America: 393,300,000 guns & 28,000 psychiatrists

(Update to 2012 America: 350,000,000 guns & 47,000 psychiatrists)


Untreated mental illness + guns = predictable catastrophes.

America in 2018 = 307 mass shootings in 311 days.

This week a veteran with presumed PTSD shot up Borderline Bar & Grill. His Facebook declaration:

“I hope people call me insane… (laughing emojis).. wouldn’t that just be a big ball of irony? Yeah.. I’m insane, but the only thing you people do after these shootings is ‘hopes and prayers’.. or ‘keep you in my thoughts’… every time… and wonder why these keep happening…”

Shall we do what the shooter seems to be asking for—help those with insanity—or just hope and pray?

Or fall into our usual anti/pro-gun divide?

Let’s analyze the irony identified by the gunman before the devastating slaughter of 13 Americans.

Let’s dive into the uncharted territory of human psychology—the mind of a straight shooter before a calamity. His prophetic post may reveal the answer we’ve been seeking.

Because we the people are responding exactly as he predicted.

Vilifying the shooter as insane.

Offering victims our hopes and prayers.

Is this the best we can do?

They say insanity is doing the same thing over and over again and expecting a different result.

Yet we keep going round and round the same post-carnage questions: Where did he get the gun? Did he acquire it legally? What was his motive?

Rather than interrogate the shooter postmortem, let’s do a psychological autopsy on the living—analyze our response for clues as to why the killings continue.

I’ve got a unique vantage point on mental health care in America.

I was once a suicidal physician. Now I run a physician suicide hotline. I’ve spoken to thousands of suicidal physicians and investigated more than 1100 doctor suicides (some homicide-suicides). Doctors have the highest suicide rate of any professions. Even higher than veterans.

If doctors can’t get proper mental health care, will patients fare any better? Unlikely. Here’s why.

America has 393,300,000 guns and only 28,000 psychiatrists (that’s 14,046 civilian-owned guns per U.S. psychiatrist—up from 7447 guns per U.S. psychiatrist in 2012).

That means we’ve doubled the number of guns per psychiatrist in just 6 years.

Increasing firearms while decreasing mental health access is not a winning strategy.

Why do we have so many guns and so few psychiatrists?

We have a constitutional right to bear arms. We have no constitutional right to health care.

America is a world leader in mental illness. Most Americans will develop at least one mental illness. More than half begin during childhood. Yet more than half of our psychiatrists are on the verge of retirement.

Meanwhile America remains the most heavily armed nation in the world with 120 guns per 100 U.S. citizens—that’s more than one gun per person. Nearly half of all Americans have at least one gun at home.

The human brain controls the gun.

People will find a way to end their pain. A civilized society offers civilized solutions. A violent society offers violent solutions.

In America it’s easier to find a gun than a psychiatrist. Ammunition costs less than medication. No prescription necessary.

So who’s insane? The shooter? Or us?

(I’m not inherently against guns. I’m against untreated mental illness. And I’m against untreated mental illness + guns, pipe bombs, machetes or anything else that can damage life on Earth).

Pamela Wible, M.D., reports on human rights violations in medicine. Dr. Wible attends therapy weekly to maintain her sanity and wishes all Americans enjoyed the same luxury.

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70 comments on “America: 393,300,000 guns & 28,000 psychiatrists
  1. Dr. Astrid Herard says:

    Dr. Wible, perfectly stated.

  2. Indya Bull says:

    Thank you Pamela. I am so tired of the “thoughts and prayers” however well intended. It is just a bandaid on a gaping and hemorrhaging wound that keeps getting bigger without remedy. My own mental wellness has been pecked away at d/t personal events as well as these larger scale social/psychological/gender/cultural/political landscapes that are at war I am sad, depressed, anxious and scared. Thoughts and prayers do nothing. Action, discussion, seeking remedies without violence, hate or alienation would be a good place to start. Cannot sleep anymore. My beautiful teens are struggling with this inflammatory and divided country and are struggling with anxiety and depression as well. And yea, it is difficult to arrange and have access to mental health therapy even for the middle class. Namaste.

  3. Alene Nitzky, Ph.D., RN says:

    All I can say is yes. We need mental health care. We need compassion for each other, even for those who own those hundreds of millions of guns.

  4. Kris Parnicky says:

    Bravo, Pamela! I love your work!

  5. Mark Goulston says:

    Another eye-opening set of statistics Pamela. Thank you. I think the issue is not too few psychiatrists and too many guns. I think it is (other than biologically based mental problems) the unrecognized, unresponded to and unhelped traumas in childhood that are often dealt with by suppression, then repression into symptoms and a forme fruste state of hibernation that are then reactivated in later life and that come out explosively as self-destruction or violence.
    Too often parents engage in a “don’t ask don’t tell” approach to their children, not because they don’t have the will to speak to them, but because they lack a way to do it. Something that parents and teens have found to be a catalyst for a long overdue conversation is the link below.

