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According to President Donald Trump, the tragic Texas church shooting that left 26 people dead was "a mental health problem at the highest level."If you ask mental health researchers, such mass shootings are much more complicated than that.On Sunday, 26-year-old Devin Kelley sprayed bullets across the sanctuary of First Baptist Church in Sutherland Springs, Texas, about 30 miles east of San Antonio. The youngest killed at the church was 17 months old; the oldest was 77 years old."We have a lot of mental health problems in our country, as do other countries, but this isn't a guns situation," Trump said during a joint news conference Monday in Tokyo."This is a mental health problem at the highest level," he said. "It's a very, very sad event."Trump's response to the Texas church shooting echoed previous comments he has made on gun violence. In 2015, Trump said he was opposed to tightening gun laws in the United States but was in favor of addressing mental health to prevent shootings.Yet various epidemiological studies over the past two decades show that the vast majority of people with severe mental illnesses, such as schizophrenia, bipolar disorder or severe depression, are no more likely to be violent than anyone else.Rather, people with severe mental illnesses are more than 10 times more likely to be victims of violent crime than the general population. And, only about 3% to 5% of violent acts can be attributed to individuals living with a serious mental illness, according to the US Department of Health and Human Services.But those statistics have "almost nothing to do with mass casualty shootings," said Jeffrey Swanson, a professor in psychiatry and behavioral sciences at Duke University who specializes in gun violence and mental illness.So exactly how are mental health and gun violence intertwined, and what is needed to end the violence?Gun violence and mental illness are public health problems "that intersect at the edges" but have very little overlap, Swanson told CNN last year.There's no doubt that America's systems of care for mental health are overburdened, expensive and inaccessible for many who need them, he said. But when it comes to gun violence among this community, suicide tends to occur at higher rates than homicides, he said."If we back up and think about firearm-related injuries and mortality as a public health problem, it turns out there is a mental health-related story, and it's suicide," he said. "If we had better mental health care and could get people better access and break down barriers to care, then yes, we might reduce gun violence by a lot but it would be from reducing suicides."Otherwise, mental illness is just one "highly unspecific" factor that may contribute to gun violence, along with being young, white and male, or a history of violence, Swanson said.Instead of policies that restrict gun access based solely on mental illness diagnoses or because a person has made contact with the judicial system or health care agencies due to mental illness, the American Psychological Association, the National Alliance on Mental Illness and other advocacy groups have called for gun access criteria based on more subtle indicators of potentially dangerous behavior.Those indicators -- such as having past or pending violent misdemeanor convictions or charges, domestic violence restraining orders or multiple DUI convictions -- have been largely informed by the work of Swanson and others.Swanson supports intervention at the point of purchase through comprehensive background checks -- but to make background checks work, criteria for inclusion on the database should be based on other indicators of risk besides mental health history, such as those indicators of aggressive, impulsive or risky behavior."A history of violent behavior is a far better predictor of future violence than mental illness," he said.Calling gun violence a mental health issue is to scapegoat and stigmatize people with mental illness, he said."It's kind of a canard, a convenient explanation that exploits the tremendous fear people have with these horrifying mass shootings," he said. "If people fear those with mental illness they're going to treat them with scorn and support public policies that restrict their liberties."After all, mental illness affects millions of adults across the country.In 2015, there were an estimated 43.4 million adults in the United States with some form of mental illness within the past year, which represented 17.9% of adults nationwide, according to the National Institute of Mental Health.The American Psychological Association recommends prohibiting firearms for high-risk groups, such as domestic violence offenders or persons convicted of violent misdemeanor crimes."Reducing the incidence of gun violence will require interventions through multiple systems, including legal, public health, public safety, community, and health. Increasing the availability of data and funding will help inform and evaluate policies designed to reduce gun violence," according to the association's website.Swanson and his colleagues examined the proportion of people in the United States with