The Shock of Sudden Violence

The shock of sudden violence is so severe it takes your breath away.

When it happens in a time and place where it is unexpected, it does more than just remind us that no one is immune to it.  It also reminds us how pervasive it is, how much it affects us all, and how important it is that we do something about it. 

In the summer of 1989, I imagined that sudden, random violence was something far removed from my hometown.  But I was about to learn differently.

An article in The Atlantichas just detailed the event, dredging up some quarter century old memories of a day that changed my community’s life.

I was running for Mayor of Middletown, Connecticut, at the time, and had reserved a booth at the city’s annual Sidewalk Sale in late July.  I was handing out yardsticks, asking for a vote “for government that measures up to your expectations.”

Suddenly, there was a commotion about a block north of where I was standing.  I noticed people running in two directions, both toward and away from the Woolworth’s store in the center of downtown. 

A young girl, randomly chosen, had been grabbed outside the store and then repeatedly stabbed by a 38 year old man.  She died on the spot.  Hundreds of people witnessed the event.

Over the next weeks and months, Middletown was in shock, just as other communities – Newtown, Aurora, Tucson, Blacksburg VA, Littleton CO, and others – have been shocked since.

The trauma in Middletown almost killed our downtown.  Its suddenness and randomness made everyone feel unsafe.  It killed much of our sense of community and personal safety.

The healing didn’t happen very quickly.

It took at least a decade or two of steady changes to the Main Street area for that to happen.  These changes were so significant that – with the exception of a few businesses, nonprofits, and restaurants that remain from that time – one would barely recognize the Middletown of twenty-five years ago in its vibrant downtown today.

The trauma to which Sandy Hook and other communities have been exposed is even greater. 

To appreciate fully the scale of the Sandy Hook tragedy, we must realize that because of it Newtown’s 27611 residents – who experienced zero murders in 2011 – may well have experienced the highest homicide rate in the nation in 2012.

The healing time will be long.  And, at some level, my limited personal experience in Middletown suggests that a community exposed to that level of violence may never fully recover.

And this suggests something even more frightening about the shock of violence in communities across the nation.

There were 14,612 murders in the United States in 2011.  That’s 4.7 homicides for every 100,000 people.

In Middletown, Newtown, and Blacksburg, the homicide rate was zero.  In Aurora, it was 3.  In Littleton, it was 5.  Even in Tucson, which lived through the shopping center massacre that year, it was under 10.

Murders are uncommon in these communities, contributing to their newsworthiness.

But elsewhere, the everyday shock and trauma of violence is so much more powerful.  And because it is so prevalent, media headlines cannot capture fully its true effect. 

The murder rate per thousand in Miami in 2011 was 17, in Philadelphia 21, in Jackson 30, in St. Louis 35, in Detroit 48, and New Orleans 58.

Here is another way to look at this.  The Aurora massacre this past summer will double Aurora’s homicide rate in 2012, by a factor of 3.6 per hundred thousand residents. 

The people of St. Louis collectively live through the trauma of an Aurora-level massacre an average of once every six weeks, the people of Detroit live through it every month, and the people of New Orleans live through it every three weeks.  No one gets used to this.

If this is hard to absorb, imagine what these war zones must be like for the children and families living in them.  Every year, 3.5% of adults have diagnosable PTSD, and almost 8% will have it at some point in their lives.  Half will have PTSD before they reach the age of 18.

What are we doing about the traumatic effect of all of this violence in all of our neighborhoods – including those where it is commonplace?  And, more importantly, what are we doing to prevent such violence in the first place?

Email Paul Gionfriddo at gionfriddopaul@gmail.com.  Follow Paul Gionfriddo on Twitter: @pgionfriddo.

The Tragedy of Sandy Hook

The entire world is in mourning over the senseless and horrifying massacre of innocent children and adults in Sandy Hook, Connecticut. 

This hit so close to home for me, about forty miles from where I grew up.  So many of my former legislative colleagues are among those trying to help the state through it. 

I can’t even pretend to imagine what this must be like for the families of Sandy Hook. 

On the first day of the tragedy, too many politicians trotted out their tired old line that “today is not the day to have the debate” about gun control.  Thank God their tone-deaf voices were silenced by the outcry of reasonable people.

Connecticut Congressman John Larson (D-1) said that “Congress should be prepared to vote on requiring background checks for all gun sales, closing the terrorist watch list loopholes, and banning assault weapons and high capacity clips. Those measures don’t solve all our problems, but they’re a start.”

