Tag Archives: violence

Watch Your Mouth: The Use of Language in Gun Control Debates

Just a few days after the addition of the Boston Marathon bombing as another wound in an ongoing tale of public violence in the United States, and following the recent defeat in Congress of a proposed expansion of background checks for gun transactions, President Obama is now focusing his efforts on enforcing executive actions requiring state agencies to release mental health records to the FBI. Federal law currently prevents individuals diagnosed with certain mental health issues to purchase firearms; the FBI uses information provided by states in order to enforce this legislation.  Prior to the 2007 shooting at Virginia Tech, states voluntarily provided these records.  However, following the incident, new legislation was passed requiring states to provide the information or face significant cuts to criminal justice funding. Recently, the Obama administration, under executive order, began working to remove other barriers that might prevent states from releasing mental health records to the FBI.

 

Interestingly enough, this tune is quite different than that of only a couple of weeks ago, when, it was reported that Senate lawmakers were working quietly to develop legislation that would bring about comprehensive mental healthcare reform.  The legislation would provide more funding and development in the mental health care sector across the country, increasing the number of health care facilities, providing early intervention training, and increase Medicaid allotments for mental health care.  While lawmakers and mental health care lobbyists initially attempted to quietly distance the mental health legislation from discussions about gun control, recent events have made the connection inevitable.

 

Such a scenario begs larger questions about the language used in media reporting about mental health and violence, especially in the current popular dialogue over gun control reform in the wake of increasingly frequent mass shootings.  If one were to read through the headlines published about the spree killers involved in the shootings in Aurora, Tucson, or Newtown, one would read scores of connections between the acts of violence and allegations of mental illness or instability.  In fact, according to Ronald Honberg, the director for the National Alliance on Mental Illness, none of these individuals have ever been formally diagnosed with a mental health issue, at least not to our knowledge.  Yet, in the wake of these shootings, the discussion about gun control centered directly on issues of mental health, reflecting subconscious societal connections between violence and mental health.

 

However, the truth is that, although many people assume that mental illness commonly precipitates violence, the annual incidence of violent crimes against people with serious mental illnesses is more than four times higher than in the general population (Teplin, et al. 2005).  If we are going to have a national conversation about mental health, then this aspect has to be included in it.  However, the current stigmas present in the media, political discourse, and social conversation short circuit the potential productivity of a mental health conversation by reducing the impact of mental health to acts of violence, a connection that is not backed up by the facts themselves.

 

A public conversation about increasing resources for addressing mental health is essential in our national health climate, especially when approximately 47% of Americans will have a diagnosable disorder within their lifetime (according to the DSM-5).  However, as we pursue this conversation, we must be extremely careful about the ways in which we conflate mental health and violence.  The language we use and the connections we draw matter immensely for our abilities to care for such a significant and valuable population in our society.

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Emotional Costs Too

Last week’s lecture focused primarily on the economic costs of violence and the important role they play in productivity losses. Most of the time was spent discussing monetary costs but costs of violence don’t always consist of monetary costs; there are also emotional costs.

sandy hook

After the Sandy Hook shooting, families, teachers, friends, and community members were all affected by the monstrosity that took place in the small town of Newtown, Connecticut. I think in light of such shooting, there is definitely more than one victim. Not only do parents suffer but everyone around the crime suffers as well. When I think about this shooting, I think about the people whose classmates were killed and how those 6 and 7 year-olds have to grow up pondering the thought of, “It could have been me.” Such trauma, as we discussed last week, can have very negative effects on a child. What if the child needs extensive therapy for years to come after the incident? What if the couples of the deceased children have to go to marriage counseling because they are so torn over the death of their child? I wonder if these sorts of things get factored into so-called “economic costs” of violence. I think the definitely should because heinous violence is what caused these people to seek out therapy. It’s hard to widen the parameters for what we consider to be an economic cost of violence but I think these things should be factored into funding for research on this cause.

Something else that I think about is the amount of people in jails for minimal crimes (like marijuana) that could be dealt with in another manner besides jail. And also how our tax dollars are used for people in jails that don’t necessarily need to be there.  The system needs 1) a better way to control jail time, and 2) a way to avoid such heavy amounts of people in jail at once and focus on early rehabilitation that will turn kids away from jail. An article on NPR stated “correctional systems…cost the nation nearly $70 billion annually.” This article went on to further discuss how more money is being spent on jails than for our education system. While I do think that more money should be spent on schools, I think the bigger problem here is that we spend so much money on jails, when it could be put elsewhere, such as towards funding research on violence, rather than funding for people who are “violent”.

