this is why we're looking at this tonight, the terrible tragedies. can these laws keep guns out of the hands of people like this? people with mental illness actually looks like this. they look like everybody in this room. they have the whole range of risk and protective factors for violence, and they range from your harmless grandmother to your neighbor's not so harmless intoxicated boyfriend and everything in between. how do we think about that? well, you know, do background checks work? there are a lot of reasons why they might not work. one has to do with the fact that clinicians can't predict violence very well. another is that states may not commit people, and other states do. it could be that people don't have to subject themselves to a background check. lots of reasons why we think they might not work very well as implemented now, but there's very little research that's been done to actually evaluate

that, and i'm going to show you some of that right now. we have a study that was just completed in connecticut, and this is sort of the punchline from the study. we found 23,000 people in connecticut who had serious mental illness, recurrent major depression, all of whom had been hospitalized. we brought together the records from the criminal justice system, from the mental health system, from the courts, and we looked at their risk in every month over an eight-year period of time of committing a violent crime as a function of whether they were disqualified, and patrolling for a bunch of other predictors. these are involuntary versus the voluntary. involuntary are people with serious mental illness who had a disqualifying health record. you'd expect them to have higher risk of violent crime, just because the criteria for getting committed are correlated with that.

now, the comparison group are volunteer. they don't have a gun disqualifying mental health record. and as you can see, from 2002 to 2006 or so, the rate of violent crime is coming down. that's the risk every month. but then after 2007, something happened. what happens is the state of connecticut began to report records to the national instant criminal background check system. so now, if people try to buy a gun and they don't disclose that, it's going to be known in the background check. you can see there that those two lines come together. you might think that works, that's good news. let me try to put it in perspective here. it turns out that 60% of the sample were not disqualified. they didn't have any kind of a disqualifying record. 35% had a disqualifying criminal record. only 7% had a record that was in the mental health arena, a

record of mental health aadjudication that would prohibit them from purchasing a gun. there's a little overlap there. and the analysis that i show you is just looking at the people who were success septemberible to that mental health policy. turns out 90% was committed by people who did not have a disqualifying mental health record. you put this in perspective, hat the effect is. and so because that's a small group of people, the overall impact of violent crime was pretty small, less than one half of one percent reduction. you can say it works as a 53% decline in the people who were did he say qualified and only a

34% decline in the comparison group. so it's on the margin. it's something that would work, but not the whole answer certainly. i'd kind of like to end in a moment with this. it really isn't about the gun. this shows you the relationship between states, gun law restrictiveness as measured by the score of how restrictive the state's gun laws are, and you can see there's a correlation here. states that have more restrictive gun laws have lower fatality rates. but that's also addition there's also a relationship between the household gun ownership rate, so states that have lots of families, you know, living in the house with a gun, 50% or 60% or more. those states also have higher firearm fatality rates. and it turns out there's a relationship between those variables. if you look at the relationship between the laws and the

fatalities, up see a strong relationship in states that don't have much saturation of guns, states that have less than 35% of the households with guns. there, the more restrictive the gun laws are in terms of gun safety and so on, the less the fatality rate. but as you move up the states that have lots of guns around, those laws tend to have less of an effect, and you can sort of see why. so i think we need to think about this comprehensively, not just one solution, but i think we need to think about a lot of different things. part of it is about the guns, reducing the lethality of guns. part of it is about strengthening background check systems. part of it is really about investing in better mental healthcare. and there are lots of different solutions that are being contemplated and enacted at the state level, and maybe we can get into more of these in detail. i'll quickly mention these and

close. what about the idea of having mental health officials be mandated to report people they see in the community or private therapy that they're concerned about? should they report them to the police? new york has a law that is something along those lines. what about mandated outpatient treatment? should we force people into community mental healthcare? that's controversy gral a point f view, but it's also a policy that have been studied. should we expand the background check definition? should we make this boundary of who is disqualified much higher? what about the idea of seizing guns from people who are considered to be dangerous, irrespective of whether they have mental illness or been committed? and then finally, thinking about, shall we just prevent the unpredicted and improve the mental health system? this link between mental illness and violence is complicated, and i think it puts the mental health in a bind, because we want to think

