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This is third and final posting in a series on the shooting of 13 people in Tucson and its implications for health and social policy in the US. This post is by Robyn R. Liu, MD, who is a family physician in the frontier town of Tribune, KS, in the far western part of the state.
The day Gabrielle Giffords and 19 others were shot is one of those days that most Americans will remember where they were when they heard the news. What I will remember is my husband saying, “A congresswoman was shot in Arizona. She was on Sarah Palin’s crosshairs map.” As our picture of the alleged shooter became more complete, we realized he was not playing John Hinckley, Jr. to Palin’s Jodie Foster. Rather, he is in all likelihood a very disturbed, mentally ill young man.
A CNN/Opinion Research poll demonstrates that most of the public agrees, and thinks that the lack of mental health resources was in part responsible for the horrific act of that day: 41% said a “great deal,” and 29% said a “moderate amount.” When NPR went to a gun show held in Tucson just seven days after the shooting, the man at the front of the line said, “Mentally ill individual, very troubled individual that unfortunately slipped through the cracks somehow. And I think that’s what we need to look at, is how did this fellow get missed.”
As a primary care doctor in a frontier state, I can tell you, those cracks are pretty big.
I wrote a piece last week for another blog about one patient’s experience with the mental health system here in Kansas. This was a patient with insurance and a continuity relationship with a psychiatrist – and even she “fell through the cracks” more than once, although her violence was all self-directed and thus never made headlines. We do not know what Jared Lee Loughner’s health insurance status was, nor whether he had ever sought a therapeutic relationship with a mental health professional. We do know that although his behavior got him rejected from both college and the military, he was able legally to purchase a handgun and a 30-round magazine. As Dr. Dora Wang noted this week in Psychology Today, “It’s easier to get a gun than mental health care.”
I decided to do some looking into mental health services in Arizona. I went to the home page of the Arizona Medicaid program, forthrightly if a bit unfeelingly called the “Arizona Health Care Cost Containment System,” or AHCCCS. I already knew that AHCCCS was looking at cuts in Governor Jan Brewer’s new budget, since by her direction 98 people had had their transplants rescinded under this program. The Division of Behavioral Health Services website describes how the governor’s proposed 2011 budget would alter Medicaid eligibility criteria for “childless adults” like Loughner, possibly removing coverage for 5,200 Arizona citizens with “serious mental illnesses.” The writer hopes, however, that a loophole in the policy will allow “more than 80% of these folks” to maintain coverage under a different Medicaid category. Oh, thank goodness! Now only 1,040 seriously mentally ill people will suddenly find themselves high and dry in Arizona.
The longer we as a society refuse to provide universal health care, with complete parity for mental health, the wider these cracks are going to get. It wasn’t an illegal immigrant who shot down a federal judge, a pastor, two homemakers, a social worker, and a little girl in cold blood. A retired Marine is not lying in the hospital with bullet wounds he suffered trying to protect his now-dead wife because of a drug-smuggling Mexican. Arizona is worried about protecting its borders, but its greatest threat may already be inside. Imagine over 1,000 Loughners walking the streets with no means to get help: it’s absolutely chilling.
...
Postscript from Josh:
In the January 27, 2011 NY Times, columnist Gail Collins quotes Senator Tom Coburn of Oklahoma from an appearance on "Meet the Press":
“The people that are going to commit a crime or are going to do something crazy aren’t going to pay attention to the laws in the first place. Let’s fix the real problem. Here’s a mentally deranged person who had access to a gun that should not have had access to a gun.”
As Senator Coburn is a physician, he should know. And, hopefully, he will sponsor legislation to create some rational limits on gun access, as well as increasing access to mental health services. But I wouldn't hold my breath.
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Showing posts with label Giffords. Show all posts
Showing posts with label Giffords. Show all posts
Thursday, January 27, 2011
Friday, January 21, 2011
Tucson is worth struggling for...
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This guest post by William Bemis is the second of three related to the recent shootings of Gabrielle Giffords and others in Tucson (in Pima County), AZ. Shortly before the shootings, the NY Times reported on a decision by the AZ Board of Education (a state agency in the capital, Phoenix) to close a Latino studies class in a Tucson High School. Urged by family members to consider relocation, Mr. Bemis, a psychotherapist and my brother-in-law, wrote this response, speaking of the Arizona city whose City Council had previously voted to ask the state to rescind its anti-immigrant law; after the shooting, at my request, he added additional material.
No, my dear, it's time for us and others like us to re-double our efforts to not only preserve Pima County as an island of sanity in this sea of ideological madness, but help the rest of the state and the nation see that leaving all the levers of power in the hands of racist corporate stooges is not going to take us anywhere but down. Having lived in this state for over 40 years now, I've seen this before - with Evan Meacham and Fife Symington, for example. After each of these lunatic lurches to the right, the state came back to at least a more moderate centrist political configuration. Arizona will never be Massachusetts or Oregon or Minnesota, but I, for one, am not ready to leave and concede this beautiful and unique place to the hate mongering front men for big money interests.
