How The TSA Perpetuates Harmful Mental Health Stigmas

I travel a lot for work. I go to conferences, give talks, do readings. My mom told me, “You should sign up for TSA Pre-Check. It’ll makes things so much easier.”

That seemed right. The Pre-Check lines at airport security checkpoints aren’t always shorter. But at least I wouldn’t have to take my shoes off or unpack my luggage in a frantic rush by the conveyor belt with some grumpy dude behind me standing in his socks.

Pre-Check, according to the TSA, is an “expedited security screening program connecting travelers departing from airports within the United States with smarter security and a better air travel experience.” I didn’t know much about the smarter security, but I could do without the bare feet. So who qualifies for Pre-Check? “Passengers considered low-risk who qualify for the program can receive expedited screening either as a member of the program or another specific trusted traveler group [such as active-duty military].”

After my digging around on the matter, I decided to pay a ridiculous sum of money and do a bunch of invasive paperwork to make my life a little bit easier at airports.

And in the process, I discovered more about what exactly was meant by “low-risk.”


To get TSA Pre-Check certified, you go to this grimy yet official office — ours was located in a strip mall — where you wait in line for a while. Think the DMV, but federal. My husband and I went together, sitting side-by-side in the blue plastic chairs, waiting to give up some of our privacy and cash in exchange for convenience. The website told us what documentation to bring, and it said to set aside two hours for the process. They weren’t exaggerating.

When it was my turn to step behind the curtain and be interviewed, I encountered a man with a laptop and an array of secondary devices: document scanners, fingerprint scanners, cameras, and more. He scanned my fingers. He took my picture. He scanned my many documents. It was all very Minority Report. Then he asked me to complete a short survey on a computer. The survey contained six total questions, the last of which was:

“6. Have you ever been found by a court or other lawful authority as lacking mental capacity or involuntarily committed to a mental institution?”

In case you haven’t applied for TSA Pre-Check, and in case you aren’t a person with a psychiatric disability (or a “PPD,” which we’ll use for shorthand), let me explain to you what this question can do to, say, a person like me who has never been committed for her major mental illness, involuntarily or voluntarily, but who has many friends who have been. Friends who are wonderful, non-violent PPDs.

That question makes us feel like we’re the scapegoats for all the evil in the world.

Think about it: Question #6, and the survey as a whole, is meant to help the TSA decide who is “safe” to allow access to an expedited route through security at airports. The TSA’s job, as its name suggests, is to oversee the security of people traveling in the U.S. — and, in the extreme, this job means preventing the incomprehensible violence of events like 9/11.

This questionnaire, however, is not a scalpel; it is not strictly tailored to predicting attacks onboard airplanes. The entire Pre-Check questionnaire is instead intended to be a general pre-screening for people’s propensity for violence.


The other queries on the questionnaire help illustrate the subtext of Question #6.

Question #1 asks about your citizenship status — only citizens and permanent residents can qualify for Pre-Check. The official reason for that policy is not one I could track down, but let’s just say, like most things in the U.S., Pre-Check is a privilege reserved for those with documentation.

Questions #2–5 ask about prior arrests or other involvement with the criminal justice system. The TSA, on their website, provides a long list of criminal activity that would disqualify a person from participating in Pre-Check, presumably on the grounds that past criminal activity predicts future violence — aboard airplanes, and anywhere else.

Question #6 asks whether you’ve ever been committed to psychiatric care — which means that, to the TSA, commitment to psychiatric care also predicts future violence.

When I got to Question #6 during my exam, I felt both a sense of dread and a sense of familiarity. The question felt familiar because, after all, I’ve taken the bar exam, with its intrusive and alienating mental health questions. But I also felt dread, a strange tickling on the back of my neck, that my horrible secret would get out — yes, I have a mental illness, and Question #6 reminds me that, in the eyes of my own government, this makes me abnormal — and a hair’s breadth away from being considered a violent threat.

Question #6, the questions like it on the bar exam, and the questions like it on gun permit applications, tell PPDs something like this: If you weren’t here, there would have been no Newtown. No Columbine. All of the violent headlines would disappear with you, if you would just go away.

And how does that question affect people who aren’t PPDs and have no contact with them? It confirms these irrational fears and beliefs. After all, the screening question wouldn’t be there if it weren’t keeping the bad guys out.


To be a scapegoat means that others place unfair blame upon you, that you take on the sins of others. Dumping blame on a scapegoat provides a small measure of peace: If we can just keep them at bay, we’ll be safe.