about improving mental health. every want to avoid person with schizophrenia is a homicidal maniac, and that's unfortunate, and i think we need to find the balance between those different concerns. thank you. >> i am a mental health director and director of the sychiatry and the law. >> thank you, everyone. this is part of a course, and decided to open up the last

part, so i'm going to continue to play professor and i'm going to assume that all of you are just sitting in. law professors call on people, so stay awake. i think the country's leading experts in this area, and we can see why. tell us if the problem of mental illness and crime, mental illness is really from suicide more than homicide. and i think that's quite right, d i noticed that the suicide studies have been dramatically understudied. i know they're doing some exciting studies on the effect of gun control laws and suicide. and you had a slide that mentioned something on that. maybe later we can ask you to do that. here's the question.

if most of violence is not a function of mental illness, that it is homicide and not suicide, does mental health have anything to say about that? if we're talking of only 4% of homicides have anything to do with mental illness, is this a mental health fellowship issue? now, you know i wouldn't be answer the question if the answer is no. the answer is it really is. while it's true that violence sent causally related to serious mental illness, and we think of things like schizophrenia in any significant magnitude. i think jeff did a good job of showing us there might be a relationship, but the base rate is too low to be significant. and, in fact, while criminal offenders have all sorts of

high degree of mental disorders as defined by the so-called d.s.m., they're much more anxious and depressed and psychotic than the rest of us are, and not just because we placed them in jail. we don't think there's a causal relationship there, but we do relationship to dysfunctional behaviors that are centered around exit. and those of you in the audience that have dealt with offenders i think or that population will probably be nodding your heads. i think that's kind of a common observation, one that's frequently made. it's kind of a depressing finding for a couple of reasons. first of all, if we think that we can prevent homicides through stopping acts of the firearm, we're not actually going to give people valid questionnaires when they want to boy a gun to see whether they might be the impulsive

type. but now fundamentally, i'm a little surprised, because we think of these things as traits. it's a little bit consistent with the stereotype of the criminal that political scientist james said. these are just bad people are bad traits, and maybe we just have to lock them up till they age out of their violence. i mean, that's an exaggeration of where this analysis could lead, and the question is, again, does mental health scholarship give us any alternative? again, you know where i'm going to go, and the answer has got to be no. the last 30 years has been a revolution in evidence-based therapy. you're tested the way they're tested rather than controlled trials. and in the last 20 years, people that have dealt in institutional settings, the v.a., prison systems and school systems, have tried to develop

therapies and address these traits or being associated with this trait to get to the problem. i'm just going to call it anger management here to take one of the more prominent therapies that you most presently need. the third question, does it work? the answer is absolutely omewhat. they're relatively popular. they're popular in part because these traits lead to loss of dysfunctional behavior, so dysfunctional that people that have that behavior exhibit it, which they didn't, also it's really important to be angry, and you think of the last time you were really pissed off. how did that feel? well, it may be good for a while, but after a while, you wished you weren't. and these people are angry all the time. they'd actually love to get that monkey off their back.

you don't have any problem in person, but you have an anger problem, and you don't a lot to do in person. so this is often oversubscribed, so lots of people jump into the therapy, and then does it work? well, hundreds of randomized controlled trials, maybe an analysis by now, so use kind of a broad summary. yeah, it does work somewhat. you get an effect of about half a standard deviation, so if you take a control group and a treatment group, people might e half a standard deviation. if you look at others, yes, but less. i'm talking -- when you talk about the therapies, you often think of prison, and that's really where those started.