I loved living in New York, but we could never afford it, and besides, although their antics are less spectacularly loony, I wouldn't call the New York state government an example to emulate. Where else? Illinois? Puh-leeze! California? Are we talking about the homeland of Nixon, Reagan, Robert Dornan, et al? Sadly, Californios have also had to deal with home grown right wing fanatics, que no? Oregon? A more congenial political environment, perhaps, and a beautiful state, but too much rain!
It isn't just here, is it? I think we have to take the long view. The so-called conservatives (what do they wish to conserve besides entrenched wealth?) are riding high right now, both here and in Washington, but in the next couple of years they are going to amply demonstrate the meaness and poverty of their ideas. Contrary to the self delusions of Russell Pearce, Jan Brewer, Mitch McConnell, and John Boehner, I think these folks are cruising for a fall. I am more worried about the failure of those of us who do not share their agenda to take advantage of this moment than I am of the pseudo-populist, big money financed Tea Party. They have the money, so we all have to write our more modest checks and work all the harder. Our own apathy and discouragement is the enemy.
Moments after writing the above, I heard the news that Gabrielle Giffords, our Congresswoman, had been shot by yet another disturbed young loner of the type who seem to implement "Second Amendment solutions " to their private frustration and alienation on an almost daily basis now, thereby spreading their own psychic pain to all the rest of us. Cue the required messages of horrified shock and condolences from politicians of all persuasions, including even Sarah Palin who put Gabby's district literally in the rifle sight cross hairs and who tells her followers, "Don't retreat, RELOAD!" Some of those messages are no doubt sincere, but the one politician who was the most eloquent to me was Pima County Sheriff Clarence Dupnik, who doesn't get nearly the amount of press as his counterpart in Maricopa County, possibly because he is a hardworking, low key, decent, and fair public servant, which never seems to make good copy. Sheriff Dupnik's comments about political vitriol triggering mentally unbalanced individuals goes right to the heart of the current political climate in Arizona and across the country.
Gabrielle Giffords is a self-described "Blue Dog Democrat". For me, her politics are way too centrist in an era when what used to be the core values of the Democratic Party are under siege. If only she fit the liberal label that the Tea Party would like to pin on her! Though Gabby's stances on a lot of issues frustrated me, I worked as a volunteer on her election campaigns because I knew she was absolutely the best person we could hope to have elected to Congress from her district, which is Republican overall and in many precincts virulently racist and violent. Gabby is smart, dedicated, articulate, hard-working, extremely personable, and so much better than her recent opponent whom she barely defeated that I would have been ashamed if he had won and I hadn't done what I could to put her back in office. She is surviving so far the bullet that passed through her brain, and the trauma surgeons are optimistic, but I can't help but wonder if she does survive if she will ever be able to function again at the level she did prior. I read somewhere that she was advised recently that she had been too inaccessible in the past, though I seem to remember hearing frequently over her four years in office about her holding meetings for constituents to communicate with her. I wonder now if our congresspeople, like so many others in the public eye will have to be so security conscious that normal interaction and give and take between them and their constituents will be impossible. Yet another weakening of democratic process in this country.
Some of the murdered in this incident include a nine year old girl who wanted to learn more about politics and government, a well-respected federal judge, Gabby's constituent services director, and three civic minded elderly retirees.
We couldn't afford to lose any of them, either. But, we mustn't think that the easy availability of guns had anything to do with this tragedy. "A well regulated militia, being necessary to the security of a free state, the right of the people to keep and bear Arms shall not be infringed." I suppose it would only show my hopelessly liberal anti-freedom bias to suggest that a little more regulation of our vast militia of arms bearing people might be in order.
.
This guest post by William Bemis is the second of three related to the recent shootings of Gabrielle Giffords and others in Tucson (in Pima County), AZ. Shortly before the shootings, the NY Times reported on a decision by the AZ Board of Education (a state agency in the capital, Phoenix) to close a Latino studies class in a Tucson High School. Urged by family members to consider relocation, Mr. Bemis, a psychotherapist and my brother-in-law, wrote this response, speaking of the Arizona city whose City Council had previously voted to ask the state to rescind its anti-immigrant law; after the shooting, at my request, he added additional material.