  6. Tim simpson says:

    I belivie it is each person right to have guns. It is what makes our country strong. And it is also as the gun owner you have a responsibility of keep those guns in a safe or have gun locks on them.and also it is a right that we have guns. Each state had to shut down metal hospitals and their were a lot of very sick people in these places. So the government also has to take blame for this.i myself can not even afford to see a metal health doctor.their are a lot more people in the world the NRA also needs to put in safety rules is a big topic and we need guns this is not heaven this is earth and we have evil souls.but when their are the problems in the world as we see each day people do get to feel hopeless and the killings will go down when the people feel their is hope.and even the media plays a roll in this process.but it has to start with stiff laws from the person who owns the gun to make sure it is safe and locked and make it his responsibility for what happens with that gun.and yes it is a double edge can own and carry a flare gun and that is as bad as a gun.

    • Jeff Johnson says:

      Totally agree with Tim. I’ve had access to guns all my life growing up in the country. But I had a wonderful father and mom who taught me to respect the guns power and it’s sole purposes: hunting, target shooting or self defense.
      I agree too many people can get guns that shouldn’t have them. Whether these untreated people get a gun, a knife, run ya over with a car I don’t wanna die in such a stupid manner because of someone else’s mental illness. It’s a mindset that starts at a young forming age, without guidance and love, respect for others that starts all this.

  7. Pamela Wible MD says:

    OMG. Tried to share via a Facebook ad and was not approved because “your Page has not been authorized to run ads related to politics and issues of national importance.” Really. Wow. Amazing how lifesaving information is censored. PLEASE SHARE.

  8. George Lundberg says:

    Great piece, but where did 19000 American psychiatrists disappear to in 6 years?

    • Pamela Wible MD says:

      “The supply of psychiatrists, already constrained, is soon going to diminish significantly. There currently are some 30,000 psychiatrists in active patient care in the U.S., 60% of whom are 55 years old or older, with many set to retire.
      As Merritt Hawkins has consistently observed in these Reviews, the shortage of psychiatrists is an escalating crisis of more severity than shortages faced in virtually any other specialty. With many psychiatrists aging out of the profession, and with a preference among psychiatrists for outpatient practice settings, it is becoming increasingly difficult to recruit to inpatient settings.” 2017 Physician Incentive Review by Merritt Hawkins

  9. Wendy Adams says:

    Wow, from someone who’s struggled with depression and anxiety, I thank you. I’ve been diagnosed with PTSD on multiple levels and GAD (per Dr notes, not mine). Im 44 and disabled after 2 boughts of cancer stole part of my jaw and left me with Trigeminal Neuralgia aka, the suicide disease. Surgery after failed surgery I decided to risk the odds and undergo a deep brain surgery to which it failed And sent me home using a walker with many months of PT, OT & ST to retrain my brain on how to walk talk and think again. This 14 year journey of hell was manageable until lost my medicaid cause my daughter turned 18. Between my $1300 disability check and my $400 monthly retirement check I was told I “make too much money” for a now single household to receive medicaid. I wasn’t asking for help paying my mortgage or utilities or food, all I sought was help paying for medical since medical reasons were the cause of my disability and still continue to drown me. Before I even get my $1300 check, $160 is taken for Medicare and then $138 for prescription part D. Then on top of this, I’m on 4 meds which one is over $300 so I skip it one is 9 and 2 are each 45 cause they can charge me for a 2 tier level even though I’ve found it cheaper to buy them without my insurance. How sad is that. Funny thing is, I spent 14 years working for a big hospital and I can’t afford to pay all my medical obligations and seek the therapy I so desperately need. Not only is it cause of financial strain but also because there are not enough doctors who will accept my medicare insurance cause we all know it doesn’t pay sh…. So while politicians play the blame game (which ever stance best helps their party’s political views), I along with countless others struggle between eating, paying for prescriptions or paying for Co pays (or even out of pocket) to see a therapist. I’m barely hanging on and do ya know what I’m asked? Are you suicidal…. If I say no, I’m not granted immediate help, I’m sent to search on my own for a therapist who will see me at some point. If I say yes, then I’m afforded resources that I need but not at the expense of someone worse off than me who might be suicidal. So what do I do to seek the help I so desperately need, wait until the burden is so great I finally crack so I’m taken seriously enough to receive help. To me It’s not a shock that so many shootings are happening but rather I’m surprised that number isn’t higher than it is. People who desperately need of help and can’t get it do desperately sad things. Maybe if the people we elected hadto live by the same standards of care as us, they’d implement better legislation and they’d do it fast.

    • Pamela Wible MD says:

      “Maybe if the people we elected had to live by the same standards of care as us, they’d implement better legislation and they’d do it fast.” Absolutely!