NPR article:

http://www.npr.org/2011/04/11/135311793/the-root-the-price-of-funding-jails-over-schools

Picture:

Screen shot 2013-03-01 at 11.20.47 PM

When we discussed resilience amongst rape victims in class on Monday, the first current event I though of was the Rihanna and Chris Brown relationship. Although she was not a rape victim, Chris Brown had assaulted her in 2009 and they broke up. Despite the dramatic interviews and the graphic pictures released from the incident, Rihanna decided to go back to Chris Brown and rekindle their love for one another.

During class, Robyn Fivush discussed a coping mechanism for rape victims who fight to remember their attacks so they can forget about the incidents. I think back to Rihanna’s situation and wonder if discussing the incident publicly helped her forget about/get over the domestic abuse incident. A lot of the times she talked about how hurt and she was because she never thought someone who loved her could hurt her so badly. However, I’m also torn because she is back in a relationship with him. Was her pain only temporary or did she forget about the incident altogether because she fought to remember it?

Once she got back together with him, the couple “looked” happy with one another, a complete turnaround from the last time we saw them together in public. Something that bothers me is that people are accepting of the rekindled relationship. There have been comments like, “Oh they’ve matured and Chris has learned his lesson,” which I think is true to some extent; however, he abused her. In discussing violence toward women, Abigail Hankin said, “The notion that violence towards women, children, or other human beings can be justified needs to be reconsidered given the enormous health and social costs that violence exacts from victims and societies. Promotion of norms and values in which violence is depicted as illegitimate and irresponsible could be important in creating social contexts that are intolerant of violence and are considerate to its victims.” Many people think their relationship is healthy, but in reality, no one knows if she is truly okay. In relation to what Hankin said, no one is talking about how unhealthy their new relationship could be to their livelihood because of the depressing history between the two. I don’t think Rihanna is being considerate of her mental state and how this could affect her health in the future. In a study about why people stay with abusive partners, research showed people hold on to the positive characteristics of their abusive partners. Some statistics include, “More than half (54 percent) saw their partners as highly dependable, while one in five (21 percent) felt the men in their lives possessed significant positive traits (i.e., being affectionate).” In relation to Rihanna, I think this is why she got back with Chris. The positive traits outweighed the abuse. In my relationships with others, once you do something bad to me, I’ll always remember that before the good memories, which is the opposite for Rihanna. She views Chris Brown in a positive light, which I think is completely wrong. I don’t believe she will ever fully recover from what happened to her because she is still around her attacker. Talking about the situation may help to forget what happened but rekindling romance with your partner will never make sense to me.

 

http://www.billboard.com/photos/stylus//2669739-rihanna-chris-brown-instagram-617-409.jpg

Nauert, PhD, Rick. “Why Women Stay in Abusive Relationships.” LiveScience.com. N.p., 13 Apr. 2010. Web. 29 Apr. 2013.

 

