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How to save lives when Congress refuses to pass gun control

Psychotherapy, antidepressants, summer jobs, and other non-gun control ways to prevent gun deaths.

National Rifle Association Holds Its Annual Conference In Dallas, Texas
The NRA annual conference in May 2018.
Justin Sullivan/Getty Images
Dylan Matthews is a senior correspondent and head writer for Vox's Future Perfect section and has worked at Vox since 2014. He is particularly interested in global health and pandemic prevention, anti-poverty efforts, economic policy and theory, and conflicts about the right way to do philanthropy.

It’s been six days since Thousand Oaks, a year since Las Vegas, two years since Orlando, six years since Newtown and Aurora, nearly eight years since Tucson, and almost two decades since Columbine.

Yet while some states have taken action on guns, federal movement toward gun control in the United States has been practically nonexistent over that period. A limited bipartisan background checks bill got close to passing in the months after Newtown but ultimately failed, and the Trump administration has moved to ban “bump stocks” that let semiautomatic guns achieve near-automatic rates of fire. But that’s about it.

That’s frustrating both for advocates and for rank-and-file supporters of gun control. The evidence is persuasive that tougher gun laws can prevent homicides, and can certainly prevent suicides. The US has a lower overall crime rate than many peer countries, including the UK, Australia, Canada, and Sweden, but it has a vastly higher homicide rate; the most likely explanation is simply that we own many more guns, and disputes that wouldn’t turn lethal in Canada often turn lethal in the US.

So why isn’t the federal government doing anything about it?

It’s a fair question, and a fair battle to wage in the halls of Congress and the court of public opinion. But it’s also worth asking: If gun control of the scale we need isn’t happening, what non-gun control measures could help as well?

Jennifer Doleac, an economist at Texas A&M University and director of the Justice Tech Lab, has a sharp piece in the Regulatory Review outlining a few possible options:

Several programs are at least worthy of consideration. Summer jobs programs for teens reduce mortality by 18 to 20 percent among participants. This effect is driven by a reduction in young men killed by homicide or suicide. Cognitive behavioral therapy for at-risk young men lowers violent crime arrests by 45 to 50 percent for participants. Access to Medicaid in early childhood decreases suicide by 10 to 15 percent later in life. Mandating that health insurance cover mental health benefits at parity reduces the suicide rate by 5 percent. Access to antidepressants also reduces suicide rates: An increase in antidepressant sales equivalent to one pill per capita reduced suicide by 5 percent.

In addition, repealing duty-to-warn laws for mental health providers — which require that they report a patient’s violent threats, perhaps causing patients to be less honest —could reduce teen suicides by 8 percent and decrease homicides by 5 percent. Repealing juvenile curfews could lower urban gunfire by two-thirds [during the hours affected]. And if the goal is to reduce mortality in general—not just gun deaths—then there are many more options policymakers should consider.

In making the case for these non-gun control ideas, Doleac argues that the fixation on gun control might be distracting advocates from presumably more tractable alternatives. “The significant time and money required to pass gun regulations — not to mention the time and money needed to enforce such laws through policing and incarceration — could be spent advocating for and implementing other programs,” Doleac argues.

I’m not so sure that’s right. For one thing, many of the non-gun control programs that reduce crime and mortality are also politically controversial. Summer jobs programs, mental health care for “at-risk young men,” and Medicaid/antidepressant drug coverage all cost money, and funding for health programs is a topic of live political debate. The number one issue of the 2018 midterm elections, based on ad buys, was health care, not guns. It might not be as hard to get these initiatives passed as it would be to pass gun laws that saved the same number of lives, but my guess is that the two are close.

And some gun control groups have embraced non-gun control ideas for reducing gun violence. Everytown for Gun Safety, for instance, has supported cognitive behavioral therapy and summer jobs as ways to prevent violence.

“I don’t credit the view there is an ‘opportunity cost,’” the veteran writer on gun issues Ted Alcorn tweeted, responding to Doleac. “Declining to fight for stronger gun laws does not benefit other approaches to violence prevention.”

But whether you think of Doleac’s ideas as a both/and with gun control or an either/or, they’re a good reminder to keep our eyes on the actual goal. Gun control isn’t an end in itself; it’s a means to saving lives, and while it would probably do that, it’s not the only way. If there are other low-cost, less controversial ways to save lives, we should be trying them out.

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