  10. Diane Hanna says:

    Hey, It’s really a disservice to all vets to lay it at the hands of PTSD associated with service. His teachers in high school came out and said he was dangerous and mentally ill as evidence by his horrible behaviors prior to his service. Please look into this, it’s harmful to link mass killings to our service men. ~ Diane

  11. Kelly says:

    Thank you Pamela for sharing some
    Alarming statistics. Today would have been my late husbands birthday and I reflect back on how hard he fought cancer for 5 years
    as he didn’t want to leave his
    Young children and me. His doctors
    And nurses worked tirelessly to help him and others. When people put more value on the right to bear arms
    than the right to affordable health care (at least the voting seems to
    go in that direction. Life-threatening or limiting illnesses warrant fear but fear of my neighbors’ assault weapon arsonal?
    I will distribute the information you’ve shared in the hope that facts and statistics still mean something in regard to mental health and violence.

    • Pamela Wible MD says:

      Fear dictates so many of our decisions sadly. Most people make decisions based on fear and not desire. Including politicians.

  12. Kathy says:

    Well said, thank you for your advocacy for a better world we need solutions not prayers

    I am advocating for veterans and elders in our society. We all need to give back, give love, hugs and find solutions. Each one of us need to help each other

  13. Dale Howard says:

    We need the Oprah Solution, “You get an AR-15, you get an AK-47, everyone gets a gun”. Then we put a $1,000 tax on every single bullet. So if you have an AR-15 with a banana clip that can hold 80-100 rounds it is going to cost you $80,000-$100,000 to max out your fire power. Now with that having been said the next thing that any shooter will have to take into consideration, “Is that life worth a $1,000 expense?” It has been calculated that it took 50,000 rounds to kill one enemy during the Vietnam War. National deficit would be eliminated ten times fold. NOBODY’S COMING UP WITH A SOLUTION SO PERHAPS…

    • CA says:

      Stupid anti-poor person solution/legislation yet again.

      Also an AR-15 is nothing like an AK-47.

      One is just a normal rifle (seriously) and the other *is actually an automatic rifle*.

      “semi-auto” is just a fancy way of saying no lever/pump action.

      Also your prohibition solution has worked great for illegal drugs to fill up your mental wards/”mental health care” facilities and prisons….

      Oh, right, it didn’t work at all, because prohibition *NEVER* works.

  14. Dr. Mark Blessley says:

    Thank you Dr. Wible. You have made a complex situation more understandable and have provided a path to a solution. Again, Thank You!
    ps. since you asked for my website I should tell you ghn stands for “Good Health Naturally” Enjoy!

  15. Donald Turken, MD says:

    Amendment II to the Constitution of the United States-
    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.
    The Constitution was written in Philadelphia 1787. The nascent nation was forming together based upon the legal system in Great Britain minus the monarchy, limited in 1215 via the Magna Carta. Thusly the Constitution and subsequent Amendments moved this country forward. The Militia was the system of local legal procedures since Colonial America central government had to depend upon states and local systems. The so-called militias of today are nothing more than right wing conservative white nationalist supremecists. The US Supreme Court has stated everyone has a right to a gun. too many guns. to an RPG (Antonin Scalia). I interpret differently. Those of us making up the Militia, todays police forces, are armed and trained. The system requires compromise from all sides, urban/rural/agriculture/manufacturing/etc.
    But that is not the point other than people love their phallic symbols, and they kill, with pleasure. The issue here is mental health and its association with violence. Psycho-pathology is in all of us to one degree or another, yet the vast majority of gun violence is perpetrated by white male fake-christians conservatives. Most people suffering emotional/mental problems are not violent to other people but themselves. And mental issues are not handled well in this country, along with end of life issues and child care for those most critical of years between birth and school. Unless and until we as a people are able to talk and to listen coherently cogently and resolve differences, there is no hope for the pandemia. We all need support mechanisms such as the Herculean efforts of Pamela whereby we support one another and we know we are not alone outside of our own selves. Victims of suicidal ideation and sexual assaults share that trait of lonely isolation and need to learn they can reach out to another for succor and peace.

    • Pamela Wible MD says:

      The trait of lonely isolation is more common than we think. Many of the shooters have this in common. As do physician suicide victims. And probably most people on the planet have had this experience especially in modern “civilized” developed nations.

      • CA says:

        I’ll give you a rundown of real causes of loneliness neither psychiatry nor psychology can treat:

        Oldness, ugliness, fatness, poverty, legitimate physical illness and anything deemed “cosmetic”.

        Also: lack of popularity, lack of fitting in, lack of societal approval/”equality” (not just the faux-equality stuff SJWs are on about but actually being equal to that hot-shot college football player or that sorority girl or that attractive older Hollywood actor/actress in *ALL* social ways…)

        As for physician suicides?

        I’ll give you a hint: You hit the nail on the head with that one. As an outside observer I’ll add – you added too much pressure to get in to begin with, and too much pressure to stay – but none of us are getting doctors, let alone better doctors out of it.

        And I mean, if they’re not better physicians/scientists out of the deal 5, 10, 20 years down the road anyway, I don’t get the point.

        I also find a system that creates and breeds heartless monstrosities for specialists who can’t tend to or care about their patients because of lack of time or simply lack of care/ability to care/monetary motivations is …well wrong, but you already addressed that one.

    • CA says:

      So it’s their body, not yours.
      Get the law/government – OUT of our own bodies/regulating what we do with them.

