Yet another senseless massacre. Enough!

In just the past five years 138 people have been murdered in mass shootings. Orlando brings the total to 188. On January 8, 2011,  Jared Lee Loughner shot Arizona Congresswoman Gabrielle Giffords and killed five others in a Tucson supermarket parking lot. Seventeen such shootings have taken place since that high profile tragedy, including the slaughter of 27 in Newtown, CT, among them many children. There were five massacres last year alone; 40 innocent lives were lost to gunmen.

As we speculate about the motive of the Orlando shooter, I submit to you that there wasn't one. Omar Mateen of Afghan descent targeted a gay nightclub filled with Hispanics. Religious extremism? Homophobia? Racism? Eenie, meenie, minie, moe. In 2015, two white supremecists, one right-to-lifer, one U.S. soldier and an apparent jihadist couple took up arms against innocent people.

The common denominators are the deadly combination of undiagnosed, misdiagnosed and untreated mental illness, and the insanely easy access to military-style assault rifles in the U.S., exacerbated by the escalating hate talk, bigotry, and extremism that is permeating and poisoning our culture.

According to the DSM (Diagnostic and Statistical Manual), the diagnosis of mental illnesses still relies primarily on behavior. Although the mentally ill are far more often the victims of violence than the perpetrators, sometimes the behavior that definitvely determines a mental illness is seemingly senseless slaughter. That's too late.

What if there were objective tests - blood tests, urine tests, brain chemical precursor tests, EEGs, CAT scans, MRIs - that could objetively diagnose a form of schizophrenia or one of the depressions? Surprise. There are. Ill, Not Insane: The Physiological Bases of Mental Illness lists more than 100 such tests. It was published in 1986. That's right - 30 years ago. I remember this well. I co-authored this book and became a passionate spokesperson for a medical model of mental illness. Although we now recognize chronic mental illnesses as physiological in nature and not the result of "something your mother did to you when you were three," representing great strides in our perception of mental illness, we have stopped far short of adopting a fully medical model of mental illness.

The brain, an organ like the heart or the liver, must be working properly for what we call the mind to function properly. Many things can cause the brain to malfunction, causing psychotic behavior. The physiological cause(s) of the brain malfunction must be determined before medications and treatments which address those causes can be prescribed, if available. Because these tests are objective and do not rely on subjective, behavior-based diagnoses, they could and should also be used as an important part of background checks for those seeking to purchase firearms. 

Background checks. Universal, strict, thorough and extensive background checks are essential. If you are not considered a good risk to board a plane, you cannot safely own a gun. If your brain is objectively shown to not be functioning well enough for your mind to make rational decisions, you cannot safely own a gun. In fact, if you do not have a legitimate reason to own an assault rifle, you should not own a military-style weapon. You are not an organized militia, per the 2nd Amendment, and we are no longer talking about muskets. Prove the need before permitting the purchase.

And how about the background checks used by security firms before arming their employees? Orlando shooter Omar Mateen passed not one but two screenings used by G4S Secure Solutions over more than a decade, despite incidents of domestic violence and indications of extremism. Note: G4S Secure Solutions is the company just hired by the City of Buffalo to ramp up security in Buffalo City Hall.

Finally, we must put an end to the vulgar, hate speech. A civil society does not brook this. Speak up against the hateful rants on social media, say no to the unfettered bigotry and hate that permeates even the current presidential campaign. This vile speech tears down the societal barriers to violence and gives permission to hate and kill.

We must stop mourning the dead and address the three explosive common denominators that are making massacres the new normal in America: the proliferation of assault rifles and lack of effective background checks, the lack of an objective, medical model of mental illness, and the breakdown of our civil society.  

Now, before any more innocent souls die.