I have been commenting at another blog site about the ongoing ridiculousness that is about to transcend reality, with politicians preparing or already passing legislation about gun control and including the expectation that psychiatrists and other mental health professionals will report any patient who may reveal thoughts of harm to self and others while having access to a firearm.  First, here is the site of mention:

http://psychiatrist-blog.blogspot.com/2013/02/bang-bang-im-thinking-about-gun.html

If you care to read through the thread, you’ll see how it does get a bit tangential with the role of inpatient care issues, and my take is that such legislation will force many of such patient matters involving firearms into hospital care.  What I don’t understand is of the few potential true patients who may actually fit this concern legitimately, what about the 90% or more that will be dragged to mental health care provider doors by police and the courts because these non clinical sources will irresponsibly assume that only “crazy people” will consider using guns to shoot themselves and/or lots of others.  Oh, and by the way, they should have NO RIGHT to have access to firearms thereon.

Well, I read today in the most recent issue of Psychiatric Times, and I will provide the link for the net readers but warn you there is a need for an account to access the articles, so be prepared to join to read:

http://www.psychiatrictimes.com/home

James L Knoll IV MD wrote about “Mass Shootings:  Research and Lessons”, and it was the last section titled ‘Narcissism and the news media” that I found the most interesting.  In there, he writes:

“Narcissism and social rejection are risk factors that work in tandem to cause aggressive behavior, and these have certainly been described in the histories of mass shooters.  Twenge and Campbell note that ‘given the upswing in the narcissistic values of American culture since the 90s, it may be no coincidence that mass shootings became a national plaque around the same time’. Extensive media attention in the 1990s may have provided a script and unwitting adulation of those who would seek an impatient route to their entitled respect.  This hints at a deeper societal pathology–a culture that has ‘grown more focused on self admiration and more enamored with celebrity and fame’.  One might argue that we hold celebrity as the single greatest achievement of life–one that should be attained by any means.”

Dr Knoll goes on to note how the news media feeds into this with the nonstop coverage these shootings get for days afterwards.  Infamy and immortality seem to go hand in hand these days, eh?

Well, my concern is where is the line between narcissism and antisocial traits/disorders?  And I did not want to weigh down another blog author’s site with my hypothetical issues and concerns, so wrote this post to just note this to readers from there or readers coming here independently:  maybe one reason why so many commenters are so outraged and unhappy with the potential for getting hospitalized is because so many antisocial people are being put in hospitals for the past 10 or more years once Clifton T Perkins became so overloaded with patients, and honest, true psychiatric patients who really need inpatient care can’t stand being housed with criminals.

Certainly have seen that in my travels at one state hospital I worked at about 2 years ago, and I am told by reliable sources that Springfield and Eastern Shore Hospitals, which are state facilities here in Maryland that have been already crippled by deinstitutionalization, they will be further harmed by this forced housing of forensic cases with the general psychiatric population.  And I hear through the grapevine that even private short stay facilities are being forced to take on forensic cases these days.

So, as I asked in my comment at the other site last night to colleagues, where can responsible and effective care for acutely ill patients be provided if we are to be further forced into forensic situations?

I know the plot line of Analyze This was absurd, but when you step back and look how the Billy Crystal character got involved with the Mafioso boss, it was an innocent car accident and Crystal tried to handle it right, but, “right” in working with antisocials is certainly perspective first, and reality is way down the line.  And that is what bothers me with this legislative onslaught that will be a cascade once Maryland follows New York’s miscues.

Remember the two adages that define what most of psychiatry is up against:

The road to hell is paved with good intentions, and

No good deed goes unpunished.

Hey, you don’t have to believe me, I’m sure your faith in the politicians you as the majority electorate reflect in repeated reelection of these effective incumbents will make your world safer and more predictable the day these laws go into effect.

Funny, why is it when I watch the Robert De niro character in the film, he reminds me of Joe Biden?  Just an observation!