but if you look at it from a public health perspective, you probably wouldn't be thinking about prison so much our school system, because people that become offended often are identified in school. they get in constant fights, and the school counselors know who they are, and the same therapies that work in prison work about as well, maybe even a little better, in school actually, but the more violent prisoners, the less therapies sometimes work. you know, i know as i look out in the audience that some of you, someone out there has a daughter, more likely a son, that has some of these traits, and you know that this could be a great, loving person who can do awful things, and you wonder where they're headed. so part of this process is a little bit of positive until i know what most of you are looking for, which is controlling violence. part of this process is to say you don't actually have to give up on the three million prisoners or the at-risk group

youth, and part of it is saying that if we're looking for solutions to gun violence, we're going to have lots of partial solutions instead of one solution, and while i understand the import of deidentifying and distinguishing violence from mental illness, because you're worried about segmentizing one group of americans that are fully mentally ill, and i think the seriously mental ill are the best example. the other is for people who are voluntarily committed, it's an overlapping group. another way to look at this is a little bit different, a little bit challenging. it's to look at people that have these traits, which are very dysfunctional traits and have a lot of the character stex of mental illness. in fact, if you have these traits, you're about halfway to some personality disorder. to look at these traits as a kind of mental illness, and then you want the best

resources in treating that and improving our treatment and modalities. well, you won't get a chance. i know you'd object your feet. but i'm not going to give you the chance right now to clap. what i'd like to do instead is invite all the speakers at this time up on the platform, and i nt to give our two principal speakers a chance to respond to each other. and then after that will come the audience participation. we have some experts in the audience that aren't here, and i'm going to ask them for any comments they might have, and then i'm going to take questions. i think we're all mic'ed, is that right? you can hear us. he want to just give them a chance to comment on each other. i think it's an excellent

presentation, and i think, you know, it points at some of the challenges here. i mean, i think the slide on connecticut where you see that in crime among the population right at the moment when the records go in, in the database, but then the limited impact, because so few people are covered in this -- ory of involuntary involuntarily committed people or people who have been deemed mentally defective is one of the problems. i think, joe, as you were saying, you know, this is -- gun violence is a very complicated problem. and there is, you know, pardon the pun, there is no silver bullet to solve it.

there is -- i think you rightly point out that there are many solutions that are not gun law solutions, but in the range of solutions that are gun law solutions, there are many, many, many things that could be , and there's good evidence are effective. so background checks is a big piece of it, but background check themselves are just one element of a system that you'd want to have work. i mean, there's been this enormous debate about background checks, and i think or ome of the discussions commentary pointed out, background checks on these people who are, as we've been talking about, federally prohibited people, who include people who have been convicted of felonies. it includes people who are in these two categories of mental illness. it includes fugitives. it doesn't include -- there are a lot of people it doesn't quite who are actually

dangerous potentially, and there are a lot of people who are probably not that dangerous. a ou were convicted of financial fraud personality 37 years ago, you may be less dangerous than most felons. but if you've been convicted of multiple violent misdemeanor, you're probably more dangerous than most 37 year ago financial fraudster, and some states have taken action on exactly those questions. so in california, for example, if you've been convicted of a violent misdemeanor, you lose your gun rights for 10 years. there's some studies that say exactly that approach has been very helpful. and then even if you have this set of laws to try to keep gun access away from people who you

have good reason to believe are dangerous, you have to have these things, enforcement, again, that's only the gun law and gun enforcement side of a ery complicated, multifactored gun violence situation. >> well, thank you. i also appreciated your presentation a great deal. the complement of advocacy and research, advocacy and evidence. i think you very effectively used a lot of numbers to show the magnitude of the problem. but also its complexity. and there's some kind of -- i think the conversations here, there's a conversation from the oint of view, that you might

say, as an epidemiologist, thinking about the public health, public safety problem of firearms, injury and mortality. from that point of view, you know, we'd like to figure out how we get people to stop behaving violently and how we imit their access. then there's also this conversation about mental health, which is complicated, because the definition behalf we mean by mental health is quite variable and elastic. as you point out, joe, we can think about, you know, violent behavior as symptomatic. you know, then there's really kind of another conversation that is important to not only framing the right research questions, but framing what the potential advocacy solutions are, and that's an argument about what the role of government and regulating