No, my dear, it's time for us and others like us to re-double our efforts to not only preserve Pima County as an island of sanity in this sea of ideological madness, but help the rest of the state and the nation see that leaving all the levers of power in the hands of racist corporate stooges is not going to take us anywhere but down. Having lived in this state for over 40 years now, I've seen this before - with Evan Meacham and Fife Symington, for example. After each of these lunatic lurches to the right, the state came back to at least a more moderate centrist political configuration. Arizona will never be Massachusetts or Oregon or Minnesota, but I, for one, am not ready to leave and concede this beautiful and unique place to the hate mongering front men for big money interests.
I loved living in New York, but we could never afford it, and besides, although their antics are less spectacularly loony, I wouldn't call the New York state government an example to emulate. Where else? Illinois? Puh-leeze! California? Are we talking about the homeland of Nixon, Reagan, Robert Dornan, et al? Sadly, Californios have also had to deal with home grown right wing fanatics, que no? Oregon? A more congenial political environment, perhaps, and a beautiful state, but too much rain!
It isn't just here, is it? I think we have to take the long view. The so-called conservatives (what do they wish to conserve besides entrenched wealth?) are riding high right now, both here and in Washington, but in the next couple of years they are going to amply demonstrate the meaness and poverty of their ideas. Contrary to the self delusions of Russell Pearce, Jan Brewer, Mitch McConnell, and John Boehner, I think these folks are cruising for a fall. I am more worried about the failure of those of us who do not share their agenda to take advantage of this moment than I am of the pseudo-populist, big money financed Tea Party. They have the money, so we all have to write our more modest checks and work all the harder. Our own apathy and discouragement is the enemy.
Moments after writing the above, I heard the news that Gabrielle Giffords, our Congresswoman, had been shot by yet another disturbed young loner of the type who seem to implement "Second Amendment solutions " to their private frustration and alienation on an almost daily basis now, thereby spreading their own psychic pain to all the rest of us. Cue the required messages of horrified shock and condolences from politicians of all persuasions, including even Sarah Palin who put Gabby's district literally in the rifle sight cross hairs and who tells her followers, "Don't retreat, RELOAD!" Some of those messages are no doubt sincere, but the one politician who was the most eloquent to me was Pima County Sheriff Clarence Dupnik, who doesn't get nearly the amount of press as his counterpart in Maricopa County, possibly because he is a hardworking, low key, decent, and fair public servant, which never seems to make good copy. Sheriff Dupnik's comments about political vitriol triggering mentally unbalanced individuals goes right to the heart of the current political climate in Arizona and across the country.
Gabrielle Giffords is a self-described "Blue Dog Democrat". For me, her politics are way too centrist in an era when what used to be the core values of the Democratic Party are under siege. If only she fit the liberal label that the Tea Party would like to pin on her! Though Gabby's stances on a lot of issues frustrated me, I worked as a volunteer on her election campaigns because I knew she was absolutely the best person we could hope to have elected to Congress from her district, which is Republican overall and in many precincts virulently racist and violent. Gabby is smart, dedicated, articulate, hard-working, extremely personable, and so much better than her recent opponent whom she barely defeated that I would have been ashamed if he had won and I hadn't done what I could to put her back in office. She is surviving so far the bullet that passed through her brain, and the trauma surgeons are optimistic, but I can't help but wonder if she does survive if she will ever be able to function again at the level she did prior. I read somewhere that she was advised recently that she had been too inaccessible in the past, though I seem to remember hearing frequently over her four years in office about her holding meetings for constituents to communicate with her. I wonder now if our congresspeople, like so many others in the public eye will have to be so security conscious that normal interaction and give and take between them and their constituents will be impossible. Yet another weakening of democratic process in this country.
Some of the murdered in this incident include a nine year old girl who wanted to learn more about politics and government, a well-respected federal judge, Gabby's constituent services director, and three civic minded elderly retirees.
We couldn't afford to lose any of them, either. But, we mustn't think that the easy availability of guns had anything to do with this tragedy. "A well regulated militia, being necessary to the security of a free state, the right of the people to keep and bear Arms shall not be infringed." I suppose it would only show my hopelessly liberal anti-freedom bias to suggest that a little more regulation of our vast militia of arms bearing people might be in order.
.
Sunday, January 9, 2011
The Arizona shootings: When will we ever learn?
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My heart -- and those of my family, many of whom live in her district -- go out to the family and friends of Rep. Gabrielle Giffords, and Judge John Roll and all the other victims of the shooting. As politicians of all stripes have said, it is a tragedy, and the perpetrator is obviously deranged. That said, the irresponsible rhetoric of those who would never do such a thing themselves is inflamm
atory, and sets off the "weapon", the sacrificial lamb, who carries out the attack. The parallels of this to the assassination of George Tiller are obvious -- politicians, radioheads, and bloviators engage in increasing violent rhetoric and then protest innocence when an unstable disciple carries out a violent attack. Can Sarah Palin deny her "crosshairs" post (now taken down) on her website? Can Jesse Kelly, who ran against Rep. Giffords in 2010 (not to be confused with her husband, astronaut Mark Kelly) deny his posters where he posed in Marine uniform with his M-16 and invited supporters to a shooting event to remove[1] Rep. Giffords? Can Beck, Limbaugh, et.al., deny that their rantings DO affect their dittoheads -- after all, that impact is what boosts their ratings, and their incomes.