impulsive angry behavior who own or carry guns and have a diagnosable mental illness in a paper published in the journal Behavioral Sciences & the Law in 2015.They conducted household surveys with 9,282 people from February 2001 to April 2003, excluding people who carried guns for work, resulting in a response rate of 70.9%.An analysis of the survey results estimated that nearly one in 10 adults has access to firearms and has a problem with anger and impulsive aggressive behavior.These people were more likely to be male, younger and married and to live in outlying areas around metropolitan centers rather than in central cities, Swanson and his colleagues wrote in their paper.They were significantly more likely to meet diagnostic criteria for a wide range of mental disorders, including depression, bipolar and anxiety disorders, PTSD, intermittent explosive disorder, pathological gambling, eating disorder, alcohol and illicit drug use disorders, and a range of personality disorders.What's more, despite evidence of "considerable psychopathology" in many of these respondents, only a very small proportion, 8% to 10%, were ever hospitalized for a mental health problem."Because only a small proportion of persons with this risky combination have ever been involuntarily hospitalized for a mental health problem, most will not be subject to existing mental health-related legal restrictions on firearms resulting from a history of involuntary commitment," Swanson and his colleagues wrote in the paper's abstract.As for Texas gunman Kelley, the state denied him a license to carry a gun, Gov. Greg Abbott said, citing the director of Texas' Department of Public Safety."So how was it that he was able to get a gun? By all the facts that we seem to know, he was not supposed to have access to a gun," Abbott told CNN's Chris Cuomo. "So how did this happen?"On Monday, Trump said his "thoughts and prayers" were with the victims and their families but did not suggest plans to take any legislative or other policy action to address the shooting. 7228

About 30,000 doses of an experimental coronavirus treatment are shipping out Tuesday.It's Regeneron's antibody cocktail that got an emergency use authorization (EUA) from the Food and Drug Administration (FDA) over the weekend. It’s also the same treatment President Donald Trump got last month.Patients who are diagnosed early with COVID-19 may be eligible. The goal is to keep them from getting sicker, so they don't have to go to the hospital.But the treatment still needs to be given through an IV.“The challenge is there has to be a place to administer it, so a place where you can have COVID patients in an infusion setting where they can be treated and monitored. This is not straight-forward,” said Dr. Helen Boucher, Chief of Geographic Medicine and Infectious Diseases at Tufts Medical Center.Any transfusion centers administering the IV will charge for those services.“The medicine itself is paid for by the government right now under the emergency use authorization. Those other charges have to be managed and they'll be managed by insurance, Medicare or Medicaid,” said Boucher.It's unclear if patients will need to request the treatment or if doctors will choose who to prescribe it to.In trying to get it to areas that need it most, the federal government will work with states on distribution. The problem is everywhere is seeing spikes right now.“We know that at least for 2020, the supply is going to be very low, so many of us in the infectious disease community and all the health care community are concerned that this resource will be allocated in an equitable way,” said Boucher.After this initial rollout, Regeneron says it expects to have 80,000 doses ready by the end of the month, 200,000 by the first week of January, and then 300,000 by the end of that month. 1796

All national forests in California will close Wednesday evening as the state sees “explosive growth of fires throughout” the state.The U.S. Forest Service closed eight national forests in Southern California Monday night, and the rapid growth Tuesday in windy weather conditions led to the decision to close the remaining ten forest areas.Nearly 2.3 million acres have burned already this year, setting a state record. Roughly two dozen wildfires are burning currently. “The number of large fires and extreme fire behavior we are seeing across the State is historic," said Regional Forester Randy Moore in a release. "These temporary closures are necessary to protect the public and our firefighters, and we will keep them in place until conditions improve and we are confident that National Forest visitors can recreate safely.”More than 140 people had to be rescued from the path of the Creek Fire this week, some were hikers and campers trapped without a way to escape the rapidly spreading flames. The Creek Fire is burning in part of the Sierra National Forest, which was closed to visitors on Monday.The Forest Service manages 18 National Forests in California, which take up almost 20 million acres. Those designated forests also supply 50 percent of the water in California. 1290