people's lives and, you know, how active should government be in our policies, and do we care more about overreaching and limiting people's rights, or do we care more about trying to event people from injuring themselves? and then there's this conversation about mass shootings. we're looking at the whole problem through this kind of weird prism of the needle in the haystack prevents, but they have a far disproportionate effect on the public imagination, and they translate into the currency of political will to do something. and so on the one hand they're important. on the other hand, they're kind of distracting because people who engage in mass shootings are not only atypical of gun crime, but also very atypical of people with psychologists. you can't generalize it, and yet you want to use this moment to try to focus on what can be done.

i think this is a hard thing to do, and i appreciate everyone coming out here to help us think about this, and i think that we need to think about critical opportunities now for research, but also for advocacy together, and i hope we can do that. >> we have just a few minutes, so i want to -- we have some people in the audience that have written on this or have a perspective, and i want to just give them an opportunity to say omething and then give the audience an opportunity to ask questions. maybe i'll ask john donahue, a colleague of mine, who's written extensively on the actually t guns could reduce crime by keeping bad guys in their place, so to speak. john's been critical of that.

just follow the gun debate closely and written on it. >> thank you. very interesting presentation by all of our speakers, so thanks for that. just wanted to inject into the discussion a little bit something that didn't come up, which is the comparative evidence of u.s. versus the rest of the world. one interesting thing is you will hear the n.r.a. types talk about the need for guns for protection. of course, it's so counter to what we see in modern industrializations of europe or japan as was mentioned. interestingly, for most countries, the pattern is fairly established that the wealthier you become, the less motor you have in the society. the one great outlier of that

relationship, which is a very robust relationship, is the united states, that we are a uniquely homicidal country. of course, if guns were something that had a powerful reducing effect on homicidal violence as the n.r.a. advocates for that position have argued, the u.s. would be a uniquely nonhomicidal country, because we have more guns than any other society. beyond that, we also spend so much to suppress crime in ways that other countries don't need to suppress. for example, in the united states, we incarcerated about seven times the rate of europe, which does suppress our crime in a very costly manner, but we were looking at worse if we incarcerated in the same way that these other countries did.

so at the interest about why it is that the u.s. is such an outlier in this regard, and, of course, i would imagine that the relative rates of schizophrenia, of course, are rather common across major industrialized nations, but perhaps you could speak to that as well. >> well, i'll take a crack at that. if you look at the patterns of crime in countries over the past 50 years, you know, what you see is that crime rate in the united states is about in the middle. it's not really that much higher or lower am it's sort of right in the middle. but then when you look at homicide, as you suggest, we're

seven times higher. u.s.a., we're way up there. makes a lot me, it of sense, and it does have to do with firearms. you know, think about it, you need to have dangerous people and guns for violence, and so if you didn't have people behaving in criminal way, then you wouldn't have gun violence. or, you know, if we didn't have guns, as other countries, you know, don't have nearly as many, they still have people who still try to harm each other, people still do things, but they're not as lethal. it has to do with lethality of a gun, and it's the same way with suicide. your chance of dying if you attempt suicide with a gun is about 80% or 90%. if you try other means, you might survive. i really think that that is -- that's -- to me that's kind of a no-brainer, and it really

changes our landscape for policy solutions, because we can't do -- we've tried it. if you look at the results of the studies that were done in d.c. with the d.c. handgun ban, it did reduce gun violence. it didn't reduce other crimes, just gun violence and gun suicide, and it didn't affect neighboring jurisdictions. it affected d.c. nevertheless, we struck that down, because our supreme court opined that was not constitutional. >> i think that's exactly right. we don't have an exceptionally unusual crime problem. we have an exceptionally high murder problem, and we don't have an exceptionally unusual rate of mental illness, and we don't have an exceptionally unusual case in cultural products, first person shooter video games are very popular in other comparable countries too. so are action movies with a lot

