Wednesday, April 23, 2014
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De cómo armar a los enfermos mentales

NUEVA YORK – El horror se ha vuelto casi una rutina. Esta vez, el lugar de la masacre fue un cine en Aurora, Colorado, donde la persona acusada de disparar, James Holmes, asesinó e hirió a decenas de espectadores. En 1999, la escena fue la vecina escuela secundaria de Columbine. Según algunas estimaciones, en Estados Unidos se producen más de 20 balaceras masivas cada año. Y siempre la misma pregunta: ¿por qué?

Cuando se compara a Estados Unidos con el resto del mundo, una razón se vuelve obvia: si bien Estados Unidos quizá no tenga más enfermos mentales homicidas que otros países, aquellos que sí lo son pueden acceder más fácilmente a armas en Estados Unidos que prácticamente en cualquier otra parte.

Según una encuesta de 2007, Estados Unidos está muy por delante del resto del mundo en términos de posesión de armas: hay 90 armas por cada 100 habitantes. El país, que cuenta con el 5% de la población global, tiene entre un tercio y la mitad de las armas en manos de civiles del mundo -aproximadamente 270 millones de armas-. Y muchos estudios demuestran que Estados Unidos supera por lejos a otros países desarrollados en términos de muertes por violencia con armas de fuego -30.000 por año, la mayoría de ellas suicidios, pero más de 12.000 de ellas homicidios-, mientras que hay 200.000 norteamericanos heridos por armas de fuego cada año.

Con esta cantidad de víctimas, uno pensaría que las leyes sobre control de armamentos serían una prioridad nacional mucho más alta en Estados Unidos que la lucha contra el terrorismo, que se promociona con bombos y platillos. Después de todo, desde los atentados terroristas del 11 de septiembre de 2001 en los que murieron alrededor de 3.000 personas, la violencia con armas de fuego generó casi 140.000 muertes y más de dos millones de heridos.  

Pero cuando se analiza más detenidamente la razón por la cual Estados Unidos es tan adicto a este tipo único de violencia, lo obvio no es tan obvio. ¿Por qué cuesta tanto sancionar leyes sobre control de armas?

Una razón importante es el lobby de las armas, uno de los mejor financiados en Estados Unidos. A pocos legisladores -demócratas y republicanos por igual- les interesa enfrentarse a la Asociación Nacional del Rifle. Y muchos norteamericanos creen que la Segunda Enmienda de la Constitución de Estados Unidos ("Siendo una milicia bien preparada necesaria para la seguridad de un estado libre, el derecho del pueblo a tener y portar armas no será vulnerado") les permite a los individuos un acceso prácticamente irrestricto a las armas.

De hecho, muchos sostienen que el riesgo de las muertes y lesiones relacionadas a las armas es el precio que los norteamericanos deben pagar por el derecho a portar armas, que consideran como una defensa poderosa contra la tiranía. Y, teniendo en cuenta cuántos tiranos en auge han desarmado a la población que intentan controlar, es difícil descartar este argumento por completo.

Sin embargo, seguramente puede haber un equilibrio entre los derechos de la Segunda Enmienda y las limitaciones racionales a la capacidad de la gente mentalmente inestable de acumular arsenales. Por ejemplo, Colorado y muchos otros estados intentaron exigir verificaciones de antecedentes más estrictas, destinadas a impedir que aquellas personas con un historial penal o problemas evidentes de salud mental se armen. Pero muy pocas de esas restricciones han sido legisladas -o no fueron cuestionadas por el lobby de las armas.

Finalmente, la oposición a leyes razonables sobre control de armas en Estados Unidos es cultural, lo que se refleja en los muchos informes noticiosos posteriores a las balaceras masivas que no admiten que Estados Unidos podría estar equivocado y minimizan el sorprendente contraste entre las leyes sobre armas de Estados Unidos y las de otras partes. Así, por ejemplo, los periodistas destacan la observación bastante patética de una realidad sombría: al menos no hay más masacres y asesinatos, y los números son estables.

Esta cobertura también tiende a individualizar y psicologizar las patologías sociales -otro rasgo estadounidense bien arraigado, reforzado por el espíritu fronterizo del vaquero solitario que es central a la mitología estadounidense (y a la mitología de las armas). Como resultado, los medios tienden a centrarse en la necesidad de una mejor crianza de los hijos y un mejor tratamiento de la salud mental. Pero es poca la cobertura estadounidense posterior a una masacre con armas de fuego que evalúa el impacto del sistema de atención médica de Estados Unidos, que es inaccesible para muchos, especialmente para quienes tienen problemas de salud mental.

Es por este motivo que, en muchas ciudades de Estados Unidos, es común ver gente con serios problemas mentales que habla sola y tiene un comportamiento muchas veces violento en la calle. No es algo que se vea tanto en países donde los sistemas de salud mental funcionan bien.

