Expertise and Advocacy in Action

Mark Smaller, Herb Gross, Michael Slevin, Wylie Tene, and Peggy Tighe

APsaA over the last two years has been a leader of the national conversation taking place in Congress about preventing societal violence. Through the strategic use of its members’ expertise, under the umbrella of its Executive Council and Executive Committee, APsaA, a relatively small organization, has had a significant impact.

Threat Assessment, Management, and Prevention Legislation

The Threat Assessment Prevention and Safety (TAPS) Act (H.R. 838/S. 265), legislation seeks to develop a national strategy to prevent targeted violence through the assessment and management of threats. The bill would create a federal task force to study, standardize, improve, and support existing state and local teams which identify, investigate, assess, and mitigate threats of targeted violence. The bill is solidly bipartisan, with an equal number of Republican and Democratic co-sponsors. At the end of September 2019, 150 members of Congress had signed on as co-sponsors to support 6the legislation, a far cry from the 20 co-sponsors last session before APsaA engaged in this effort. Of the more than 7000 bills introduced in the U.S. House of Representatives so far this session (2019-2020), there are only a handful of bills that are bipartisan and have more than 150 co-sponsors.

APsaA’s Journey and Role in Advancing Legislation

How did we get here? Under the leadership of immediate past-president Harriet Wolfe, APsaA’s role as a national mental health advocate was re-imagined. A task force, chaired by past-president Mark Smaller, determined policy priorities focused on the expertise of APsaA members that were consistent with long-term APsaA values and actions. Child development and trauma, concerns at the core of psychoanalytic history and knowledge, were two of those priorities. Protecting privacy and opposing the stigma often attached to mental illness were two others. After consideration and approval by the Executive Committee and Executive Council, a newly formed Advocacy Committee was directed to find areas where APsaA involvement consistent with these priorities could make a significant impact.

Late in 2018, APsaA member Reid Malloy brought the TAPS bill to the attention of APsaA president Lee Jaffe. Malloy, a nationally recognized expert in threat assessment, was working closely with Congressman Brian Babin (R-TX) and Representative Val Demings (D-FL) and their staffs to rework an earlier form of the legislation. The goal was to create a bill that would help curb targeted violence while protecting privacy, civil rights, and civil liberties.

Malloy’s request that APsaA engage with the TAPS bill was taken up by the Advocacy Committee. Its members, appointed by APsaA president Lee Jaffe, in addition to Mark Smaller, are APsaA members Herb Gross and Michael Slevin, APsaA director of public relations Wylie Tene, and APsaA lobbyist Peggy Tighe. The team holds weekly strategy discussions to ensure APsaA’s voice is targeted, clear, and effective. Communication between conference calls by email is frequent.

The committee began its review of the legislation by determining the TAPS bill was consistent with the values and goals of APsaA. APsaA has a long history of position statements and actions to counteract societal violence. As psychoanalysis was the first mental health theory to recognize the psychological importance of trauma, APsaA, institutionally and through its individual members has significant expertise to bring to the table. And, we recognized that many APsaA members understand the challenge of assessing a threat that may become violent and determining how to effectively intervene—while protecting privacy and avoiding profiling. The bipartisan TAPS bill, with its increasing support, presented us with an opportunity under which APsaA expertise could inform the ability to help decrease societal violence for our patients and others.

The committee also did its homework. Experts in threat assessment and prevention suggest that in 60-85 percent of mass shootings, the perpetrator has let others know (“leakage”) of his or her anger and rage, which is usually connected to some personal grievance. If that grievance and accompanying feelings are not responded to, a “pathway toward violence” is more likely to occur. Leakage is a direct or indirect communication to family, friends, school peer group, teacher, or colleagues in a workplace setting and may emerge in conversation or via postings on social media. Mental health professionals or law enforcement are often the recipients of such communication but get stuck in not knowing how to respond if an actual threat has not been made. Mental health professionals understandably become conflicted regarding confidentiality and their duty to protect the public or the privacy of a patient.

From a psychoanalytic perspective, this leakage may be that individual’s last desperate attempt to communicate the need for help regarding a narcissistic or emotional injury that has not healed but festers. It is this kind of injury and lack of response that can lead to unregulated aggression. Often these grievances are then transformed into ideas or convictions related to white supremacy, violent behavior rationalized as a religious conviction, or merely a need for revenge in a workplace where the individual may have been fired, laid off, or felt mistreated.