of people getting shot in them. what's different is we have both a lot of guns and very weak gun laws. and i think the question is, is this only a problem that can be solved by getting rid of the guns? we know that constitutionally now and politically, it's impossible. or is it a problem that you can solve by accepting that we have a gun culture in our country, but we're going to have a gun culture where we make it much for dangerous people to acquire guns, misuse them, hold people accountable for illegally possessing guns before they shoot someone, and can that work? and i think in the comparative space, there's some evidence that it could. you know, there are some comparable countries that have not as high rates of gun

ownership as the united states, but significant rates of gun >> germany has about 1/3 rate of gun ownership. they also have somewhat higher than their comparable country's rates of gun deaths. but their rates of gun deaths are way lower than the u.s. because they also have very significant laws. in analog to think of what we can do with guns is cars. we have a car culture in america. people love their cars. most people aren't for banning cars. but we have found a way to make our car culture much safer. in the last 50 years for every mile traveled the death rate has gone down by 80%. and it wasn't air bags or seatbelts alone or better

signage on roads but all of those things, and we have managed to do that without making cars exor ba tenantly expensive. it did cost something. you can still have the car of your choice in any color you want, but we made this car culture much, much safer, and i think there is the opportunity to do that with guns and the politics of it are a bit tougher. > great. why don't we take questions. in fact, i think the way this works is the ethics center has a procedure down where someone comes by with a microphone when i point you, so there's your mike. >> great. wonderful. >> good evening, and i want to thank all of you for the comments you had tonight and i'm particularly grateful that

we got into this conversation with the scapegoat that -- people with severe mental illnesses because i think we tried to label and blame these individuals. and forgive me because i had to write it all down but it's kind a n issue of violence as larger, psychological kind of turmoil if you will and we started to talk about youth violence and violence in the communities but when we look at this like last year and the mass shootings that occurred and we took a strong interest in those occasions. chicago had -- akin to just mass shootings for the entire summer and basically these issues were with black and brown boys killing each other have kind of not really talked about in the media.

so i'm just kind of interested in are there things where we can talk about social and economical issues where they might not be actually creating mental illnesses, surely they are contributing to psychological mall fitness so with can we talk about how policies can possibly intervene on that and deal with these issues of violence? >> thank you for your question. i'd like to start by agreeing with you that violent behavior is -- has a lot of causes, and many of them really have to do with social disadvantage, with overty, with people's exposure over the life course to bad

environments. and the important thing to realize with mental illness is the people with mental illness are subject to those same risk factors. something we didn't show you from our study in connecticut is that the strongest determinant of violent behavior with these people with mental illness are age, gender, bstance abuse and minority racial status which is a proxy of social disadvantage which we were not able to measure directly. and new give me a choice between knowing these two things. could i know someone with these mental factors? and all politics aside can we try to predict violent behavior. the demographics that are amenable to the intervention that could improve that, the problem is as a policy

solution, that's something that's a long-term project. a lot longer than the elected term of an elected representative who is under pressure to do something about mental illness, changing background checks than it is to think about all the causes of violence and these factors throughout in society. how do we think about kids growing up? and how do we think about these communities? and i think that is all very important. and it isn't either or. even with people's mental illness, if someone commits a violent act, it's seldom the case that the psychopathology is the explanation for that and the fact is that people who engage in that behavior often -- besides schizophrenia and bipolar disorder, there's other things that are amenable to

mental health conditions in ddition to improving our conditions so thank you. >> and think i that your comment gets to -- your question gets to -- other things that make these mass shootings so focused on -- so different from the gun violence that's taking so many lives across the country. the perpetrators and mass shootings we focus on are white. they are often in wealthier communities. newtown was one of them. and you know, these are also these tend to be months-long, planned attacks. most gun murders are not month-long planned attacks. and there's of course a very disproportion nat share of those perpetrators and victims of gun violence who are not

