The recent shootout between a patient and a psychiatrist in a Philadelphia-area hospital surprised not only the average American, but also psychiatrists around the country.
“I had a holy cow reaction -- a psychiatrist with gun in his office!?” said Dr. Stephen Marder, a schizophrenia expert and director of the section on psychosis at the Semel Institute at the University of California, Los Angeles. “The idea of a psychiatrist having a weapon in his desk is entirely new to me. I haven’t heard of anything like it before.”
Psychiatrists and mental health experts interviewed by NBC News didn’t see gun-toting doctors as a new trend. In fact, they said, guns really aren’t the best protection against a violent patient with severe mental illness.
“My guess is that arming psychiatrists is more likely to be harmful than helpful,” said DJ Jaffe, executive director of Mental Illness Policy Org, a nonpartisan science-based think tank focused on serious mental illness.
The weapon mental health professionals would like to have is legislation that makes it easier to commit dangerous patients before a tragedy occurs.
“Violence by the mentally ill is always due to them being untreated,” Jaffe said. “We need to change commitment laws. We can’t wait to commit someone until after they become a danger to others.”
Some states are more in need of reform then others when it comes to treatment of severely mentally ill patients, experts said.
“In Pennsylvania the law says you have to be a clear and present danger before you can be committed,” said John Snook, deputy director of government affairs at the Treatment Advocacy Center. “That means if you’ve got a deteriorating family member, health professionals can’t do anything until your mentally ill loved one has tried to hurt you or someone else.”
Still, experts cautioned the public not to conclude that all mentally ill patients are violent and to be feared.
“In terms of the general population of people with mental illnesses, if you rule out substance abuse, about 7 percent in one year will do some kind of act of minor or serious violence –- and that could be shoving or slapping someone on the face, not necessarily an act of mayhem,” said Jeffrey Swanson, a professor of psychiatry and behavioral sciences at the Duke University School of Medicine. “Among those with schizophrenia, one in about 70,000 will commit a homicide against a stranger. It’s really rare.”
In fact, while incidents like the one in Upper Darby, Pa., tend to catch the public’s attention, hospital shootings are rarely perpetrated by the mentally ill. A study published in 2012 in the Annals of Emergency Medicine found that just 4 percent of hospital shootings involved someone who was “mentally unstable.”
The American Psychological Association said the shooting near Philadelphia was out of the ordinary, but declined to say anything further in response to NBC News.
"The APA has no official position on unusual incidents like this one and has no comment at this time," said APA spokeswoman Eve Herold.
Even in the rare cases involving a potentially dangerous patient, “there are a lot of things mental health professionals are trained to do to limit the risk of violent incidents,” Swanson said. “One thing we do know is that the presence of firearms doesn’t necessarily provide protection –- and sometimes it does just the opposite.”
First published July 25 2014, 3:08 PM