A question to ask, is "How many are mentally ill and should not have access to weapons?" The answer is rather elusive today and a look into out history may provide some insight. I have typed and deleted this twice, I think it needs looking at.
If you look at mental health care back to the early 1900's and up through the 1960's you will find that there were large mental health facilities with staggering inpatient populations. Looking at just NY State shows around half a dozen or more Hospitals managed by the NYS Dept of Mental Hygiene. Patient populations range from 2,500 in Binghamton, NY to the huge Pilgrim State Hospital which was just one facility for NYC. It was where "One Flew Over The Cuckoos Nest" was filmed, and saw numbers over 10,000, and there was still a couple more in and around NYC. The numbers showed a large percentage of the population that required inpatient beds for mental illness. The percentage of people needing mental health care stayed pretty constant up to the early 1970s. These hospitals were a large institution that was self-sufficient and was very separate from the surrounding communities. Institutions had large farms, bakeries, laundry shops, carpenter shops, police/fire Depts., etc to the point of needing nothing from the "outside world". Patients who were able to actually worked in the shops, on the farms, landscaping, and other parts of the institution. The institutions were expensive to maintain and took a pretty large chunk of state budgets.
Patients required different levels of care. Some were nursing home patients with nowhere else to go and they pretty much were bed or bed to chair patients on wards of 40-50 patients. Patients with a true metal disease were divided into two classes. Those who were able to function in the controlled environment of the huge acreage of the institution with staff supervision. The other class were deemed a danger to themselves or others and were on locked inpatient wards. Diagnosis categories ranged from severe psychotic disturbance to mental retardation and simply needed folks to watch out for them. In the 1950s came the first psychoactive agents that had any real clinical impact on diseases like schizophrenia, and other disorders. The side effects were unpleasant and the biggest problem was to trust the patients to actually take their meds. Meds have been refined over the years to reduce the side effects. They are not as bad today, but they are still there and patients are often noncompliant with their meds. The good news was that a percentage of the patients were able to transition to outpatient management and reducing the inpatient bed needs by a few percentage points.
In NY State, the money to run these huge institutions began to dry up. Institutions were downsized dramatically with Binghamton State Hospital dropping from 2,500 to 250 patients. Nursing homes sprang up to care for the elderly and the mentally ill were moved to outpatient management. There was no magic pill that made people all better, and the percentage of people suffering from mental disease stayed the same. What changed was, and is, that the former patients now interfaced with the general population. Patients were, and are, still noncompliant with meds because of the side effects of antipsychotic agents. Not all the patients had family or friends to house them, and they have trouble maintaining any decent employment. This drove up the number of people living on the streets. When behavior becomes dangerous or offensive, LEO is the first contact for the mentally ill. From there the courts and correctional institutions are what shelter, feed and "care for" people with mental illness. The percentage of mental illness has not changed that much over the years. What has changed is the care and tracking of the mentally ill.
It seems to me that with no way of tracking and caring for the mentally ill in our society, they will go untreated, undertreated, and fall through the huge cracks in the system. The possibility of violent interactions between people with mental illness and the rest of our population. The LEO community is not equipped to handle the needs of the mentally ill. LEO and the courts plug them into the outpatient clinics, but there is no way to force them to take their meds and attend outpatient groups. They avoid care because of the stigma mental illness still carries, and because they hate the side effects of the meds. Thus the patients get lost among the homeless and are avoided by everyone else. There is no place to house and care for the mentally ill. There are acute care beds, but the courts limit involuntary stays to the absolute minimum. There are patients who have been involuntarily committed to psych hospitals and those beds are there because our laws say they must be there. There is no place for the others who were for so long patients at the huge mental institutions that were there until the 1970s.
If there are funds allocated for the care of mentally ill patients, and the needed bed spaces are there, the huge chasm that exists can be shrunk. If we can better identify, treat and track our population that needs mental health support, the risk of violent interactions will drop. Today there is no really tight system that identifies and handles our mentally ill. Today they are "treated" by our LEOs, courts, and jails. The go back on the streets with a month of pills and an outpatient clinic appointment. Most of the time the pills get traded off for heroin and the cycle begins again.
That's my $.02 for what it is worth. I have seen to big institutions, and I see what is on the city streets today. They are the same mentally ill people, just in different, and mostly worse places.
Thank you once again for putting into words exactly what I was trying to do.
Until every level of the current system is funded and run properly, as it's intended; this "debate" is useless.