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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

After running a year-long competition that drew interest from hundreds of cities and a number of states, Amazon has chosen New York City and Northern Virginia to split duty as its second headquarters.On Tuesday, Amazon announced it has chosen New York's Long Island City and Virginia's Arlington for HQ2.The development projects promise to bring the cities a giant infusion of high-paying jobs and tax revenue, but are almost certain to draw fire from critics concerned about their impact on infrastructure and property values.The search began in September 2017 when Seattle-based Amazon announced it would start accepting proposals for what quickly became known as HQ2.During the process, Amazon narrowed 238 bids to 20 finalists. The potential cities were Atlanta; Austin; Boston; Chicago; Columbus, Ohio; Dallas; Denver; Indianapolis; Los Angeles; Miami; Montgomery County, Maryland; Nashville; Newark; New York City; Northern Virginia; Philadelphia; Pittsburgh; Raleigh; Toronto and Washington, D.C. 1016

Amazon's search for the perfect home for its next headquarters could be leaning towards larger cities.Executives have visited some of the bigger names on the list of 20 finalists in recent months, according to a report in the Wall Street Journal. They dropped in on New York City, Miami, Chicago and Newark, while possibly ghosting smaller or more suburban ares like Raleigh, North Carolina, and Montgomery County, Maryland.Amazon may have decided that a city is necessary for luring the best employees."The key for Amazon is that they want to build a second HQ that is an attractive place to live and work for young professionals. This is why quality of life in the city will matter," said Nathan Jensen, a professor of government at the University of Texas at Austin.Other than both being finalists for HQ2, places like Miami and Montgomery County don't have much in common. Miami is a cosmopolitan city that draws business and tourists from around the world. Montgomery County, located outside of Washington D.C. is less well known and lacks some of the splashier attractions of a warm city perched on the beach.Not getting Amazon could be a mixed blessing for the less urban locations. Absorbing up to 50,000 new workers would be a major undertaking, notes Jensen. And many of those would be high-wage positions, which could recreate some of the issues with soaring housing costs, income inequality and gentrification seen in Amazon's home base, Seattle, as well as other regions with major tech companies.The issues wouldn't be insurmountable."Unlike an unplanned expansion of the workforce, cities do have the ability to plan for this. This has been one of my disappointments in not seeing most cities HQ2 proposals. This is exactly the time when we, as a community, can thinking solutions to these challenges," said Jensen.Amazon has searched for a home for its second headquarters — nicknamed HQ2 — for more than a year. The company has whipped up suspense around the decision. It has cities competing with glossy proposals and tax cuts and Amazon watchers are eagerly looking for clues, and odds-makers are aking bets.The new facility would create 50,000 jobs and cost billion to build. After the company received 238 proposals, it selected 20 finalists cities and metropolitan areas in January. Amazon has said it will announce the winning city by end of the year. 2405

Actor Will Smith, who became a household name after starring in “The Fresh Prince of Bel-Air,” shared photos from a cast reunion celebrating 30 years since the show launched.The actor posted, “Today is exactly 30 YEARS since The @FreshPrince of Bel-Air debuted! So we’re doin’ something for y’all… a for real Banks Family Reunion is comin’ soon to @HBOmax! RIP James. #FreshPrince30th” with a photo of the cast reunited. 428

According to the CDC, more than 30 states are reporting West Nile virus infections in people, birds or mosquitoes. Early symptoms of West Nile are similar to any virus or the common cold. These days, that means it's hard to differentiate from COVID-19.In Los Angeles, it's a big job to mitigate mosquitoes. The Greater LA County Vector Control District serves nearly 6 million people in 35 cities. So far this year, more than 230 mosquitoes have tested positive for West Nile.“Every year, our mosquito season seems to get longer and longer and that goes into it being warmer and warmer,” said Anais Medina Diaz, the public information officer for the LA County Vector Control District. “Now we’re seeing mosquito season go from March to the end of October, sometimes into the beginning of November.”Officials say there have been two West Nile deaths and more than 30 human cases in Los Angeles County. They've gotten creative in order to reach people, to inform them of the threat in their own backyard.They've done a TikTok dance video and Diaz said, “We’re looking at trends on social media to see what catches people’s attention.”One TikTok video Diaz’s organization released was a parody to one of Lady Gaga’s famous songs. That Lady Gaga remake even has the mosquito taking the lead.“There was a toss a brush makeup on TikTok and we did a toss the sponge little video and that’s because the Aedes mosquito, most people don’t know, but they lay their eggs around containers and the best way to get rid of those eggs is by scrubbing out the container,” Diaz said.California has had more than 90 human cases, more than 270 dead birds, and 2,300 mosquitoes sampled in 2020."Mosquitoes don’t respect city lines or district lines or county lines so we need to really think of it beyond geographic boundaries,” said Dr. Aiman Halai, an epidemiologist for the LA County Department of Public Health.Public health officials say this is where it becomes a problem that affects everyone everywhere. Dr. Halai specializes in infectious and vector borne diseases like West Nile.“The symptoms range from mild illness to severe illness,” Dr. Halai said. “Most of the cases we get are severe because that’s when the person will go to the hospital and get tested.”When we asked how to differentiate symptoms of West Nile versus that of COVID-19, Dr. Halai said, “Early on, it could resemble COVID-19 as well its non-specific so fever, body ache, tiredness that could occur with West Nile as well as COVID-19.”But the real difference, Dr. Halai says, is when symptoms become serious.“COVID-19 is primarily a respiratory virus,” Dr. Halai said. “It affects the breathing system which causes cough, shortness of breath, and in severe illness, a lung infection or pneumonia which is then very different from severe illness caused by West Nile virus.”She says severe symptoms of West Nile involve confusion, blurry vision, drowsiness, and limb weakness, as it affects the nervous system. Mild cases of West Nile often go undiagnosed, meaning there are far more cases than we know of. West Nile is not contagious; you can only get it from mosquitoes, which is another huge difference when compared to the coronavirus. But those at risk are in the same category.“It’s our elderly, people with underlying medical problems, hypertension, diabetes, chronic heart and lung conditions those are the people we need to protect and they’re the ones that should be prioritizing preventive action for both these viruses,” Dr. Halai said.For the coronavirus, that means wear a mask and socially distance. For West Nile, that means removing all standing water anywhere on your property, checking your window screens, and wearing bug spray.“Unfortunately, this is our new reality we have to wear repellent and use one that has an active ingredient recommended by the CDC and EPA which is Deet, Picaridin and oil of lemon eucalyptus,” Diaz said.As with the coronavirus, officials urge people to do their part. It's a community effort and everyone's job to keep mosquitoes in check. 4055