Economics Behind Violence

            The focus of the class this week was the relationship between violence and economics. The lecture speaker, Dr. Phaedra Corso, emphasized the economic implications that occur as a result of violence. This type of information was cited as being significant for policy-makers in public health, law enforcement, etc. because it allows these individuals to assess tangible data in order to formulate a large-scale response. For example, if hospital data shows a noticeably high rate of domestic violence patients, programs can be put into place in order to raise awareness about resources for abuse victims.
            This discussion reminded me of Dr. Robert Agnew’s lecture on strain theory and the social causes that lead to violent behavior. To paraphrase, strain theory holds that stress/stressors cause individuals to react negatively and may lead to violent crime. Also during this lecture, the idea of social control and social disorganization was discussed. Violence, it is held, can result from the loss of social control mechanisms, such as fear of punishment and positive family environments.
            Economics, in my opinion, has an important role in the discussion regarding these two theories. Although Dr. Corso focused on the economic effects of violence, there is also room for serious research and discussion about the economic motivators that lead to violent behavior. This idea encompasses many forms of violence, from war to interpersonal and self-directed violence. While not absolute, there seems to be a clear connection between economic difficulty and high rates of crime and violent behavior.
            There is a particularly direct relationship between poverty and crime. Gary Becker, the influential economist, is known for his idea (1968) that people resort to crime if the costs of committing the crime are lower than the possible benefits. Following this logic, people who live in poverty have a much lower cost/benefit ratio than those individuals who are not in poverty and, thus, have more to lose. Lack of education, unemployment, poor living conditions, drug use, and dangerous environments are all associated with poverty, and each of these factors is also linked with crime.
            This is an important relationship to consider because the economic aspect behind violent behavior helps perpetuate violence in low-income regions, from housing projects in urban American cities to the slums of developing countries. In fact, scholars and experts following this logic have designed responses that incorporate components of poverty, such as this study by J. Gilligan in which education of violent inmates is the primary suggestion for violence reduction. Ultimately, in order to successfully develop and institute programs that decrease violence and rehabilitate victims and communities, the economic situation must be considered, both as a result of and a reason for violent behavior.

Morals Meets Finance: Doctor-Assisted Suicide

Cartoon following the failure of a Massachusetts ballot measure that would have legalized doctor-assisted suicide, by Dan Wasserman

Cartoon following the failure of a Massachusetts ballot measure that would have legalized doctor-assisted suicide, by Dan Wasserman

Other than marijuana (see last week’s post), my home state of Oregon is known for its Doctor Assisted Suicide.

Currently doctor-assisted suicide in Oregon is dealt with the Death with Dignity Act. In order to qualify for the life-ending medication, the patient must be diagnosed as terminally ill with a prognosis of less than six months to live. It is, of course, completely voluntary on both the patient’s part and the doctor’s part. The Death with Dignity Act does not qualify legally as “suicide.”1

How frequent is this program? The 2012 Oregon Health Authority reported that 115 prescriptions were written last year in Oregon. The median age was 69 years old, and the most frequent diagnosis was cancer.2

Is right for our doctors to aid in ending a life? According to the 2011 Gallup poll, 45% of respondents agreed it was morally acceptable and 48% found it morally unacceptable, making it the most hotly debated topic in the survey.3 The moral debate can go on for ages –some will always view doctor-assisted suicide as cold-hearted justification for taking a life too soon while others will be comforted by the option of choosing death rather than being forced to live in pain.

So instead of telling you my opinion, I turn instead to the economics of doctor-assisted suicide. As we all know, end of life care can be expensive. So economically speaking, such measures could ultimately decrease the costs of terminal illness in cases where the patient will not recover and does not want to be sustained. According to an estimate from Emanuel and Battin, legalizing physician-assisted suicide could save as much as $627 million annually in the United States.

It is precisely because of its cost effectiveness that causes some to worry. The New York State Task Force on Life and the Law explains that “patients may be pressured to consent… when their care is expensive or burdensome to others.”  Even if not explicitly pressured by others, they may feel guilty about continuing their life for financial reasons.

Furthermore, those in the health care sector might be a source of pressure. Emanuel and Battin calculate, for example, that a large managed care plan could save around $3.3 million a year from doctor-assisted suicide. More than just care plans, hospitals also stand to save money from such a program.4

How should we deal with these competing economic factors? A bioethics and law expert Maxwell J. Mehlman, J.D., urges us to think about how a financial motivation would affect the situation. Suppose a patient is poor and seeks to participate –should we stop him or her from participating? Are we forcing them to die? But then, does denying the option of doctor-assisted suicide improve their condition in any way?5

Many questions can be asked about doctor assisted suicide, and they should be if we wish to develop comprehensive health-care for the terminally ill.

Links:

1.http://public.health.oregon.gov/providerpartnerresources/evaluationresearch/deathwithdignityact/pages/faqs.aspx

2.http://public.health.oregon.gov/providerpartnerresources/evaluationresearch/deathwithdignityact/pages/faqs.aspx

3.http://www.gallup.com/poll/147842/doctor-assisted-suicide-moral-issue-dividing-americans.aspx

4.http://www.nejm.org/doi/full/10.1056/NEJM199807163390306

5.http://www.thedoctorwillseeyounow.com/content/bioethics/art1976.html?getPage=4