As psychoanalysts and clinicians know, the immediate and long-term impact of the trauma caused by these shootings cannot be minimized. Individuals, families, and whole communities are traumatized by a shooting and the effects of that trauma continue for years. The TAPS bill has provided APsaA with an opportunity to create a national policy addressing one of the most important social issues facing our country and to reduce the loss of life and trauma in our country.

Threat assessment, management, and prevention is not a new field. We learned from our esteemed colleague Reid Malloy—a leading researcher in the field for more than 30 years who spoke to APsaA at our conference in San Diego last summer—that threat assessment, management, and prevention is a multidisciplinary effort involving mental health professionals, law enforcement, social services professionals, and others who have been actively engaged and quite successful in preventing societal violence in the U.S. It’s simply less common that you hear or read about violence that did not happen.

Threat assessment, management, and prevention works now through a patchwork of laws, guidelines, and practices at the state and local levels. The TAPS bill seeks to better manage and guide those efforts through federal review and coordination. The task force created by the TAPS bill would become a resource for local, state, and federal agencies; schools, corporations, families, and individual clinicians. Grants would be offered to entities, such as a corporation or school district, to create and train threat assessment teams how to evaluate an individual leaking information that they are on a pathway to violence—and, more importantly, how to intervene.

Tighe, our legislative strategist, also recognized that Representative Babin’s bill had a chance to pass and a chance to make a difference in the prevention of targeted violence and its subsequent trauma. With prior approval from APsaA’s Executive Committee and Council, we proposed language changes to the bill sponsors. Those changes were included in the legislation. They were pivotal, we believe, to the bill’s value to communities seeking to address societal violence, its appeal as a bipartisan solution, and its future ability to move forward in the current, partisan congressional environment.

Decisive Action to Gain Desired Results

APsaA engaged in several different tactics to help advance the legislation. We first crafted an endorsement letter to the bill’s sponsors; then, we enlisted our allies in the Mental Health Liaison Group (MHLG), on which APsaA has a seat and where Tighe as a board member has a leadership position. The MHLG works in coalition to represent consumers, family members, mental health and addiction service providers, advocates, payers, and other stakeholders committed to strengthening Americans’ access to mental health and addiction care. Trusted leaders in the field, with 70+ member organizations, the MHLG is dedicated to elevating our national conversation around mental health and addiction, working for federal policies that support prevention, early intervention, treatment, and recovery services.

To enlist MHLG allies, Congressman Babin’s staff, along with the staff of Congresswoman Val Demings (D-F) (original co-sponsor of the TAPS bill) made presentations to the MHLG board. Ron Schouten, a forensic psychiatrist at Harvard and past president of a chapter of the Association of Threat Assessment Professionals (ATAP) gave clinical examples of how threat assessment and prevention works. Mark Smaller presented APsaA’s interest and support for the bill and recommended that other groups join us. The resulting letter garnered the support of 21 national organizations belonging to the MHLG.

That letter was the start of a significant increase in the number of co-sponsors to the legislation. We didn’t stop there. We also devised, organized, and led two “fly-ins,” visits to Capitol Hill with other leaders supporting the legislation, to gather even more co-sponsors. The July visit included more than 30 representatives from various MHLG groups, along with threat assessment experts with mental health and legal backgrounds. They visited dozens of congressional offices to gain support for the legislation. Once Congress was back in session in September, the Advocacy Committee organized a group of leaders among our allies to again visit staff and members of Congress. We partnered with APsaA member Reid Malloy and Ron Schouten and spent an entire day on Capitol Hill enlisting support. We have since added to our core group the counsel of Michelle Hoy-Watkins, board certified in police and public safety psychology, who is director of threat assessment at Northwestern University.

Prospects for Action, Continuing Efforts

Our work is far from done. The House Judiciary Committee has indicated it plans to take up the TAPS legislation. This is excellent news, especially in light of Congress’s current impeachment focus. The Senate Homeland Security Committee would be the next committee to consider the legislation. The legislation would also have to be passed by both the House and the Senate.

Admittedly, the legislation has its detractors, from the far left and the far right of the political spectrum. There are those who say it doesn’t do enough, who fear it would effectively stigmatize mental illness or challenge civil rights—even those who think the legislation would challenge their gun rights. We respect these views, but know that none of those criticisms accurately depict how the legislation would work.

We are committed to ensuring that by having added mental health professionals to guide any and all discussions of threat assessment and prevention, we are best positioned as an organization and as leaders in this debate, in this politically divisive climate, to effect real, positive change that could ultimately save lives.