      Also your left wing extremist viewpoints are showing.

      I find it depressing indeed all my potential physicians are far left wing or religious right prude types.

      Also you “interpret” differently because you forgot *AND*. And in English signifies where a period break could easily be used but would be clunky. That is “well-regulated” meant in working order – had nothing to do with regulation and the “and” part is a real kicker – the PEOPLE’S right shall not be infringed.

      Ever think I’d choose the USA over the UK, Canada, Australia, the EU and the like, precisely because, at least in premise/the spirit of the laws, this clause.

      I shouldn’t have to be in the military or some state ran paramilitary org. That’s not the point, it never was.

  16. Janice Makela MD says:

    For the longest time the liberal were supporting money for mental health, and the conservative were not supporting spending money on it. But with the gun debate the conservatives are now saying “Its not about guns. we need to focus on mental health.” But the liberals are saying “no, you are just using it as a smoke screen to not talk about guns. Lets talk guns. Mental health is not an issue because people with mental health issues are not violent.”
    I get so frustrated about this. I have been saying mental health needs money for treatment and doing so could help violent shootings. Sure most people with mental illness, even combat related PTSD, are not violent. But most violent people seem to have some sort of mental illness. (I consider it the extreme worst case complication of mental illness, much like the DKA is to diabetes.) But instead of the two parties coming together to solve a problem, they just repolarized on opposite sides.
    I keep saying to my friends on the left who say this stuff, “look the conservative want to spend money on mental health now. Sure, talk about guns. But isn’t this what we want? Money for mental health? Stop complaining take the money and run.” Now that said, I’m hoping my conservative friends are not just blowing smoke about mental health funding and I am going to be holding them to their words.

    But what to do? It seems like there could be good bipartisan solutions to help mental health across the board and solve many of our societies ills. But it seems the parties would rather bicker.

    • Pamela Wible MD says:

      Mental health care should be as bipartisan as dental health care.

      • Janice Makela MD says:

        SO any proposed ideas for mental health that could get bipartisan support?

        • Pamela Wible MD says:

          How about on-the-job mental health support for police, firefighters, physicians and other high-risk professions. Anyone against that?

          • CA says:

            That would be great if you could keep stodgy boards out of it and keep people ensured their job/livelihood wouldn’t be lost and they wouldn’t be living under a microscope for life.

            Good luck with this.

  17. Arun says:

    Thanks for this insightful article. Can you/have you tried sending this article for publication in places like Washington Post and NYT?
    It is worth a try. Good luck,
    see you sometime, hopefully.

  18. Barney Lejeune says:

    This makes so much sense. High graduates were given incentives and granted scholarships to go to college to become a teachers when there was a shortage of teachers in America in the late sixties and early seventies. Why can’t we do the same today in an effort to get more people to go to school to study psychology, counseling or whatever?

    I believe that everyone in America should be taught the warning signs of suicide and what to do when we see someone exhibit these signs. I facilitate a support group and I hear parents, spouses, brothers, sisters and others tell of the events that led to the suicide–they saw the warning signs, but did not know that this was warning signs of suicide. And, if they suspected that it may be warning signs of suicide, they didn’t know what to do or how to help. Our organization strives to teach as many people as possible the warning signs or suicide and how to save a life, but we cannot do it alone. We need help at the federal level to teach QPR or something similar to as many Americans as possible.

    • Pamela Wible MD says:

      Barney, thank you so much for all you do. is there a link or video you could share here to help teach these prevention and awareness strategies to readers? I’d love to learn more myself and certainly want to share with others.

  19. Joe Potts says:

    We evolved as humans to live in small bands of hunter gathers. In these bands each person was loved and supported by the others in the clan and they all felt that they had a purpose within the clan. Today we live in overcrowded cities where many people live in isolation, unloved and with no purpose in life. This can leads to suicide or mass killings. This frantic clamor to be “noticed” in this huge, anomalous, population is evidence by the rise of “Facebook” and “Tattoos”. When you add mental health issues to this lifestyle you get suicides and mass killing. I recently moved from the big city to live in a rural setting with a small group of people and have been amazed at the decrease in anxiety level and increase in feelings of purpose.
    I have worked with patients in hospitals for 25 years and have seen many people want to stay in the hospital just because of the attention they were getting. People just want to be noticed and cared for.

  20. Jaime Andrews García says:

    America has the worst legislation about guns and all type of firearms of the developed and middle income countries.
    This is something that for History of people to west. Like were dangerous the adventure, all had firearms, because theres not a great Police Force.
    But, you know, are strong lobby in favor of arms.
    In my country only can have a firearms, after psiquiatric evaluation, register in office of Army, and only in house. Is forbiden, stay in a car with the gun.
    Only can shoot if a criminal enter the property.

  21. Denise Bogard, M.D. says:

    Well spoken Pam!!!

  22. Jed Diamond says:

    Pamela, As usual you are spot on. I would add that I believe we need to recognize that the shooters are predominantly male and most of the mass shootings are murder/suicide. I believe we have to ask more questions about men. Why are so many men depressed and angry? Why do so few of them seek out treatment? Why do we ignore men’s cry for help? Why are there so few psychiatrists and health-care professionals who are expert in treating males?

