Violence and Gunplay - Why Nobody is Informed by the Media Anymore

Mass shootings have been a phenomenon of my lifetime.  I can still clearly remember the University at Texas-Austin shootings that occurred  on August 6, 1966. A single gunman killed 16 people and wounded 32 while holed up on the observation deck of an administrative building until he was shot and killed by the police. I first read about it in Life magazine. All the pictures in those days were black and white. Some of those pictures are available online on sites such as "Top 10 School Massacres.”  I generated this timeline of mass shootings when Google still had that feature in their search engine. 

The problem of course is that the mass shootings never really  stop.  In the USA, the press is so used to them that they seem to have a protocol.  Discuss the tragedy and whether or not the perpetrator was mentally ill, had undiagnosed problems or perhaps risk factors for aggression and violence.  Discuss any heroic deeds. Make the unbelievable statement that the victims were "in the wrong place at the wrong time."  And then move on as soon as possible.  There is never a solution or even a call for finding one.  It is like everyone has resigned themselves to to repetitive cycles of gunfire and death.  It is clear that the press does not want to see it any other way.

When you are practicing psychiatry especially in emergency situations and hospitals, you need to be more practical.  When I took the oral boards exams back in 1988 and subsequently when I was an examiner, one of the key dimensions that the examiners focused on was the assessment of dangerousness.  Failing to explore that could be an exam failing mistake.  Any psychiatric inpatient unit has aggression toward self or others as one of the main reasons for admission to acute care and forensic settings.  With the recent fragmentation and rationing of psychiatric services, many people who would have been treated in hosptials are diverted to jails instead.  That led one author to describe LA County jail as the country's largest psychiatric facility.  

I have introduced the idea of looking for solutions into professional and political forums for over a decade now and it is always met with intense resistance.  Some mental health advocates are threatened by the idea that it will further stigmatize the mentally ill as violent.  Many people consider the problem to be hopeless.  Others see it as the natural product of a heavily armed society and no matter what side you are on that argument - that is where the conversation ends.

In an attempt to reframe the issue so that this impasse could possibly be breached the Minnesota Psychiatric Society partnered with the the Barbara Schneider Foundation and SAVE Minnesota in the wake of a national shooting incident to suggest alternatives.  Rather than speculate about psychiatric disorders or gun control we were focused on solutions that you can read through the link below.

The actual commentary was never published by the editor who apparently stated that there was a conflict of interest because we seemed to be fishing for research dollars.   It appears that the press can only hear the cycle of tragedy, speculation about mental health problems, and the need to move on.  The problem with that is that we continue to move on to another shooting.

George Dawson, MD


A Commentary Statement submitted to the StarTribune January 18, 2011 from the Minnesota Psychiatric Society, The Barbara Schneider Foundation, and SAVE - Suicide Awareness Voices of Education

Why This Blog?

I thought that a blog written by a psychiatrist who has no stake in bashing psychiatry and who has successfully treated patients for over two decades is long overdue. In the absurd world of today's media and their completely unrealistic portrayal of psychiatry and psychiatrists, political arguments can be advanced against the field and that leads to a rapid acceleration of bashing of the field fueled by others who frequently don't know a thing about psychiatry. I plan to post a few examples in the days that follow about that process and also about the political motivations for that process.

I also do not want to set myself up as a guru or somebody who is unique. That is often the viewpoint taken by critics of the field. At this point in my career, I personally know hundreds of technically competent psychiatrists who are every bit as skilled as me. In fact, I like to provide the example of a patient who came to see me for geriatric consultation. At the end of the visit she produced a previous evaluation from a colleague who trained with me at the University of Minnesota. That note right down to the diagnostic evaluation and plan was identical to what I had in my handwritten notes to that point.

Finally, the viewpoints expressed here are probably not mainstream psychiatry. Psychiatrists in general like to avoid conflict and attempt to resolve problems in a non confrontational manner. Physicians in general seem to ascribe to this tactic. While I agree completely that it is necessary to be neutral in all interactions at a clinical level, that does not extend to politics - especially in an era where an activist government and a managed care cartel are restricting psychiatric care at a much higher rate than they are restricting access to medical and surgical care.

What follows here is strictly my opinion and not the opinion of any of my current or past employers or of my professional associates.