Dear Mitch . . .

A letter that's still timely

since you emphasize mental health —

In 2022, one month after the Uvalde, Texas school shooting that killed 19 children and two teachers while injuring 17 others, the first gun control legislation was passed since the Federal Assault Weapons Ban in 1994. That’s 28 years between any laws having to do with guns in the U.S.

In 1999, the Columbine school shooting left 12 students and one teacher dead. In 2012, the Sandy Hook school shooting left 20 children between the ages of 6 and 7 dead. Between Columbine and Sandy Hook, there were 31 other school shootings in the U.S. It was after the Uvalde shooting that legislation was brought up and passed by the House and Senate and signed into law by President Biden. Still, only 10 states ban assault weapons themselves, with other states banning large capacity magazines for assault weapons and have additional gun control in place, such as universal background checks, waiting periods, permit and licensing requirements.

Mitch McConnell, Senator from Kentucky had historically maintained the position that guns were not the problem, but shootings in the U.S. were a problem of mental illness: “It seems to me there are two broad categories that underscore the problem, mental illness and school safety.”

In the spirit of the well-known satire by Jonathan Swift in 1729 titled “A Modest Proposal” in which the author proposes a solution to the burden of too many poor Irish children by butchering them and selling them as food to wealthy English landlords— a savage comment on England’s legal and economic exploitation of Ireland— I wrote, in addition to each U.S. Senator who had accepted campaign contributions from the NRA, a separate letter to Senator McConnell:

Dear Senator McConnell -

I know I wrote to you earlier this week, but it occurred to me after I wrote that I hadn’t mentioned what you are most concerned about regarding the problem we have in the U.S. with mass shootings. You have indicated that you believe that the most important issue when it comes to the problem of these shootings we’ve been having over the past couple of decades or so in this country is the issue of mental health. As a mental health clinician, I believe you are absolutely right!

Since the majority of these shootings have been at the hands of adolescent males, I think that this is ample evidence that there should be a separate diagnosis for any person who is 1) adolescent; 2) male. There is ample evidence that an adolescent has not completed the developmental task of mastering several accomplishments, one of them being impulse control. Also it is well documented that adolescent males’ testosterone levels peak at between 17 and 19, and testosterone has been conclusively shown to increase aggression in males as well as being physically implicated in the development of musculature which can aid in the acting out of aggressive feelings.

Therefore, I believe it is expedient to develop a new diagnostic category for an amendment to the DSM-V (the Diagnostic and Statistical Manual of Mental Disorders). It could be listed in the section “Disruptive, Impulse-Control, and Conduct Disorders” (p. 461). Along with other diagnoses in this section such as “Intermittent Explosive Disorder” (p. 466), “Antisocial Personality Disorder” (p.472), and “Oppositional Defiant Disorder” (p. 462) we could also indicate the diagnostic features, development and course, risk and prognostic factors and comorbidity issues (such as substance use disorder). This new diagnosis could be known as: “Testosterone Saturation Psychosis of the Adolescent Male,” or TSP/AM, exacerbated by an underdeveloped or missing cerebral cortex. Pretty much every male between the ages of 15 and 21 would fall into this category, so this complete population would be mandated to be heavily medicated with neuroleptic drugs (much as the rest of us have fluoride in our water) as a matter of course until they have safely navigated the Scylla and Charybdis of adolescence, after which they can re-enter society having passed several qualifying tests certifying that they have developed impulse control as well as deferred gratification and are fit for society.

We can also require that any adults who have not, at an age-appropriate time, acquired these skills have the same treatment as the adolescent males until they too can pass the qualifying tests.

The issue of assault weapons being available at all can be addressed separately, but I think that a mass diagnosis of adolescent males is a good place to start. Of course treatment would be government funded, much as COVID vaccines.

Respectfully yours,

Patricia Ross, MFT