    • Adelaide H Steely says:

      Yes, so many men go into a real funk if lose a girlfriend or wife because as I have observed over 70 yrs of life, dudes need a mother as a link to the world. I am the mother of 3 sons as well as wife of 2 guys, not at the same time, and envy the few women who found guys who are balanced. Isolation and no one saying, stop and think about what you are proposing is something I always said to my males. Like grab the I-Phone from the Tweeter in Chief, LOL.

      • Pamela Wible MD says:

        Testosterone and firearms is a whole ‘nother component to these tragedies. Testosterone leads to increase velocity to anger, hypersexuality, and more respect in a patriarchy. Firearms mixed with sexual frustration and anger have played a part in a subset of these shootings.

        I’m not anti-man by the way. Heterosexual here.

        • CA says:

          Your belief in a “patriarchy” would state otherwise.

          Furthermore I would like to point out anger is a valid response to invalid/unjust stimuli.

          Also some of us would quite find “hypersexuality” to be a perk/boon – not an illness.

          Again – you have no medical/mental health way of “treating” sexual frustration OR anger though, do you. Just treat the latter like “mental illness:” and the former because of such, and you can write off any who might otherwise be “cured” with a cure to the “frustration”.

          Though, only if the frustration is linked.

          Also – try not drugging away the sexuality/looks of young boys/men/medicalizing boyhood/childhood. Tends to help.

          I would know. I lived through it. You can’t “therapy” unattractiveness, unpopularity, low social, sexual or economic marketplace value (I’m sorry, but if you want to be taken validly as social scientists of any stripe – you had better acknowledge that social and sexual “value”/proof are a thing> ) and can say that I get tired of being the first one thought of (before the rise of incels being blamed for literally every shooting/men being blamed/guns being blamed/bad mental health being blamed) anytime there’s a murder, a rape, etc.

          Do you know what THAT is like to endure since the middle of college? I do. Do you think I’d endured that were I physically healthy, athletic, stereotypically masculine, not a nerd/dork/geek/spaz/neckbeard etc? – Of course I wouldn’t have. And I know it too.

          Also where’s this increased respect? We must not have a patriarchy or they never gave me my man card. 🙁

          I want my man card, gosh darn it. Some increased respect would be kind of nice.

      • CA says:

        Are you legit off your rocker?

        The link to a mother has nothing to do with a need for a mate/lover/partner/bff.

        Are you one of these weird women that thinks men who like firm natural breasts have mommy issues too?

        “Balanced” doesn’t come from having a “mother as a link to the world”….

        Also the rest of this comment makes too little sense to decipher, and I’m pretty sure President Trump has nothing to do with any of this.

  23. Family DOC says:

    Hi Pamela,

    I think expectations, attitude, and coping skills that have been developed in early life experience also play a role. Psychiatrists will agree that CBT plays a huge role in the treatment of PTSD. To illustrate what I mean is how many white men would develop symptoms of PTSD switching from a life of well educated suburban America to the life of a black man in poor urban America? Then you could also reverse the sociological situation and ask the same question but I doubt you’d get the same amount of PTSD. You would need a very strong mind to be able to handle such a transition and maintain a positive outlook when you are experiencing social oppression.

    We need to look at our sociological constructs for gender, race as well as education at large in the way they shape one’s life experience and either improve or degrade mental health. We also need to look at attitudes within families that shape future generations in particular with a focus on the emotional development and empowerment of boys and the sexual development and empowerment of girls. Both of these things are shaped by the behaviors of mom and dad.

    If parents allow their sons to get away with things they’d hold their daughters very accountable for then it sets gender biased expectations for outcomes in response to an individuals actions. In other words boys end up growing with an attitude of expecting more by doing less and girls expect getting not much after giving it their all. Mass shootings are a symptom of expectations also.

  24. Richard Stanton PhD says:

    Dear Pamela Wible. It has been a long time since I last commented or spoke with you. I do appreciate your continued services which address our lack of mental health attention to Health Providers; and I especially liked your attention in this posting to the mushrooming practice of the US’s overextension of gun rights and the slaughter of innocent victims. Please continue.
    Dick Stanton

  25. Lynelle Paulick says:

    Ah Pamela,

    You’re wonderful, doin’ great work here. I’ll continue mine, and you please don’t ever be deterred from yours. I Appreciate the energy, passion, and intelligent thought you bring to your work.

    All the Very best to you.