Senator Joseph Lieberman (I-CT) and Senator Richard Blumenthal (D-CT) also called for an assault weapons ban.  

But does our nation have the will to do this and more?

I hope so, because if the images of six and seven year olds staring down the barrel of an assault weapon in their last split seconds of life do not motivate us, then nothing will.

And there are two big things that it is past time to do. 

This first is to get lethal firearms out of the hands of people who are not defending us.  The second is to reverse the damage we’ve caused by neglecting and discriminating against people with mental illness because we mistakenly think that they are the cause of all the violence.

According to data reported in July by the Manchester Guardian, we are by far the most gun-toting of all of the most civilized nations in the world.  If the population of Newtown, Connecticut, is just average, then among them they already own 24,513 firearms. 

Adam Lanza’s mother owned the three of them used in the Sandy Hook massacre.  A self-described gun enthusiast, she was reported to feel she needed all this weaponry for safety and self-defense.  In the moment before her life was taken, did she feel safer, or better defended?

A member of Congress from Texas, Rep. Louie Gohmert (R-1), thinks we need even more. Does he really believe that the other 24,510 Newtown firearms made the children of Sandy Hook any safer that day?

Perhaps the horror of this massacre might open our eyes to something else – every day, an equal number of our sons and daughters die in our towns and cities because someone shoots them to death.

In 2007 alone, over 9,000 people in our country died because of gun violence, far more than the 6,656 Americans who have died in both the Iraq and Afghanistan wars since their beginning. 

We can do much better than this.  And, as President Obama declared in Newtown, “we will have to change.”

But making real change is not just finding someone to blame.

After tragedies, we often find at least hints of mental illness in the people using the guns.  But when we do, we miss the point. Violence is not a mental health problem, it is a public health problem.

Today, we are too quick to equate violence with mental illness, too quick to send people with serious mental illnesses to jail, and too quick to balance our state budgets by neglecting the people with the greatest service needs.

Connecticut’s Governor, Dannel Malloy, has shown leadership in his response to the massacre.  But another test of that leadership will come soon.  He recently ordered the rescission of up to $9.5 million in mental health services funding in Connecticut.  This funding is desperately needed to prevent and mitigate mental illnesses.  Governor Malloy is not alone in this regard – in all fifty states $4.6 billion has been cut from state mental health services during the last four years. 

Will Governor Malloy rescind that rescission now, and call on his colleagues around the country to do the same, so we can re-build our nation’s mental health services infrastructure, and better detect and treat mental illnesses early?  Will he help de-stigmatize those with mental illness, who are more often the victims of violence than its perpetrators?

Will the nation have the will to raise the money we need for prevention?

Because only if we do will we be able to say that protecting all of our children from harm is our highest priority.

Addendum:  There are news reports that Adam Lanza’s mother may have, for behavioral reasons, removed him from school at some point for home schooling.  I believe that voluntary or involuntary removal from school is often one step in a years-long chain of events that leads to bad outcomes. 

This time might therefore become a critical intervention point to change a bad trajectory and prevent future tragedies of all sorts – if we were to change our special education policy as follows:

Whenever a parent or a school believes that a special education student needs to be removed from his school for behavioral reasons, either via suspension, expulsion, or voluntary removal, for at least five consecutive days or for at least ten days in the course of a school year, there must be a mediation scheduled within 10 days with the school district, the parents, and the state education department as a mandatory third party.  The purpose would be to develop a new IEP with additional services.  The new IEP must have the input of a child’s regular health and mental health providers, if there are any.  If not, health and behavioral evaluations should be done to inform the mediation, with the state picking up the cost.  If any two parties agree to the additional services, then the services must become an immediate part of the IEP, with the state picking up the additional cost.  If the parents are not one of the parties in agreement, they still reserve their right to go to due process.  If the student is not yet admitted to special education, then the same event should trigger an immediate outside evaluation for eligibility for special education services.

Let’s assume that all parties would act in good faith.  But just in case one were concerned that a local district would low-ball a set of services from the start to shift more costs to the state, then a district could be made responsible for the costs of either its existing plan or the average cost of plans for comparable students in other districts, whichever is greater.

We’re all searching for answers.  This is just one suggestion.

Note: This column was published early this week because of the timeliness of the issue.  My prayers are with the people of Newtown.  Our Health Policy Matters will be return to its regular publication on December 26 and January 2.