We — people, pundits, and politicians on the left and the right — often place blame on PPDs for our society’s most vicious tendencies. Even politicians on the left are pushing for mental health screening as a solution for gun violence. On the right, the chant is no longer just “guns don’t kill people; people kill people”; it is “homicidal maniacs” kill people (to quote Wayne LaPierre of the NRA).

But LaPierre is so very wrong.

Let’s take a quick look at the numbers. According to the CDC, in 2013, a total of 33,636 deaths-by-firearm occurred in the U.S. Furthermore, 84,258 people were injured by firearms. These statistics show that there is a massive amount of gun violence in the United States each year — over 117,000 injuries and deaths in 2013 alone — yet only a tiny portion of this violence can be attributed to media-magnet spree-killings perpetrated by PPDs. We know this, in part, because of those deaths by firearm, only a third were homicides. The rest were accidents and suicides.

Furthermore, the national media tends to ignore multiple firearm murders committed by non-PPDs, often because they are tied to “domestic violence.” And domestic violence, unless it is committed by a professional athlete, isn’t newsworthy.

It’s true: Gun violence in our society is a large, scary, seemingly intractable problem. Over 117,000 people per year means 320 people injured or killed per day, more than 13 per hour. How do you even think about a problem that large? You can see why blaming the problem on scapegoats — PPDs, or those with criminal records — might be a tidy, enticing solution, one that ameliorates some of our collective fear.

But people with psychiatric disabilities don’t deserve the blame. (Nor do those with criminal records.)

The vast majority of PPDs are never violent at all, and of those who are violent, the violence is most often directed toward themselves (as the gun violence rates themselves show). Indeed, even “severe mental illness [does] not independently predict future violent behavior.” Research confirms that, statistically, PPDs are no more violent than any other member of our society. However, the scientists who conduct these studies point out that convincing the public of the validity of their findings may be impossible, given the deeply ingrained fears of mental illness.

In short, we, as a society, are irrationally terrified of mental illness.

But what bothers me most about Question #6 is that, at its heart, it concerns medical treatment. Medical treatment should not be part of an airport survey. It’s not public record. Commitment, involuntary or no, is a medical issue, not a criminal one. And we should want people to seek medical treatment, not scare them away by stigmatizing it.

Beyond the fact that PPDs are no more violent than any other member of society, it’s important to note that people are involuntarily committed for reasons that don’t necessarily correlate to their degree of psychiatric disability, and certainly not to the permanence of it. A person might have a common adverse reaction to a steroid prescribed for poison ivy or a bee sting — something called “steroid-induced psychosis.” A person might have an autoimmune reaction that causes temporary psychosis. A person might be involuntarily committed because he or she is poor, a person of color, or has no family or other support system at home. (Although, let’s be honest. These days, poor people, POCs, and people with no support systems are far more likely to be arrested instead.)

And in the end, the difference between involuntary commitment and voluntary commitment, so much of the time, is simply having someone tell you these words: “Just go voluntarily because otherwise you will have this on your record.”

Just sign yourself in. Then you don’t have to say “yes” to Question #6.

Using involuntary commitment as a proxy for potential future wrongdoing — for future violence — is not only an inaccurate metric, it is also wildly misguided. If our government, with our cultural endorsement, ties rights and privileges to the avoidance of medical treatment, then what we’ll end up with is people who need treatment doing all they can to avoid it.

When faced with what seems like inexplicable violence, it’s easy to blame a population that’s either unable to or too afraid to stand up for itself. It doesn’t matter what the gun violence statistics at the CDC say: It comforts people to think that perpetrators of gun violence are crazy outliers — scapegoats. But the uncomfortable truth is that this presumption is based on a lie — one that does active harm to a significant population of people.

I don’t have to take my shoes off at the airport now. But every time I fly, I think about Question #6. It will always be there in the back of my mind — a reminder that I am always considered just a little suspect.


Lead image: flickr/Elton Lin

The Establishment

The conversation is much more interesting when everyone has…

Katie Rose Guest Pryal

Written by

Novelist (Entanglement, Chasing Chaos, Fallout Girl), Essayist (Catapult, The Establishment, Motherwell, Women in Higher Education), & Attorney (the good kind)

The Establishment

The conversation is much more interesting when everyone has a voice. Media funded and run by women; new content daily.

Katie Rose Guest Pryal

Written by

Novelist (Entanglement, Chasing Chaos, Fallout Girl), Essayist (Catapult, The Establishment, Motherwell, Women in Higher Education), & Attorney (the good kind)

The Establishment

The conversation is much more interesting when everyone has a voice. Media funded and run by women; new content daily.

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