  26. Bill Timmons says:

    Hi Pam, I am a long ago retired clinical Social Worker. A behavioral scientist. I wrote you once before about suicides. When someone mentions suicide, I move quickly. I have a do not harm contract that I share with others. In 2010 I had an out patient surgery and got a medical reaction from the drugs they used. For two months, my life was bad. I had clinical depression and severe anxiety. My gp wasn’t much help. I finally went out to a mental health center and saw a man with the same training that I have. They wanted me to enter inpatient. I said not without an eod. It was 2 weeks before I was able to see a pa. She gave me a drug. Before I saw her my symptoms had vanished. The offending drugs were out of my system. No problems since either. Just onery at 86. I finally got an anesthesiologist (sp) to say he had seen cases similar to mine with reactions to drugs. I am adhd and hyper manic. I may be old, but I still garden work in the yard, garden, fish and am active in my church. I am also a lapidary, which I enjoy, but am color blind which doesn’t help. Most of professions who must be obsessive compulsive to get there, have problems with depression and suicide. Psychiatrists and dentists and CPA’s and lawyers are on the list. I wasn’t suicidal per sea, but had death ideation. I was making plans for what was going to happen after I was gone. I thought I was going to die. I used to say that depression couldn’t happen to me and then said why. I understood what was happening, but couldn’t get the correct help. I didn’t need the med the pa gave me. The symptoms had passed. Antidepressants didn’t help.
    Yes I have guns. Several of them. I went to the gun show in Tulsa Saturday and sold two and bought one. My hunting days are over except for the blasted squirrels in my back yard. I never was a deep therapist, but had a knack of working with the backwoods folks and rednecks. I enjoyed it . I worked with some of the vets with PTSD. That can be rough. I had a couple that committed suicide. I actively tried to stop one of them and failed. It still hurts after 30 + years.
    Depression can be rough. Medication isn’t always the answer. Sometimes having faith and turning it over to the Lord can help.
    Thanks for listening to an old geezer. Hope you are able to overcome the depression. Say psychologists and Social Workers
    treat many with depression successfully. Find a Christian Therapist. It might make a difference. Bill Timmons MSW used to be LCSW NASW. bft

  27. Eric Byman says:

    We certainly need better access to mental healthcare in this country, and not just to prevent violent crime (although our local sheriff once said that 1-in-3 of his inmates has a known mental illness diagnosis).
    We also need to find a way of limiting the access of mentally ill people to guns, without trampling on rights or discouraging people from seeking help. Should a paranoid schizophrenic be barred from gun ownership? Probably. What about a woman who had post-partum depression two years ago? Probably not. I do worry about the suggestion of some, that anybody with ANY mental illness be barred from possessing guns, both because of how many people would lose the right (consider how many conditions are in the DSM-5), and because many gun owners would be discouraged from seeking the help they need for fear of having their guns confiscated (similar to the reason many doctors don’t seek mental healthcare).
    I don’t have all the answers, and look forward to hearing what others suggest; but I’m glad some are at least having the discussion in a way that doesn’t have to devolve into name-calling between pro-gun and anti-gun zealots.

  28. Paul S. Zosel says:

    Hello Pamela: My name is Paul Zosel and we met man-years past in your office as my role was in development of resources for individuals who had ABI. The focus is not on ABI rather changing resources and leadership resources in schools and communities. I plan to share a cover letter and information on plans to date in the next several weeks. I look forward to being a small part of a plan to create change that begins with students and parents. Stay well.
    Paul Zosel

  29. LR says:

    Bless you, brave Pamela Wible!
    Great post, and thank you for this powerful statistic to spark new conversations. May you always continue to bring a light to the darkness!

  30. CB says:

    Brilliant! I’ve not seen the comparison between guns and psychiatrists as well as the constitutional rights and lack thereof.

    You ought to submit this as an editorial piece to the major newspapers now!

  31. CA says:

    If someone has not committed a crime – the right to bear arms shall not be infringed.
    As you know so called “mental illness” is an arbitrary, relative, subjective construct with not one single reliable objective measure of proof of any kind.
    Furthermore I dislike big government, big regulation on individual liberties and curtailment of dissident speech.

    Guns are not your problem.
    Mental illness is not even your problem.

    The so called labeling of too many as ill relative to the social, sexual and economic pressures that break most people – with a caveat of “functional human being” being tied directly to 50+ years of labor (that is, we are walking labor animals) IS. While there is not currently a better way to earn goods/services than capitalism, it is hardly “ideal”.

    Also your idea of “treatments” include sexual and “cosmetic” side effects which I, differ from you the “clinician” on.
    For example: the accelerated aging of antidepressants, the sexual dysfunction of antidepressants, the stupefying factor of, and weight gain/sex dysfunction/endocrine disruption factor of so called “antipsychotic” drugs, etc.

    Because you can not, reasonably without any drug, invasion to person OR invasion to the rights *of individuals who have yet to commit an actual violent crime based solely on your opinion of sanity* provide any evidence of anything but your desire to “treat mental illness”, I can not side with you or any other clinician on this, and, of course, you would label me as “ill” based on such, simply ramming your “professional opinions” down my throat until I was either compliant, or therapied.

    I get free psychiatry, but not free cialis or facelifts etc.
    I assure you, guns are not cheaper than psychiatry.

    I assure you psychiatry does more damage to people than guns, I for one, would rather be dead than psychiatried.
    Oh, and given where I found you from, it is odd that you are advocating for psychiatry, knowing how false their profession and model of “illness” is.