white. and what you see i think is the un is an ingredient that makes situations that are challenging and difficult, life-ruining for two parties. both the person shot who also tend to be young. 18-29 is the sort of core demographic and the person who pulled the trigger who is probably in that demographic, too. which is a life ruiner. can we stop, you know, can we do something? do we need toe address all these underlying circumstances? absolutely. but i think we have an ingredient here which makes otherwise things that are bad and undesirable from high levels of theft and crimes like that or illegal drugs -- drug trafficking and selling, but i

think one thing we can try to o is make all that less fatal. yes? >> i'm just pointing to the northern green. >> as i think through what was presented and the tone in which the facts are again being reiterated in the panel discussion, i am searching for a ray of hope. sand i'm not getting anything. i am getting the sense that all the facts are what they are, the right to have guns, the fact that guns make this country much more or far more tal for violent crimes so as specialists, what should we be hopeful about? because there's nothing here that i am hearing that's going to change the landscape of what

you have depicted as statistics, which, you know, frankly, they are just statistics and numbers but really reflect a very sorry state. well amongst savvy, politically, because you're in the politicalal arena so maybe we can give that one to you? >> well, i think there's -- in both of our presentations there's a fair amount of data to suggest that laws make a difference, and we are, you know, that we can do comparative research within our own country, because states vary freyly in their own gun laws and there's an enormous amount of research when you put it together strongly suggests that gun laws can matter and stalled in ion is congress and many have been acted in places not just

states that contain places like newtown. in nevada one of the houses of the state legislature just passed universalal background checks and it looks like it will move through the other house of the state legislature as well. so there is some movement and there's evidence to think that this momentum matters. that lives will be saved by what has happened in states around the country. and as that evidence piles up, i think that will put the pressure on to do more of this at a federal level. >> and if i could very quickly, one reason for hope is that if you look across the states, there's a lot of varyibility in the rate of firearm depths and

not fatal injuries. some states have more of a severe problem and other states less. so what is it about the states that have not as serious a problem? and maybe that's the key to optimism is there and it isn't that it is bad everywhere. there are places where actually the problem is far less. >> and i might just throw in the fact that if we expand the problem as we should to include suicide which is the majority of deaths here, my guess is that the research is going to show that not surpriseingly if we have background checks and people that fall into certain categories, mental illness, are part of the background checks, we will get more of an affect there and we just haven't found that, yet. i think that's the cause for some optimism. >> if you look at there was a study done here in california showing that of all the people

that tried to jump out of the golden gate bridge, when you follow them only 57 of those o tried to jump were stopped eventually committed suicide but if we have something as lethal as a gun, there's no reversibility there. if we can treat the mental illness we can make a difference. >> thank you again for having this forum as part of the class. i guess kind of as somebody who works with those who have mental illness, can you comment a little bit on stigma? both stigma, for example towards those with mental illness there's a study done in the american journal of psychiatry done on that, but also stigma for those who might seek treatment and how policies and even this discussion how

that might affect those folks. >> well, i could commencht on that briefly from the point of view of the research literature. and there is some -- there's literature on public opinion about people with mental illness. and you -- a couple things there. one is that about, you know, 60% of adults in this country believe that people with schizophrenia are likely to be dangerous, which is a huge exaggeration of the actual evidence for it. it's a little bit lower, about 40 if you think about anybody with mental illness. that's what people believe. second thing is that that attitude is actually tied to desire for social distance from people with mental illness and tied for coercion for social

policies and there's a nexus of attitudes that are related to stigma, and those are damaging to people with mental illness and they actually have an affect that is just, you know, the opposite of what you would like, which is keeping people from disclosing that they have mental illness. so i think it's very important to think about that when we you know consider policies. there's a policy now in connecticut that's going to expand the category of prohibited persons from firearms to those who are voluntarily admitted into the hospital. i think there's reason for concern about that. because a, it might have a chilling effect and drive people away from services or keep people from disclosing that they are thinking about harming themselves and also results in know, it

