the next mass shooting by an angry white guy? I mean, you could make a compelling argument that toxic masculinity and white entitlement are mentally unhealthy, but those sicknesses exist at the cultural level rather than the individual level. Are we addressing any of that? Are we addressing the fact that domestic violence is a much better predictor of someone becoming a mass shooter than a mental health diagnosis is? Or are we scapegoating people with mental illnesses and calling it a day?

And let’s pay attention to the fact that we are scapegoating people with mental illnesses.  That stigma already exists.  People already face rejection, fear, and stereotypes when anyone finds out that they’ve got a mental health diagnosis.  When we paint mentally ill people as a shooting spree ready to happen, we only add to that.  And that stereotype isn’t even true.

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The police are part of the problem – Guns and Mental Health Part 2

This post is part of a series.  Part 1 is here.

In my previous post, I talked about the privacy concerns raised by the proposal to modify HIPAA to allow therapists to either submit mental health information to the background check database or provide it directly to law enforcement.

My next big concern is with providing this information to law enforcement, and what the police will do with this information. The police already have a tendency to shoot people who they view as behaving erratically or who they see as a threat. Telling them in advance that someone they’re going to interact with has a mental illness can prejudice them toward a belief, maybe unfounded, that the person is dangerous. And, like everything else, those prejudices get amplified when dealing with any minorities, particularly black people. So, my big question is, what information from someone’s private mental health records do you want the police to have? When police have this information, how do you ensure that they’ll behave reasonably and proportionally? How do you ensure that putting Bob’s depression or bipolar diagnosis in the hands of law enforcement doesn’t get him shot?

As a related question, if you’re changing HIPAA, are police officers now bound by HIPAA (with the related training that entails)? Or, once they know that John Q. Smith of 471 Maple Drive in Anytown, NY is diagnosed with depression and bipolar disorder, do they get to disseminate this information? And, again, what if it’s wrong? If it was actually John H. Smith who had those diagnoses, what recourse does John Q. Smith have about the false information that’s out there? Is he entitled to know the police are keeping those records? What safeguards are they using?

Before we mess with HIPAA, I have some questions (Guns and Mental Health – Part 1)

This is a multipart post.  Subsequent posts will go up on a schedule. (Hey, I wrote four posts today, I’m getting at least a week’s worth of mileage out of them.) They’ll also link back to the previous posts.

Part 1:  Before we mess with HIPAA, I have some questions

I have seen a lot of people arguing that HIPAA laws need to be changed so that if your therapist decides you’re dangerous, they can tell law enforcement. This was also one of the policy points from March for Our Lives yesterday.  (To be clear, I give the Parkland kids *so much credit* for taking the horrible thing that happened to them and working to make sure it doesn’t happen to the next group of kids.  This is criticism and questions of specific policy proposals, not of their motives or them as people.  We also shouldn’t expect teenagers to put out perfect policy proposals, because of course they lack the experience that adults bring to these issues.)

I have questions. And concerns. This will be long, so I’m breaking it into multiple posts.

First of all, therapists are already *required* to report if they think you’re going to harm yourself or others. This is covered under existing laws.

So what, specifically do you want to change? You want a lower standard for mandatory reporting?  Okay, what specifically needs to be reported and to whom? The therapist reports directly to the background database? Okay, who’s in charge of reviewing the therapist’s assessment? That is, what prevents a therapist who thinks *nobody* should have guns from reporting on people who aren’t actually a danger? What prevents a therapist from using this process selectively, whether deliberately or because of subconscious biases? Is the patient entitled to know that this information has been submitted? If it’s incorrect, what rights do they have to appeal it? What data on a patient’s diagnosis stays in that database, and how is it protected? (If you are found guilty of a crime, that’s a matter of public record. Your health information is not, and it requires a whole different level of security than the existing background check database currently does.)

What do you do in case of a breach? If someone steals the list and plasters it all over the web, who’s responsible, and what kind of damages are those patients entitled to? For that matter, who decides what mental illnesses get you on this list? Is there a list of illnesses? Specific symptoms? Is there a specific screening tool, or is it completely up to the therapist’s discretion? What are the diagnostic criteria? Who’s in charge of updating them as knowledge and understanding of mental illness changes?

Basically, can you ensure that whatever you’re proposing is an accurate reflection of someone’s likelihood of becoming violent, doesn’t inappropriately expose their private medical information, and doesn’t inappropriately take away their right to own a gun.

Immigrants and Bikes

I’ve seen the argument that DACA recipients are like “kids whose parents stole a bike and think they should get to keep it.” I think that’s a flawed analogy for many reasons.