    • Pamela Wible MD says:

      Assembly-line psychiatry and the mass drugging of America is obviously not the solution either. I’m no fan of 7-minute office visits for schizophrenics and suicidal patients and yes I do know psychiatrists who see 6 patients per hour for “med management.” Insane.

      Problem starts in medical school per this video.

      • CA says:

        Also the subjective and relativistic nature of the label “mental illness” as well as the inability to ever have it truly “removed” (without being stuck addicted to life altering, harmful, addictive, toxic chemicals for life) strikes me as cruel, as apparently 25% of the whole human population is “ill” with these “illnesses” at any given time.

        If you ask me, I don’t think, from a physiological/anthropological or mother nature standpoint, ma nature/evolution screws up that badly.

        Especially if you take into account that, if you say you can become “mentally well” again – it might never be the SAME 25% of the population, possibly covering a larger swath of the human genomic whole.

        Would you find those opinions “insane”, erratic, ranting/raving of a madman etc?

        What say you from a physician’s point of view?

        • Pamela Wible MD says:

          I agree with the overuse of “mental illness” labels for pharmaceutical profit and medicalizing normal behaviors so there is a pill for ever “ill.” It’s not Mother Nature who has screwed up. Again, insanity of short-term profit over people and the fragmentation of family and social safety nets creates a very unstable society. We all need mental health care just like we all need dental health care. Easy access to guns and lack of access to mental health care is a travesty.

          • CA says:

            Ive already totally watched that video by the way!

            I just don’t see this access as so easy I suppose.

            I never saw psychology or psychiatry as a matter of “health” so much as a religion and behavior control scheme. Thing about “normal” behavior – is it’s entirely subjective, relative, dependent on the individual – and has so many mediating variables that it would be impossible to label such without at least SOME of your OWN bias or opinion vs. another individual’s. My normal is your insane, okay not really, but it’s not entirely sane by comparison either.

            7 minutes IS insane. Then again, even 7 hours with one of those is insane.

            Well ma nature isn’t curing the aging process sadly. Though if you did beat ALL signs of physical aging – you’d kill a lot of the “depression” right there. Cut out any monetary problems or other physical health issues instead of relying on psychiatry as a substitute – and well, there you go.

            Also it’s not short term profit when you have lifetime patients/clients. You have an entire industry going on here. “Well” people don’t need therapists/counselors – a booming industry. They also don’t need nurses/psych nurses, GPs… psychiatrists… I think you get where I’m going there.

            I find it ludicrous anyone thinks it’s that easy to just buy a *LEGAL* gun by the way. Almost all “shootings” have been carried out by males who have been psychiatried (permanently ruined by the system/”meds” when they were disillusioned to begin with) with stolen or illegal guns to begin with. Again – if the society is broken – don’t blame access to firearms OR psychologists/psychiatrists – blame society, human nature or social darwinism, as I truly feel, a lot of that simply plays in more than it’s given credit.

            But I am a bored out of my mind (chronically ill, no less) skeptic whose thoughts and feelings count for little.


  32. Anon says:

    Wow, there’s a wake-up call. Juxtaposing those numbers is a startling insight! (Wouldn’t it be interesting to compare those numbers with those of, say, France? I do remember that few people see (or admit to seeing?) psychiatrists and I believe there are far fewer suicides and we do know that there are few shootings (other than ISIS/Daesh).

    Thank you for your continued research, efforts and the time that you devote to this “crusade”.
    Be well (and I am happy to hear that you do take care of your own mental health – and can afford to do so – in light of all that you know and care about on this subject).

  33. JoAnn says:

    Thank you for offering this JOLT in our thinking. Very powerful and I have forwarded it to all my friends and colleagues.

  34. Adelaide H Steely says:

    redirected to pro and con group of people in my e-mail list. Hope it leads to financing more college degrees for doctors as well as get folks to read your blog.

  35. Mark Luce MD says:

    Oh yes there is a devil, of that there is no doubt, but is he waiting to get in us, or is he waiting to get out?

    Death by gun, death by car bomb, death by rampaging auto, death by suicide. The world is filled with stories of loss and despair, initiated by people who are filled with the pain of loss, and the crushing weight of despair. Is there a cycle in this?

    Between our southern border and South America, we are supporting a “Drug War.” Just as in the days of Al Capone, making these substances illegal, drives Black Market pricing, for which people will kill. Wikipedia on the Mexican Drug War notes:

    By the end of Felipe Calderón’s administration (December 1, 2006 – November 30, 2012), the official death toll of the Mexican Drug War was at least 60,000.[43] Estimates set the death toll above 120,000 killed by 2013, not including 27,000 missing.[44][45]

    What is the chance some significant portion of these drugs are being used for self-medication for depression and anxiety? What is the chance that our mental health crisis plays in this? Should we consider some compassion for the lives of many families of our neighbors to the south that have been shattered by this?

    The lack of compassion in the struggle between the desire to control the devil trying to get in us and the understanding of the hell that exists inside of some already, blurs the lines of rationality when politics try to settle problems. The expense of good mental health might detract from the profits of the industrial-military complex if we made such a shift.

