GUN CONTROL 

WILL NOT CURE 

SEVERE MENTAL ILLNESS

The horrible random shootings in a Charleston church and a Lafayette movie theater have reignited the debate over gun control and mental illness. 

The mental illness debate centers around the deinstitutionalization movement that began in the 1950s when the living conditions of isolated, underfed, restrained, and abused patients in large “Insane Asylums” and “Mental Hospitals” were exposed in a Life magazine article aptly named “Bedlam 1946”. These “psychiatric asylums” were exposed as places of horror and abuse, and the public began to rapidly close them and return patients to community care and self-recognizance. More than 500,000 people were in public psychiatric facilities in 1955; today that number is 45,000 (Sisti, Segal, & Emanuel, 2015). The very word “asylum” still causes a knee jerk revulsion in the American public. 

In Social Work Today, Dominic Sisti, PhD suggests we rethink this visceral reaction. In an article published in early 2015 in the Journal of the American Medical Association (JAMA), Sisti and fellow ethicists, Ezekiel Emmanuel, MD, PhD and Andrea Segal, MS, call for the return of psychiatric asylums. Their argument: The deinstitutionalization wave of the past half-century has been such a failure for some people with serious mental illness that the only way they can receive ethical and humane care is in the structured setting of an asylum. 

The transfer of people with mental illness into the criminal justice system has been especially troubling. For Sisti, the current state of the mental health care system in the United States is reminiscent of the conditions that shocked reformers in the mid-1800s. What's more, those suffering with severe mental illness are left on their own recognizance to take prescribed medications and seek care when they feel they need it. This standard of care is clearly neither protecting the patient nor the public. 

Their suggestion to reinstate asylums, however, was not well received by all professionals in the field. “No matter how well-intentioned Sisti and his colleagues are in proposing humane asylums,” says Phyllis Solomon, PhD, “safety and security, economic and political pressures would soon start to push these modern facilities back toward their sordid past as warehouses for unwanted humanity.” Well-intentioned professionals continue to debate how best to protect severely mentally ill patients and society from the effects of this illness. 

Social workers, however, don’t need to wait for politicians and policy makers to help improve care for people with serious mental illness. In fact, the NASW is a founding member in the Campaign to Change Direction, a national movement to promote dialogue with the public about mental health, mental illness, and mental well-being. 

Individual social workers must advance the discussion in their own communities and take a leadership role in crafting solutions. No one is more invested or knowledgeable regarding the plight of patients suffering from severe mental illness or the dangers this illness poses for society. We must face the failure of our mental health system and not leave the discussion about random violence to the gun control lobby. Severe mental illness is our field. If we fail to identify the root cause of these horrific acts of violence, we will continue to suffer repeated acts of random violence. 

Let's all take an active role in this discussion in our own communities. Any of our communities could be the next Charleston or Lafayette.