ANOTHER SCHOOL SHOOTING

Victor Bloom MD

In April two students killed 13 others before turning the weapons on themselves. It was in Columbine High School in Littleton, Colorado. There were some school shootings before and some after. The latest is from a small town in Oklahoma, a shooting perpetrated by a 13 year old. The unfolding history of school shootings seems to point unmistakably to a copy-cat trend. Not surprising, since there was a raft of suicides after Marilyn Monroe's. Many people are right on the edge, and a certain timely publicity can push them over it. Some people take the latest news for the most modern trend in suicide style. Perhaps school-shootings have become fashionable. One can only wonder what the next trend will be.

School shootings constitute a rare anomaly. They happen less often than train crashes, plane crashes and getting hit by lightning. But they do happen. I don't believe it is possible to prevent them by education or security guards. People who are suicidally depressed will kill themselves sooner or later, one way or the other. It is their right. They shoot horses, don't they?

While the populace is considering the fact that the government will be spending more money to ensure that everyone is covered by medical insurance, psychiatry is relegated to its own category, where benefits are limited. The reasons for this are as longstanding as they are vacuous. Psychiatrists through their national organizations and lobbyists have been pushing for parity with all other medical specialties. The fact that more and more research has found that many psychiatric conditions are neurochemical, pushes our understanding of mental conditions in the direction of the physical (biochemical), in contrast to the 'functional' (bad habits). These conditions require psychotherapy along with medication for optimal results. But presently medical insurance plans shortchange psychiatric services.

Further complicating the problem is the lack of a state hospital system for the mentally ill, and especially the lack of adequate inpatient facilities for children and adolescents. The state of Michigan used to fund such state agencies liberally, and many children were successfully treated in longterm facilities (residential treatment) by a team of mental care specialists: psychiatrists, psychologists, social workers, occupational therapists, recreational therapists, psychiatric nurses and attendants. The average stay was over six months. Where has the money gone that was 'saved' by emptying the state hospitals? Now that we have a state surplus, what consideration is given to enlarging our facilities for the treatment of mentally disturbed children, at the very least?

Forty years ago children were not killing children at the rate they are today. At that time movies and video games were not so violent, and parents were more parental. Children were taught, in effect, not to do anything major without getting the parents' permission, but now kids are making up their own minds and doing what they please. Many parents do not realize that children need lots of protection against bad influences and guidance to do what is right. They used to be taught respect for their teachers and fellow-students. Teachers have quite a time nowadays, controlling classes and being able to teach in a receptive environment, what with many parents being advocates for their offsprings' misbehavior in school.

Parents nowadays have quite a job shielding kids from values emanating from media sources, such as movies, television and video games. The content of much media productions carry the message--- BOLD>anything goes.<BOLD The whole trend of modern parenting is that the child should have 'freedom' to do what it likes. And occasionally a child 'likes' to use people for target practice, likes to take his "15 minutes of fame," likes to feel his power.

We don't like to think that children are capable of murder, preferring to think they are 'innocent'. Many kids get worldly pretty fast, and with the added freedom of our times, they feel free to test limits to the max, to see what they can get away with. Given millions of children in the country, and millions of firearms, the chance for accessibility and consequent tragedy increases exponentially. When we include the fact that every human being is in a delicate balance between primitive instincts and civilized controls, it should not be surprising that unexpected tragic consequences ensue--- it is a matter of great probability.

Given this obvious fact, more than ever we need to outreach to disturbed children, preferably before they start using people for target practice. A strong state mental health system will not be the whole answer, but it seems a necessary beginning to get out of our paralyzed inaction and be more effective against the pressing problem of untreated mental illness.

Dr Bloom is Clinical Associate Professor of Psychiatry, Wayne State University School of Medicine. He is a member of the American Academy of Psychoanalysis and on the editorial board of the Wayne County Medical Society. He welcomes comments at his email address--- vbloom@comcast.net.