Muchas enfermedades mentales, como la esquizofrenia y el trastorno bipolar, pueden causar alucinaciones auditivas que "ordenan" al paciente cometer actos de violencia. La medicación controla este tipo de síntomas psicóticos. Pero un diagnóstico y un tratamiento apropiados requieren dinero, y se está recortando el financiamiento.

De hecho, según un informe de febrero, los estados norteamericanos han tenido que recortar los servicios de salud mental casi el 10% en tres años, lo que amenaza con "inundar las salas de emergencia y aumentar los costos de la atención médica para todos los pacientes". Pero, si los pacientes no pueden recibir atención psiquiátrica ambulante a un costo bajo para enfermedades crónicas como la esquizofrenia y el trastorno bipolar -que requieren un control continuo para ajustar la medicación-, habrá más violencia letal, especialmente si las armas están al alcance de la mano.

La atención de los pacientes hospitalizados también ha sufrido recortes. En las últimas décadas, las instituciones mentales y los centros de reinserción social han cerrado al por mayor, muchas veces en nombre de una reforma de la atención. Pero nada sustituyó esas instalaciones, lo que dejó a muchos pacientes sin hogar y a sus síntomas psicóticos severos sin tratamiento.

A pesar de las deficiencias bien documentadas de los servicios de atención mental de Estados Unidos, son pocos los responsables de las políticas de este país que están dispuestos a encarar la cuestión. Mientras no lo hagan, el fácil acceso a las armas no hace más que asegurar que las masacres como la de Aurora seguirán siendo un estribillo norteamericano amargo.

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  1. CommentedGabriel Nagy

    The fanatic attacks of September 11 made the Government of George W. Bush Jr. to launch his infamous ‘War on Terror’. While getting rid of the Saddam Hussein the cost in terms civilian deaths totaled more than 116,657 casualties. Evil hit from outside and America was ready to stomach the cost in order to defend their country.

    Just in the last seven years there has been 9 shooting including: ten dead in school shooting (2005); four girls killed in an attack on an Amish school (2006); 33 students massacred in Virginia Tech (2007); 10 die in shooting spree in Alabama, gunman kills 13 in siege in Binghamton, NY and in a deadly shooting at a US base 11 people are killed and 31 injured (2009); nine die in US work place shooting (2010); 8 dead in California shooting and 2 die in Virginia Tech shooting (2011); and this year (2012) seven die in college shooting and only two days ago James Holmes, a 24 year old student, killed 12 and left 58 wounded in a killing rampage in a movie theater in Colorado.

    How can a student assemble such a deadly arsenal from legal supplier without raising any suspicion? Why didn’t anyone alert the authorities? Doesn’t this make the suppliers accomplices of a serious crime? When are politicians going to take seriously this killing and declare war on guns? Powerful weapons are being used against innocent and defenseless fellow Americans. Holmes’ motives are irrelevant and make no difference now. What really matters is to put the necessary guns control to limit and to stop any future gunman to acquire any weapons that hurt and kill Americans.

  2. CommentedBill Woollam

    Gun confiscation legislation, Staged shootings, Banking fraud, Economic collapse, and Martial law http://www.blissful-wisdom.com/gun-confiscation-legislation-staged-shootings-banking-fraud-economic-collapse-and-martial-law.html
    My perspective doesn't fit pro-war, pro-banking fraud news feed.

  3. CommentedTom Bolt

    Michigan has eliminated all their mental health facilities and depend upon private contractors to fulfill what the state once handled. Thhe problem here is that good care has gone out the window for the dollar bill.
    I think mental facilities should operate for the good of those suffering from illnesses, yet at the same time I do not believe they should be operating at the expense of the people.

  4. CommentedTom Bolt

    I have no truck with this argument. There is a place in Georgia where they require every head of house hold to possess and carry a firearm. It has the lowes crime rate of any city in the U.S. There are stipulations. persons who object to firearms, religious reasons, emotionally disturbed and convicted felons cannot possess a firearm. Yes, we need some laws to guide us, but not to make us subjects to elected officials. This is the central issue that needs to be addressed and random acts of hoplophobic reactions.

  5. CommentedTom Bolt

    NRA and other firearm organiations are only doing what needs to be done or this Nation will beome a tyranny and all Americans will become slaves or surfs. There is a precise history of what happens when a nation evolves to the confiscation of firearms--it leads to a tyranny and the people loose all freedoms and liberty. Constructing a narrative to discombobulate the population is sour journalism.

  6. CommentedTom Bolt

    These are generalized statements and point to nothing real. Its like Alice in wonderland. In Michigan, according to the State Police records, suicide by firearm has reduced since the enactment of the "Shall issue rule" even accidential shootings have lowered. This is a result from persons learning the function and the safety use of a firearm. Empty numbers perform the function to scare the crap out of the ignorant. If closer research is performed it will be revealed that most of the deaths were created by criminals and gang members.