All hail the king."Black Panther," Marvel's first film directed by an African-American, brought in an estimated 2 million for its three-day debut in North America this weekend. That's the fifth biggest opening of all time.The opening for the film starring Chadwick Boseman and Michael B. Jordan did not just shatter expectations, it broke multiple box office records too.It blew away the record for the largest opening for an African-American director. That belonged to F. Gary Gray and "The Fate of the Furious," which opened to million last April.Disney estimates that the film will bring in 8 million domestically for the four-day holiday weekend. The film brought in an opening of 1 million around the world."Black Panther" also shattered the record for an opening in February, which belonged to "Deadpool," the R-rated superhero film from 20th Century Fox that brought in 2 million when it opened in 2016.It is the second biggest opening for a Marvel Studios film, behind 2012's "The Avengers." It out paced other huge hits like "Avengers: Age of Ultron," "Captain America: Civil War" and "Iron Man 3." It is the studio's 18th straight number one opening.The record-breaking weekend is watershed moment for Hollywood. With "Black Panther" reaching box office heights that have eluded other African-American titles, the film's totals could impact change in the industry by encouraging diversity in front of and behind the camera.The film is an "important milestone," according to comScore senior media analyst Paul Dergarabedian."'Black Panther' exceeded even the grandest box office expectations while simultaneously breaking down cinematic barriers and marking a turning point in the evolution of the genre," he said.The film garnered an "A+" CinemaScore from audiences and a?near perfect 97% score on review site Rotten Tomatoes, which makes it one of the best-reviewed superhero movies of all time. 1935

After losing her mother to COVID-19, a comedian has launched a mask-wearing crusade.Through a pixilated image on her iPad, Laurie Kilmartin strained her eyes desperately hoping to see her mother’s chest rise on the other end of their Facetime call, but after five minutes of silence, Laurie knew the coronavirus had won.Joanne Kilmartin died alone inside a California nursing home.After an hour of crying into her screen, Laurie and her sister told doctors it would be okay to end the call. They had spent the last 69 hours on FaceTime with their mom, knowing the end of her life was near.“Facetime makes this noise when it closes out and it closes out immediately, it doesn’t go to a corner and fade away. So, my mom just disappeared. There was this noise and she was pulled back into the universe,” Laurie said via a Zoom call from her home in California.Just weeks earlier, Joanne, 82, was enjoying her evening vodka martini at Laurie’s home where she’d been living. The 82-year-old had some underlying health issues but for the most part was doing okay, until one day when she started suffering from shortness of breath.Knowing what she knows now, Laurie says she likely would’ve never let her mom be checked into a short-term care facility after being discharged from a local emergency room.“It didn’t occur to me at all that this was still running through nursing homes like that,” she explained.When Joanne was checked into York Healthcare & Wellness Centre in Highland Park, California, not a single person had COVID-19. But just days later, dozens of patients had suddenly contracted the virus. After testing positive, Joanne’s condition quickly went downhill.“I couldn’t rescue her. Had I known what would happen, I would’ve gotten her a hotel room and hired a nurse,” Laurie lamented.By the time it became clear that Joanne wasn’t going to survive the virus, doctors set up an iPad in her room. Laurie and other family members would spend hours just watching their mom breath, offering words of comfort at any hint of movement. All of it done virtually in an attempt to keep the virus from spreading.COVID-19 has robbed families of the opportunity to grieve together in person.“My mom got the worst send off and at the end we were only voices that we hoped she could hear. It’s a terrible way to say goodbye to somebody, it doesn’t feel real,” Laurie said about her mom’s death.But Laurie has tried to find some purpose in her pain. As a professional comedian with a large online social media following, she decided to chronicle her mom’s final days of Twitter. It was an effort, she said, to educate the public about the true scope of the kind of suffering the virus causes. Laurie has even used her platform to criticize people who push back against mask-wearing policies.“To someone who doesn’t want to wear a mask, you’re incredibly selfish, you’re harming yourself. Even if you think, ‘Oh it’s just old people,’ do you want to lose an old person like this? Is this how you want your grandma or grandpa to go out? Is that fair?” she questioned.Having watched her mother take her final few breaths via a FaceTime call, Laurie is left to wonder why so many states are reopening as quickly as they have, even as COVID-19 cases continue to spike.“There’s over 100,000 stories like mine, and 100,000 families like mine that are shocked and numb, you could be me pretty soon.” 3397