The Danger of Cuomo’s “Mental Health Database”
In the aftermath of the shootings in El Paso, TX and Dayton, OH, Gov. Andrew Cuomo has gone far beyond the usual offerings of thoughts and prayers with a much more fascist response to the gun violence epidemic in America.
The “Make America Safer Pledge,” which Cuomo hopes all Democrats will unify behind, is nearly identical to every liberal’s proposals for gun control reform. It outlines the federal government’s commitment to an assault weapons ban, the implementation of red flag laws and universal background checks. While these policies could be more radical, few could argue that they aren’t popular policies that prevent folks from obtaining the means to harm others on a massive scale.
However, Cuomo also promotes implementing a “mental health database” that would expand the federal government’s ability to track those who are diagnosed with a mental illness and limit their ability to purchase or own a firearm. The proposal has received backlash from mental health advocates for its ability to be used for harm and for its bad faith effort to combat violence that stems from white supremacy.
But, to many gun-control advocates, this might seem like a good step forward. If folks with mental illness are unable to own a firearm, that would make all of us safer, right?
The Stigmatization of Mental Illness
Stories of mass shootings litter our timelines weekly and headline after headline speculates about the supposed “sickness” or “mental disturbances” that afflicted the (white, male) perpetrators. How could somebody so “normal” do something so “evil?” In the face of trauma, people want answers.
But, the tracking and limiting of folks with mental illness isn’t the answer. People diagnosed with a mental disorder are far more likely to be victims than perpetrators of violence and prior victimization made folks 11% more likely to commit violence. So, if we really wanted to prevent mentally ill people from committing violence, we would invest in public health programs to ensure their safety. But we don’t. Why?
The broad public’s beliefs about mental illness have been crafted by the media’s portrayal and the government’s treatment of mentally ill folk. Acts of violence, particularly violence deemed “senseless” by the wider audience, are often seen as consequences of a deep-rooted “psychosis”, the “sociopathic” nature of the perpetrator, or a crime of passion. Many say that whether or not the perpetrator of violence has a mental disorder classified in the DSM-V, nobody “sane” could commit violence on a mass scale. As conservative Candace Owens tweeted: “if you think you can pick up a gun and slaughter 20 people without having a mental health issue — then you are a moron.”
According to this framework, mental “health” is not the absence of a diagnosable illness but instead, simply the conformity to the expected roles and ethics of the dominant culture. In this case, mental illness represents the ability to do something that we deem reprehensible or “evil.”
And that isn’t wrong. The DSM has historically been a tool to oppress folks who do not conform to the dominant culture. This is most obvious in the case of gay, lesbian and bisexual folks whose attraction to people of the same gender was a disorder in the DSM until the early 70s. In this case, mass murder is, of course, not comparable to attraction to the same gender. But it is important to consider who determines what is reprehensible enough to be categorized as “mentally ill?”
In tracking police violence, The Washington Post reported that nearly 1,000 people were murdered by police shootings every year in the last four years. Feeding America found that nearly 40,000,000 struggle to afford food in the richest (and “free-est”) country in the World. 51% of black trans women are likely to be homeless at some point in their lifetime and 22 black trans women were murdered in 2017. Is this not mass violence? Is Candace Owens concerned about the mental health of our police force, political figures, and/or transphobic citizens?
Granted, many conservatives do not actually care about mental illness as evidenced by their continuous defunding of community mental health programs and mental health care. But, for those of us who do advocate for stricter gun control and do care about folks in the mental health care system, we must seriously consider who is holding the power to determine what categorizes a “mental health issue” and how that power has historically been used.
Psychiatry and State Violence
Since their foundations, the fields of psychiatry and psychology have contributed to the institutional marginalization of non-white, non-male, non-straight or -cisgender folks. It is widely understood that Freud’s diagnoses of “hysteria” were based around the dominant and sexist views of women in his time but we rarely question why women today are four times more likely to be diagnosed with Histrionic Personality Disorder than men. Many folks will admit to the historic use of IQ testing to perpetuate white supremacist institutional violence toward Black folks, but to this day, Black people today are four times more likely to be diagnosed with schizophrenia, categorized as one of the most “severe” mental illnesses.
These disparities are rooted in both the biased criteria of the DSM and implicit bias of counselors who assign diagnoses. Despite the APA’s claims that the DSM-V incorporates greater “cultural sensitivity,” it still uses a symptomology-based approach that cultural psychiatrists argue universalizes culturally-varied responses to and beliefs about mental illness. Research demonstrates that service providers using the DSM-V consistently overdiagnose minority groups and underdiagnose the majority. The DSM-V was also dismissed from use in research by the director of NAMI, Thomas Insel, in a statement that criticized its lack of validity in terms of diagnosis.
This ineffectuality is compounded by practitioners with implicit and explicit bias. Services provided in individual settings often assign the power of gatekeeping to one practitioner. This leads to disparities among groups in responses from care providers, adherence to long-term care, and reports of quality care.
This has real consequences for folks diagnosed with mental illness and people from other marginalized groups, particularly when politicians are proposing federal registries. In the early twentieth century, nearly 60,000 disabled and socially disadvantaged people were forcibly sterilized across the United States. California was responsible for nearly ⅓ of these compulsory sterilizations as the law stated that anybody committed to a state asylum would undergo the procedure. The law was followed by a wave of racial and sexual minorities being committed by court order or family. Similar sterilization laws among states were in effect until the 1970s.
This history of institutional, state violence has largely been forgotten among service providers, psychiatrists and the powers that be. But disabled, Black and brown folks will never forget. Government powers from around the globe have used federal health programs maliciously from the Nazi’s systematic euthanization of 300,000 psychiatric patients to the U.S. Public Health Dept.’s denial of syphilis treatment to 399 African-American, poor males for decades after penicillin was the standard treatment. We must act quickly in the face of politicians proposing wielding that power again.
Cuomo’s demands, though lacking in detail, would surely provide the federal government the opportunity to enact violence, eugenics and the denial of human rights to disabled people. Making America “safer again” requires a host of reforms from the reduction or abolition of firearms, to the elimination of special interest and corporate funding of elections, to the tackling of white supremacy on a state and federal level. But, as proposed, mental health databases fail to make people safer — and allow for the power of the elimination of anybody deemed undesirable. We must hold our governments accountable for these proposals and remind them of the harm they have caused generations of people. If we don’t, they will use their power as they wish.
Edit: the original version of this piece referred to disabled people and folks with mental illness as separate groups rather than as collectively “disabled.” Made with feedback from @seemiaroll on twitter.