  7. CommentedGary Marshall

    I would think it probable that there are many more people capable of presenting a superior argument in a local meat shop. Why does Project Syndicate then persist in giving us this rank intellectual garbage with the options available?

    GM

  8. CommentedGary Marshall

    That's right, Naomi. No citizens with legal firearms permits were allowed into the theater with their weapons. Had they been, such a tragedy would probably never have been such a tragedy.

    Thanks again for showing us how utterly incompetent you are in reasoning through the plainest of circumstances and the simplest of arguments to the most obvious of conclusions.

    If one wishes to protect himself from the most manically lethal of people in the most vulnerable of places, he will not unless he has some equivalent means of self-defence at hand.

    If the US is such a dangerous place in which all sorts of nutjobs are running about shooting innocent people, then the answer is not to deprive potential victims of the means and right to defend themselves.

    Your headline exactly describes your argument, which is let the crazed few have their weapons. Only a Naomi Wolf could and would advocate for that insipid cause.

    Maybe there is reason in your madness. Maybe you're just improving your chances when you enter the proverbial theater and unleash your murderous rage.

    GM

  9. Commentedtom hoser

    Check out John Lott's book "More guns, less crime". It makes the somewhat counter intuitive point by siting studies in municipalities and countries where more guns were introduced and the crime rate fell dramatically This does not include the "wild card" mental illness which most countries with decent health care address effectively. We have structured our society to benefit a few at the expense of the many, just the opposite of most everywhere else.

  10. CommentedPatrick Holman

    3,000 people die everyday from heart disease, yet no one says a word. If you take away guns, then you leave a vacuum for tyranny. In your book, End of America, you forgot one step in Nazi Germany that took place; Nazi's confiscated my Jewish Grandfathers guns and the rest of the countries. Luckily, he left in in time. Gun control and gun confiscation is anti-Semitic. The medication that Holmes was taking is the real problem. Pharmaceutical companies pushing their untested drugs on America. The Government closed the state mental institutions and let them all out... we can't afford it. However, if I was at the theater, no one would have been shot except the lunatic.

  11. CommentedChris Elliott

    Succinct presentation as usual. Naomi as ultimately hit the real problem with a bullseye. But firstly Jason in Friday the 13th Films and real life 'Jason's often don't use guns. In countries were guns aren't readily available they don't. In England the most common weapon is an hammer, murder rate around 800 a year, mostly domestic and has been for a couple of centuries. Murders were down last year in the UK yet there are more illegal guns on the street due to hopeless border controls on that little green island. Those who have been on killing sprees gave no mental health indications.

    However, new words or phrases are going to become increasingly used in our future. One is ‘Fear Consciousness’. Present governments rule by creating fear. The very opposite to thier ultimate excuse for lying to us, 'protecting us from our fears'. Americans are not going to be parted from thier weapons while ever that fear consciousness is so high and there is no alternative.

    Noteworthy is that new weapons are already in production that are just as deadly and don't fire projectiles. They will also be used unmanned as perimeter defences, in due course as civilian property security. To make it simple, they have three settings, stun, unconscious and terminally liquidate soft tissue organs.

    Why do we need these weapons old and new? Because of inequity and injustice as well as the masses having no power. So weapons we turn on each other will be a part of our culture for a while yet.

    Naomi is perfectly on track with regard to addressing mental health, although it is my opinion that Holmes Junior was black ops weaponised to damage his Father and his forthcoming evidence.

    There is a whole raft of so called mental conditions that we know nothing about really and we as a community act like early doctors, if its broke chop it off! With mental health we cut it off by pigeon-holing it and boxing it off because we simply have no answers. We need to learn that there is nothing wrong with many, particularly the ones born after 1990 just that they are wired differently, a new species if you like. They are not nurtured these new humans they are caged and driven crazy like many wild animals which have been caged for various reasons. Societys produce them because they don't konw how to deal with them.

    I expect to be labelled myself for this comment or at best accused of possessing arcade knowledge, which is true but its not secret it is readily available for those with open minds, who seek it wishing to evolve thier knowledge and understanding. To those who don't it will be dismissed as craziness. Just as Nikola Tesla was 100 years ago. If JP Morgan and Edison had not destroyed him, we would have be so much better off now as humanity. We still need to over-come that same greed of the few to evolve.

    In the next few decades everyone will become fully aware. In the meantime, will anyone listen to Naomi's eloquent cry of more resources to support mentally alternative functioning people, so the craziness can be prevented from happening? If the USA wants a serious heads up they should look at how the Belgian's treat thier people who are different. Finally, who's to say that those deemed mentally ill by the authorities, but who never take a life, are the only ones who have the ability to see the truth and arm themselves in self-defence against a lie-infested government who create that fear.