reinforcing this idea that everybody with mental illness is of concern around violence and dangerous situations. and finally there's evidence, too, that media portrayals actually increases -- there's a new study about this that johns hopkins has written. that people who read a report about a sensational mas kill red flag more likely to think more people with -- then to have these negative attitudes, and even people with negative attitudes have -- there's a certain phenomenon of self-stigma. and i think this is an important part of this problem that i think we need to think about. the u were talking about possibility of mandatory disclosure of memory health

providers and if you think about that, two potentially negative things would come out of that. one is a patient would not tell a therapist that they are having any potentially dangerous thought because that would mean the police would come over and cease them or their guns but also the other one is the mental health professionals then probably would be liable if they suspect that something might be happening but they didn't act on it. so on either part of the spectrum, it might be very difficult. > yes. >> good evening. my name is nancy and i am retired now, but i had a 20-year career as a psychotherapist working in mental hospitals with locked units and things like that, so i have a lot of experience with mentally ill people.

i have several comments to make not questions really. i think one of the floobs we have such a stig anyway against mental illness is one medical insurance companies don't cover it as they would other illnesses, so right there it's different from having diabetes or heart trouble or whatever. so i think the government needs to do something to make sure ntal illness is covered by mental illness companies and the other thing is we're talking about a lot of people not understanding what mental illness is and i think that this is something that can be taught to children in school. how to recognize when somebody is having a mental problem. i could give you a specific example that my former daughter-in-law is mentally ill and she became psychotic, and i happened to have been with my granddaughter who was 3 at the

time when this happened. and i was able -- she kept saying mommy, mommy i'm sorry as if she was done something and i was able to talk to her when telling her when this happened to your dad's leg, he had a cast put on and your mom has an injury in her head and that's why she is going to a hospital to see a doctor and my granddaughter refers to that time as when mommy was sick in her head so, i think there's a lot that can be done to educate people and the familys are so desperate, they move out of the area and don't have the same support systems that they do in europe. a lot of people in europe still live with their parents so they have people who care about them to see that they are troubled or there's just a whole different nurturing community.

and so i think a lot can be done. i have friends who say well, this spern schizophrenic. i say to them do you understand what skitsfrena is? mental illness is such a -- to most people that i think a lot can be done to educate people there wouldn't be such a stigma and that it could happen to anybody. >> yes? >> well, we have time for one more. so let's try that. keep them short so we can get everybody in. >> i think there is one hope. my name is tom i'm a retired pediatrician. i think there's one hope that the brain institute that is being established may actually who we licity and supply taxs so we can do the

research of, for instance, we know that all behavior is do to brain activity in adolescent and s, -- world, risk, impulse control is a neurological problem, seems to be that the connections are not right, and we need to study aggressive animals which are different. aggressive dogs are different than quiet dogs. who guide -- who are guide dogs, and we need to study people in the same way. we can visualize their patterns and see what's going on now in the brain by functional, am i right? and we should spend a lot of money in trying to study these people. mental illness, teenagers,

people who commit suicide, brain trauma to see why the onnections aren't there or why there are hormonal stresses. i think a lot of biology is very hopeful besides the research that shows that guns need to be restricted. but that needs to be publicized and educated and much more in the forefront 12k3w4r06789 maybe in 10 years this will be a neuro biology talk as well. >> just a quick response. sir, i think what you have described captures very well the empty sis and priority that the national institute of mental health really places now on research. if you listened to the directors it sounds very much like let's really you know solve this problem by understanding brain circuitry

and let's understand these neuro mechanisms and then let's have better treatments. and i think that is important. i agree with you to an extent, but i also would say this. even we understood that and we have the magic molecule to vastly improv our treatment, we still have so many people all over this country who suffer from serious, disabling mental health conditions and can't receive the treatment even that we know works now, because they are addicted or they are omeless or they are in prison. or they don't believe they are mentally ill and don't want treatment. so until the great here after when we have these solutions, i still think we need to focus not only on research and point t public resources on better interventions and service

