Quoted:
Quoted: Here we go...
I'm saying people with mental instability, hallucinations, paranoia, delusions, and suicidal/homicidal ideation should not own weapons... because they are at significant risk for using those weapons on themselves (schizophrenics have 5-15% lifetime risk of suicide, depending on what study you read). They also have a habit of preemptively "defending themselves" against the imagined horde of CIA assassins that's being led by that shifty convenience store owner down the street (He thinks I don't know!!!) who keeps calling the police to kick you off the property.
I'm as pro-gun as anybody, but I deal with these patients professionally.... You can think what you want., but I'm not for arming those who are of unsound mind. |
I understand.
Does this mean they should not have kitchen implements? Automobiles?? Where do you draw the line?
I ask this respectfully, because as an obviously educated and experienced person, you know that someone who is going to do harm (to themselves or others) WILL find a way to do it... hence my suggestion that if they are such a risk, they not be free. |
Fair question... and I'll try to answer it.
We take all sorts of things into account when we decide to keep/release somebody (do they have a house full of guns? Do they have a 5-gallon-bucket of tricyclic antidepressants they're going to funnel into their stomach the moment we release them?) I never turn anybody loose who I think is a danger to themselves or others... but psychiatric facilities have limited space, and can only hold onto patients so long. They eventually get stabilized, released, then what happens to them is in their own hands.
If they don't like their medications ("they give me dry mouth," "I don't like the way they make me feel," etc), then they'll eventually relapse. If there's no place to put them long-term, they can go through this "revolving door" many many times. You have to understand that many of these patients are uninsured, homeless, etc (or under-insured, because lots of plans don't cover mental health services beyond a VERY minimal amount). There is a definite "downward socioeconomic drift" with these patients.
You do what you can.
As an aside, loss of rights/privileges is not unprecedented when a danger is presented to the public, or to the patient. Seizure patients are unable to get drivers licenses in most states without a seizure-free interval of anywhere from 6-12 months. The rationale being that if they are prone to frequent seizures, they shouldn't do it behind the wheel of a 6000lb bludgeon, moving at 70mph.
States have various laws that allow health care providers to constrain the rights of those with mental health issues, substance abuse issues, etc, etc... but those only go so far.
People will kill themselves with other things, you're quite correct... I've seen them jump from buildings/bridges, leap into traffic, suicide-by-cop, drowning, hanging... you name it.
You have a responsibility to attempt to make things as safe for the patient as you can (eg. don't prescribe a bucket of tricyclics... restrict them to SSRIs), and then you cross your fingers and hope for the best.
Unfortunately, either due to relapse, medication non-compliance, lack of social/family support, lack of facilities, etc, it doesn't always work out.