  12. CommentedPhillip Points

    That is BS Naomi. You are lumping all guns in the same bucket. How much of these numbers were attributed to criminal activity?

    One thing should be understood and that is criminals will get their hands on guns no matter if there are heavy gun laws or not. Ban weapons or heavily restrict them and crime will skyrocket as it did in Australia when they banned guns.

  13. CommentedProcyon Mukherjee

    Some of news items associated with the Colorado incident took me by surprise like what had been reported on 23rd July in Seattle Times, which talked about increase in arms sales immediately after the incident or the Forbe's report on 23rd July which talked of huge rise in market capitalization of gun companies like Ruger or Smith and Wesson in the last two years. In fact in both these companies immediately after the incident the stock prices shot up.

    This leaves a sobering thought that societal acceptance of a tragedy and its reversal in form of an euphoria amongst the investors, who trade from such news and information, are signs of animal instincts that have gone awry in the human societies of current times.

    Procyon Mukherjee

  14. CommentedYoshimichi Moriyama

    There was a period in Japanese history when rising feudal lords and barons, trying to distinguish themselve militarily, politically and socially from other classes of people which they had hitherto belonged to and started to rise from, forbade the masses to possess arms (swords in Japan). It was undemocratic.

    If the Japanese or Americans were allowed to have guns or bazookas respetively, I do not know if this would make Japanese or American democracy more democratic.

    An American young man was in Japan as an English language instructor. His parents came to visit him. On an evening the son was in the kitchen, preparing food. The parents were watching Japanese TV news. They did not know a word of Japanese but from the tone of a newcaster they perceived something had happened, so they asked their son what had happened. The son replied from the kitchen, "Someone fired shots." The parents waited for the son to go on but he did not explain any further. So the parents, impatient, asked, "How many were killed?" "Nobody was killed" was the reply. The parents were flabbergasted. Nobody killed, would that make news in Japan? Yes, that makes nation-wide news in Japan.

  15. CommentedMichael Butryn

    It is alarming that you have included in your assessment of the failure of our health system, one of the fundamental reasons why it fails; stigmatism. The majority of those afflicted with mental illnesses do not walk around speaking to themselves and acting out. As a professional and respected speaker, you should have thought about that generalization a little more carefully. It can actually be taken as downright offensive. I would cite sources supporting my position but Many Bergman has already done so in her comment.

  16. CommentedMandy Bergman

    I agree wholehearted with Ms. Wolf that mental health funding both in the USA and Canada ( I am Canadian) is in need of a serious influx of cash. Prevention is undeniably cheaper than treatment and ethically sounder. However, Ms. Wolf is guilty of the stereotyping and stigmatizing of ALL mentally ill individuals based on the behavior of the few. This is especially troubling as people with mental health issues already suffer from higher levels of stigma than other ill patients, such as those with cancer or diabetes.

    In fact, according to statistics and research taken from the University of Washington the following is true about violence and mental health:

    "Although studies suggest a link between mental illnesses and violence, the contribution of people with mental illnesses to overall rates of violence is small, and further, the magnitude of the relationship is greatly exaggerated in the minds of the general population (Institute of Medicine, 2006)."


    "…the vast majority of people who are violent do not suffer from mental illnesses (American Psychiatric Association, 1994)."


    "The absolute risk of violence among the mentally ill as a group is very small. . . only a small proportion of the violence in our society can be attributed to persons who are mentally ill (Mulvey, 1994)."


    "People with psychiatric disabilities are far more likely to be victims than perpetrators of violent crime (Appleby, et al., 2001).

    People with severe mental illnesses, schizophrenia, bipolar disorder or psychosis, are 2 ½ times more likely to be attacked, raped or mugged than the general population (Hiday, et al.,1999)."

  17. CommentedE Michael Kahn

    As a psychiatrist, I appreciate Ms. Wolf's impassioned plea for mental health resources. It seems important, still, to make the distinction between the rare, spectacular tragedies perpetrated by individuals in the throes of psychosis, and the daily, hidden tragedies of suicide and domestic violence. Easy access to firearms shapes the ways that this drama is played out, daily. Public health measures, such as depression screening and substance abuse education, likely have a role in mitigating gun violence. [See http://www.theatlantic.com/national/archive/2011/01/the-geography-of-gun-deaths/69354/ for an informative analysis.]

  18. CommentedThomas Haynie

    Brilliant! Perfectly articulated what I've been thinking for some time. I'm becoming a fan of your work.

    The question becomes to what level are Americans willing to fund (through taxes) the mental health system in order to reduce these sorts of killing? Or increase restrictions and enforcement on guns?

    Of course there is the third solution touted by the Rt. We should ALL be carying concealed weapons. But then I'd bet my rt leg accidental shootings, shootings from mementary rage, and shootings from the inept momentary hero or vigilante will increase.

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