delivery systems and to have a system that is not so fragmented and ineffective, so i would just put in as a alancing point that comment. >> you know, i'm going to -- sir, i'm going to let some other people talk and -- yes? >> hi. the problem you're describing here, i would describe the political problem is that complete disjunction between a public health perspective and the policeman discussion around the problem. to public health people every person counts as one whether they are suicide or a kid in an inner city, whether they were killed in a single murder or in a mas murder. and the public health perspective, the perspective so prevent bad things from

happening not waiting until they happen and then respond to them. and this is the tension with the normal policy responses that people 4 v have in this country, which is nothing bad, there's nothing bad if i don't see it. if there's nothing bad if it hasn't happened yet and i only respond to certain kind of shale yants of bad and i think in policy areas it's killing us. so i guess the question is whether you think there's a way -- focusing on the gun issue for the moment -- a way to bring public discussion and public awareness closer to a public health perspective on this issue or if we are just stuck with taking the worst priming events. worse in terms of what really matters, the mass killings and just trying to squeeze something out avenue that event that's sensible from a public

health perspective. >> well, i think there's an enormous amount of what you're saying that's right. be also, if you look at the ost newtown policy response, basically, there were three kinds of legislative proposals that were discussed in the first two weeks after newtown, two of which related directly to what happened to newtown and one of which did not. so the two that related directly to newtown were a assault rifle ban and high capacity magazine ban. and this is federal policy. lots of other proposals and some of those proposals have moved at the state level and the one that did not relate droll newtown was universal background checks. this wouldn't have been covered under any version of the universal background check because he got the gun from his

mom and essentially took it from his mom. but was that a sensible from a public health pierzynski spective health priority? it was. there were a lot more deaths that you could prevent with universal background checks than you're likely to breent an assault rifle ban. you would prevent some with both of those measures, and i think that did speak to some of the advocates, some of the people, legislaters and folks in the obama administration who did take a little bit of time and thought, this is the one that makes the most sense. and it also speaks to some political realities which is if you look at assault rifle high-capacity bans, both tend to get majority support, universal background checks

have been in the 80%-90% including massive support from gun owners which you don't see for assault rifle and high capacity magazine bans so in some ways i think the focus of the discussion has been around a policy priority that does -- is a place where politics and public health kind of meet. is it a sufficient junction? no. but maybe it's the best we can hope for? contemporary washington. >> now tiff sad duty to end in in a second. i think that we can stick around a little bit longer. i think we get kicked out of here and the lights go off in about 10 minutes. so before that happens, i'd like to thank our panelists that came in to talk to us, and thank the students and thank all of you who were a student

far day in our class. and the good news is that i'm an easy grader. thank you. [applause] >> next, live, your calls and comments on "washington journal." afterthat, newsmakers. with the american medical association president and then a discussion from the clinton global initiative forum on the global economy. >> one of the points that we make in this book is a perennial question, did it make a difference? and i think we come down on the side, yes, it did make a difference. the senators begin to ask like

house members which is not something a senator wants to hear. scaveaging for votes, they actually had to go out and deal with the people to where as if you had a state legislature and there were 26 members of your state senate, all you needed was 14 votes and all you had to do was pay off and they did paying off their mortgages in a couple of notorious cases to buy their election. >> more with historian emeritus of the u.s. senate dr. richard baker tonight on c-span's "q&a." >> this morning on "washington re- al," marilyn werbe serafini from the federal health care law talks about the penalties being delayed from 204 to 2015 then "new york times" correspondent elizabeth rosenthal discusses a recent

report that shows america has the highest childbirth cost in the world. from egypt a guest. eric trager, "washington journal" is next. [captions copyright national cable satellite corp. 2013] [captioning performed by national captioning institute] host: good morning and welcome to "washington journal." on this sunday, july 7, 2013. immigration tops the list of issues awaiting members. well, the "washington post" on its front page today looks at childhood hunger and the role of government in feeding hungry children. we'd like to hear from you this morning on what you think the government's role should be in feeding kids. here are the numbers to call. democrats. republicans and independents.