But, let’s say that your parents acquired a bike in violation of some criminal or civil law. This includes kids whose parents stole the neighbor kid’s bike at gunpoint, parents who bought the bike not knowing that it was stolen, and parents who received the bike in compensation for work, were therefore supposed to pay taxes on it, and didn’t (some deliberately, some who honestly forgot or didn’t realize). The whole range of major to minor offenses, both criminal and civil, both deliberate and inadvertent.

Whatever your parents did, you had no control over it. You may have known that something was shady about your bike, or you may have been blissfully unaware. You just got a bike. With that bike, you got a paper route when you were 10 or 12. From that paper route, you built up some savings. Later, at 16, you used the bike to commute to your part-time job at the grocery store. You kept saving and eventually bought an adult-size bike, which you still ride. You went to college or trade school. Your paper route and grocery wages didn’t pay for the whole thing, of course, but they helped. And that second bike saved you an awful lot of gas money while you were in school. Even if you’d paid for the second bike another way, you probably wouldn’t have had the confidence or skill to bike commute in college, if not for all that time you’d spent on the first bike as a kid.

You get a job and start building an adult life. Maybe you get married and have kids, maybe it’s just you and your cat. Maybe you buy a house.

One day, a government official comes to your door and tells you that because of the way your bike was acquired, it’s now forfeit. Your second bike, which you still have and ride, is also forfeit. In fact, all of your assets are going to be taken by the government, regardless of their relationship to the bike. You have a choice. You can leave your current hometown, job, friends, and family, and start your life over from scratch with nothing. Or, you can go to jail. Indefinitely. Eventually, maybe after several years, you will have the chance to explain to a judge why you should not have everything taken from you and get to stay where you currently live. Because you yourself aren’t being charged with a crime, you have no right to a lawyer.

Regardless of the crimes or civil offenses committed by the parents, or when the child became aware of them, is this a just and reasonable punishment? Because that’s what we do when we deport people.

Struggling

I can’t say it any better than Caitlin Stout does.

If I’m being honest, I have been struggling quite a bit lately. This past year has been marked by a depression diagnosis, lots of sleepless nights, a new patch of gray hair, and a noticeable dip in my academic performance. I am weary, in the most profound sense of the word. And I am so scared to admit that, because I know that people like my professor will hear it and say to themselves, “Well, that’s just what happens when you give in to sin.”

I think he might be right.

I think maybe depression is what happens when you are constantly told that you are inherently broken. Maybe anxiety is a natural response to multiple anti-gay harassment incidents. Maybe stress takes its toll when the responsibility of speaking on behalf of an entire community is placed on your shoulders. Maybe joy feels elusive when you spend your evenings comforting friends who have been rejected by their families. Maybe it’s difficult to concentrate on homework when you’re busy meeting with school administrators to ask them for equal rights. Maybe it’s fair to be tired when you’re constantly made to fight.

Maybe this is just what happens when the Church gives in to the sin of homophobia.

“Maybe this is just what happens when the Church gives in to the sin of homophobia.” A-freaking-men.

My fat acceptance/feminism/anti-racism/LGBTQ activism will be intersectional or it will be bullshit.

So, the last time I posted something about LGBTQ issues, I got a comment criticizing me for bringing them into fat acceptance, because fat people are the majority, and LGBTQ people are “fringe” and their rights are a “far left” ideology.  Apparently allo/cis/het fat people are supposed to ditch LGBTQ folks so that centrists and right wingers will be better disposed toward us.  Yeah, fuck that.

And today was the Women’s March, and apparently some TERFS decided that instead of protesting the President’s ill treatment of women and minorities, or any of the current crises, they needed to use their time and energy at one of the marches to hold up a sign about how “trans women are men.”  Look, sweetie, the fucking President sees you as either a pretty young sex object to be used, or an ugly old bitch to be ridiculed or ignored.  It turns out that a bunch of the dudes in the media who relentlessly trashed Hillary Clinton were sexual predators themselves.  People are getting murdered by Nazis and white supremacists. The HHS just created a new division dedicated to making sure your pharmacist doesn’t have to fill your birth control prescription, or your Catholic ob-gyn can stand around and watch you die from sepsis rather than complete your miscarriage.  Flint still doesn’t have clean water, Puerto Rico still doesn’t have power, and our President keeps flirting with all-out nuclear war over Twitter.  And you looked at all of this crap and decided that the biggest threat was trans women?  Are you shitting me?

