We are creating a perfect storm for tragedy. We have woefully inadequate mental health care and unlimited access to weapons. When I read of shooters described as mentally ill, I imagine the public spewing venom about the idiotic psychologist who failed to hospitalize the patient in time to prevent the shooting. So, I am on my soap box to say, “Easier said than done.”

Mental health professionals may press for more intense treatment, but insurance companies often resist covering the treatment of mentally ill individuals, and they certainly don’t want to foot the bill for lengthy hospitalizations. On numerous occasions, I have attempted to have a patient in active psychosis admitted, only to be told they “don’t meet the criteria.” As recently as two weeks ago, we sent a potentially dangerous patient to the ER. She was given a Prozac and sent home. Her family was able to help her safely through her episode, but it might have ended differently. There is an acute need for the revamping of the mental health system. The current practice of waiting until after a tragic event, and then imprisoning the person, or burying them, isn’t working.

What scares me the most, however, is the number of people I know of with explosive disorders, anger issues, and personality problems that have stock-piled, yes, literally stock-piled, weapons. What will it take for someone like this to slip over the edge and kill himself or someone else? And this isn’t taking into account the mood swings and impulsivity of young people. In 2010, more than 1,900 kids between the ages of 5 and 19 committed suicide with a firearm. Where do we think they got those guns? Further, eighty-five percent of suicide attempts with a gun are successful, as opposed to one to two percent with, say, wrist-slashing. We need to be more aware of depression in teens, work to get hospitals to admit severely depressed people, and do whatever is needed to protect our youths from themselves. Some gun-owning parents with children suffering from depression have actually, gasp!, removed firearms from their homes.

There is a lot of work to be done at the juxtaposition of mental health and criminal law. Let’s push for real progress.