And all the protestations that the aggressive elimination of gun control laws in Arizona and other states have nothing to do with guns being used for murder; the swaggering of gun-on-hip posses showing up in coffee shops to intimidate "liberals" not creating an environment where a murderer or assassin can legally be carrying a gun, are vapid. The NRA says "Guns don't kill people -- people kill people." That is true, but people with guns are able to kill more people, more rapidly, from a greater distance. You can bludgeon someone to death, but would John Roll be dead and Gabrielle Giffords in critical condition if Jared Loughner had attacked with a baseball bat? You can kill someone with a knife, but even if Loughner were an action-movie hero and could have thrown his knife with deadly accuracy at Rep. Giffords, would 9-year-old Christina Green be dead? Come on! Be grownups! You can't say one thing -- all guns of all types should be freely available -- and then deny the inevitable result! Well, of course you can, and it is done all the time.
If there is anyone who is eligible to be considered a hero in this tragedy, it is Pima County (Tucson area) Sheriff Clarence Dupnik, who movingly spoke of
his friends, and, in what might be a "politically risky" statement condemned the "vitriol" in the public debate that leads to such horror. (Video: http://www.cnn.com/2011/CRIME/01/09/arizona.shooting/index.html). The contrast of his obviously pained and saddened but measured, rational speech to the stormtrooper raids of his more infamous counterpart, Maricopa County (Phoenix area) Sheriff Joe Arpaio could not be greater.
We grieve for the dead and the wounded, and we grieve for our country. And we will take it back, our candlelight vigils against their M-16s.
My heart -- and those of my family, many of whom live in her district -- go out to the family and friends of Rep. Gabrielle Giffords, and Judge John Roll and all the other victims of the shooting. As politicians of all stripes have said, it is a tragedy, and the perpetrator is obviously deranged. That said, the irresponsible rhetoric of those who would never do such a thing themselves is inflamm
atory, and sets off the "weapon", the sacrificial lamb, who carries out the attack. The parallels of this to the assassination of George Tiller are obvious -- politicians, radioheads, and bloviators engage in increasing violent rhetoric and then protest innocence when an unstable disciple carries out a violent attack. Can Sarah Palin deny her "crosshairs" post (now taken down) on her website? Can Jesse Kelly, who ran against Rep. Giffords in 2010 (not to be confused with her husband, astronaut Mark Kelly) deny his posters where he posed in Marine uniform with his M-16 and invited supporters to a shooting event to remove[1] Rep. Giffords? Can Beck, Limbaugh, et.al., deny that their rantings DO affect their dittoheads -- after all, that impact is what boosts their ratings, and their incomes.And all the protestations that the aggressive elimination of gun control laws in Arizona and other states have nothing to do with guns being used for murder; the swaggering of gun-on-hip posses showing up in coffee shops to intimidate "liberals" not creating an environment where a murderer or assassin can legally be carrying a gun, are vapid. The NRA says "Guns don't kill people -- people kill people." That is true, but people with guns are able to kill more people, more rapidly, from a greater distance. You can bludgeon someone to death, but would John Roll be dead and Gabrielle Giffords in critical condition if Jared Loughner had attacked with a baseball bat? You can kill someone with a knife, but even if Loughner were an action-movie hero and could have thrown his knife with deadly accuracy at Rep. Giffords, would 9-year-old Christina Green be dead? Come on! Be grownups! You can't say one thing -- all guns of all types should be freely available -- and then deny the inevitable result! Well, of course you can, and it is done all the time.
If there is anyone who is eligible to be considered a hero in this tragedy, it is Pima County (Tucson area) Sheriff Clarence Dupnik, who movingly spoke of
his friends, and, in what might be a "politically risky" statement condemned the "vitriol" in the public debate that leads to such horror. (Video: http://www.cnn.com/2011/CRIME/01/09/arizona.shooting/index.html). The contrast of his obviously pained and saddened but measured, rational speech to the stormtrooper raids of his more infamous counterpart, Maricopa County (Phoenix area) Sheriff Joe Arpaio could not be greater.We grieve for the dead and the wounded, and we grieve for our country. And we will take it back, our candlelight vigils against their M-16s.
[1] “’I don't see the connection," between the fundraisers featuring weapons and Saturday's shooting’, said John Ellinwood, Kelly's spokesman. ‘I don't know this person, we cannot find any records that he was associated with the campaign in any way. I just don't see the connection.’” (AOL news)
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