    I would hope the parallels found in Europe, Asia, the Middle East and South America are easily correlated. Different reasons for lack of compassion but very similar results. Are we not doing the same thing over and over in many of these situations? Whether we talk about 9mm Glocks, or Cruise missiles, is there some chance we are talking about something that is rooted in lack of compassion?

    You can ask anyone who works in an emergency department, the most time consuming and difficult patient to place is the mental health emergency. I believe this is a reflection of the same world-wide crisis. I think Dr. Wible’s call for compassion is way overdue.

    Caring for each other might have something to do with breaking this cycle. Mental health issues beg very difficult questions, but it seems like we have been very resistant to admitting our humanity and taking substantive steps in the direction of health (and maybe peace too?)

  36. Bill McConochie says:

    I am a clinical psychologist, among other specialties. One is building questionnaire measures of traits that underlie violence, both by civilians, as in school and community shootings, and by political leaders, specifically warmongers. Both are easily identified by questionnaires. Violence-proneness is measured by a 58-item questionnaire with versions for children and adults.

    Warmongering-proneness is measured by a 50-item rating scale, taking the average score across several raters for each leader. These ratings, or ones on a briefer scale I’m working on at the present, can be done on well-known candidates for elective political office while they are running for office, as by journalists, who can then inform citizens prior to voting.

    School children can complete the violence-proneness questionnaire in a counselor’s office. The test is scored online. Then counseling services can be focused on the dimensions on which the person is high. The dimensions are Rigid Thinking, School or Career Failure Feelings, Impulsiveness, Unresolved Anger, Enjoying Hostile Activities (such as violent video games), Being Indifferent to Counseling, Homicide Endorsement, Gun Skill and Access, and Lying on Questionnaires. And one more: Social Rejection, which is often the last straw. Each of these is measured with several items. All scales have good reliability. All correlate significantly with the Homicide Endorsement scale. All differentiate incarcerated from non-incarcerated citizens. With one exception. Teens are still open to counseling. For more info, see my book, Party Time (on Amazon), or check out my web sites: and To make use of these tools takes some political will, and power, to overcome fear and resistance among some citizens. I’m better at building the tools than marketing them. I’m working on a 150-item questionnaire to measure about 35 traits that I suspect put medical personnel at risk for suicide, inspired by Pamela’s Work. She spoke at our Rotary Club here in Eugene, OR a couple of years ago. Thanks, Pamela, for your wisdom, courage and leadership!!

  37. J says:

    It is true that you could buy cheap or used guns and ammunition in bulk. But most people don’t do that.

    Most people that commit suicide impulsively and most shooters I would guess if they’re using assault rifles have actually bought ammunition commensurate with their needs. That is if they haven’t stolen them they’ve likely have several thousand dollars worth of guns and have paid significantly more for their ammo than several dollars and cents.

    However this is beside the point- the economics are less about the money than about doing it “right” or to make a statement. I have never heard or seen.of gun costs factoring into the decision to end it all. Mental health access on the other hand is huge

    Anyways I like your message but I disagree with your numbers…

    • Pamela Wible MD says:

      I get it. For the individual gun and bullet cost not a big factor. As a society ease of access guns versus mental health care a huge factor.

  38. nancy says:

    Really good discussion and points. History will continue to repeat itself until something changes.

  39. Margaret says:

    Fortunately, help for emotional illnesses is widely available now. Some free or nearly free options include all the many 12 step type groups in all their permutations. Skip over all the god stuff if you’re not into god and take what helps and leave all the rest. Definitely, take the fellowship and camaraderie. These groups are fantastic! Another great group is Adult Children of Alcoholics and other Family Dysfunction. This group helps in releasing the frozen grief of the pain, trauma, and abandonment that occurred in childhood, which means one can stop acting out one’s childhood abuse on others in adulthood. Another great group is Recovery International, which is fantastic for coping with emotions like fear and anger. Reading all the Dr. Bradshaw books on the family helps a lot, too. The adult is always the mirror of the child that was…. There is a HUGE amount of recovery out there just for the asking! And most of the best of it is FREE!

  40. Richaqrd Sheldon, D.C. says:

    Dear Dr. Wible:
    I cannot describe in words, how thankful I am for your willingness to teach all of us about this terrible problem. I will be forever thankful to you for spending the time to talk to me about my son, Dr. Brad Sheldon. At age 39, my beautiful, kind, gentle son took his own life. Leaving a beautiful loving wife and a six month old baby girl. He had gotten to bed late as he attended a Woman’s Club fashion show fund raiser with his wife, step daughter, my wife and myself. He was seemingly happy as we bid on items. I was concerned that he had to be at work at 6am, for his 12 hr(Emergency Rm duty)Also a board certified family physician. No drugs, nor alcohol issues. Happy Life, Happy wife. As his best friend, I sure missed something?? Nine years of heartache.
    Thank you

  41. Lindsay Harris says:

    I loved reading your perspective on this! Thanks for all you do Dr. Wible!

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