Like, seriously, if you don’t like trans women, you’re not obligated to have trans friends, or eat lunch with your trans coworkers.  I doubt they’ll miss your company.  You’re totally free to leave the restroom or locker room if someone you deem “insufficiently feminine” shows up. The primary thing trans people as a group ask of you is that you leave them alone, and stop getting them killed.  Don’t falsely accuse them of being sexual predators, or assault them for using the restroom. Don’t make stuff up about sex changes on little kids in order to scare parents out of acknowledging that their kid is trans.  If you want to go further along the path to “not being a total asshole,” you could also abdicate your position as the gender police, and call people by the names and pronouns they ask you to use.  To misquote Thomas Jefferson, it neither picks your pocket nor breaks your leg for someone to identify as a gender that you don’t approve of.  It costs you nothing to take people’s word on their gender and treat their genitals as need to know.  (And you don’t need to know.)

I’m not even asking you to work together with them on common issues, because they’re at enough risk as it is, without choosing to associate with someone who sees them as Public Enemy #1.  But it would be awesome if you could drop the anti-trans crusade and focus on one or more of the many actual catastrophes that could use that level of passion and activism, rather than continuing to kick a tiny and extremely vulnerable minority.

Every single progressive movement, every single movement for the rights of any group of people, needs to be intersectional.  Women’s rights has to mean black women, queer women, disabled women.  Fat acceptance has to be for poor fat people and gay fat people and trans fat people. Gay rights can’t just be for the white, cis gay dudes—it has to be for the whole alphabet soup of LGBTQIA, and the whole spectrum of race and class and gender and ability.  Because it’s all one interconnected fight.  And when we try to kick people out of the club, we dilute our power.

I’m not saying everybody has to get along and sing kumbaya.  I am saying that we’re all minorities by ourselves, but a majority when we work together, and that it would be good and useful to focus on the people who are actually trying to harm us.

 

The Fantasy of Flying While Thin

Last week, I flew home from my second ever trip to Alaska.  My brother-in-law moved up there, so that’s where the big family Christmas was this year.  I got to see my adorable nephews, which is definitely worth 12 plus hours on a plane. Each way.

Some time between the previous flight and the last time I’d flown, I reached the size at which I need a seatbelt extender.  On that previous flight home, I was miserable.  In theory, window seats are a good thing, but I was jammed into a space with not enough leg room, the armrest poking me in the hip, and my shoulder against the wall (right on a fibro trigger point, of course).  There were also one or two flights where I was too embarrassed to ask for the damn extender and just sucked my gut in hard and tried not to breathe too much. (Don’t do that; it sucks.)

I actually broke down crying on the flight, not just because I was so miserable, but because I was figuring that the only way to actually see family in Alaska was to diet myself down to a more flight-friendly size.

And then, there was the puking.  I occasionally get carsick, but this was the first time I’d been sick on a plane.  I can only apologize profusely to the poor soul who had to clean that bathroom, as well as to anybody who had to wait longer to pee than they otherwise would have.  On the second flight, I at least realized that I was about to puke in time to avoid defiling any lavatories.  (By the way, if you want to see how fast a flight attendant can move, ask for an air sickness bag.)

At some point on the trip, I realized that the level of misery I was experiencing had nothing to do with the size of my ass and everything to do with air travel being generally craptastic and with my actually being ill.  I’m not sure when exactly this dawned on me.  The vomiting was a good clue, as was sitting in the airport shivering, and realizing I was probably running a fever.   (I ended up missing a day of work when I got back, if I needed any more confirmation that I was actually ill.)

As I thought about it later, I realized how insidious the idea that losing weight is the magical cure to any and all problems really is.  I mean, I blog about fat acceptance for pete’s sake.  And yet, there I was, jumping straight to the conclusion that everything would be better if I were just thinner.  And this wasn’t even something caused by my size.  I mean, yeah, if there were less of me to fill the seat, there would be less pressure on trigger points, but it’s not like the fibro would magically go away if I were thin, or like things wouldn’t hurt for no reason even if they weren’t pressed up against a wall or an armrest.  And since even a successful diet wouldn’t make me any shorter, the lack of legroom would have still been painful.  I’m also pretty sure that weight loss does not prevent either air sickness or sinus infections.

It wasn’t until the second trip, which sucked a lot less, that I fully realized how untrue that was.  I had a little fibro pain here and there, but nothing horrible.  (One of the crappy things about fibromyalgia is that the pain feels pretty much like the aches and pains that come with the flu, so it can be hard to tell getting sick from having a flare.) Same me, same size. I still needed the seatbelt extender (that I was actually smart enough to ask for and use on all six flights).  The whole difference was not being sick.

(The title of this post is inspired by Kate Harding’s classic post The Fantasy of Being Thin, whch is worth a read if you missed it ten years ago. Yeah, it’s really ten years old.  Now if you’ll excuse me, apparently I need to tell some damn kids to get off my lawn and go to bed at a reasonable hour.)