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How can we be safe in a society flooded with guns?

Two issues have dominated this discussion: mental illness and gun control. Though it is reasonable to question why guns only useful for mass killings are available to the general public, my focus is on the place of mental illness in this conversation.

Based on 30 years of experience as a General and Forensic Psychiatrist, I suggest that the population of greatest concern should not be the mentally ill, but rather people with a propensity for violence. Most people with mental illness are not violent and a minority of people with a propensity for violence are mentally ill. Demonizing all mentally ill people is unnecessary and may inappropriately limit civil liberties.

Here is information that should be part of this discussion.

1. A very small portion of people diagnosed with a mental illness are ever violent. I have treated approximately 60,000 mentally ill people. Few have ever been violent. Most have owned guns and used them responsibly. People with mental illness are much more likely to hurt themselves or have violence perpetrated against them than they are to be violent.

2. Most people who commit acts of violence do not have a serious mental illness.

3. There are specific risk factors for violence in the mentally ill community. We can learn those risk factors from mental health experts and pay attention to people who have them without taking away the Second Amendment rights of all mentally ill people.

4. The single greatest predictor of future violence among all people (mentally ill or not) is a past history of violence.

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What should we do as a community to ensure both safety and the Second Amendment rights of all citizens?

1. Our community would be significantly safer if people who have a history of past violence did not have access to guns.

2. We can identify mentally ill people who are at high risk of violent behavior. Our community would be safer if that group did not have access to guns.

3. Our community needs to have an integrated system of care for mentally ill people who are at high risk for violence that goes beyond our current system, which does little more than hold people in a hospital setting until they say they no longer intend to be violent.

We need to focus on people who have been violent and have risk factors for future violence if we wish to improve the safety of our community. Taking away the Second Amendment rights of the mentally ill will not significantly reduce violence.

Dr. Steve Manlove is Board Certified in General Psychiatry, Forensic Psychiatry and Internal Medicine. He has practiced psychiatry in Rapid City since 1987.

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