The senseless access to guns in this country has once again been brought into sharp focus by the latest shootings — of two Roanoke, Virginia news network personnel by former station employee, Vester Flanagan. Flanagan has been described in the press as “deranged,” “depraved,” and a “narcissist.” His family is yet (by press time) to come forward and shed any light on Flanagan’s mental health past. As far we know, Flanagan lived his life either undiagnosed and/or untreated, although employers had encouraged him to seek mental health support, which he had refused.

But the sensationalist adjectives deliberately ignore the more obvious explanation for Flanagan’s actions. His wild fluctuations between “the funny guy” and an intense persecution complex; the mood swings of charm and rage; and a delusional sense of self-importance, present themselves as textbook symptoms of severe, unmedicated bi-polar disorder (also known an manic depression.)

While many suffering from bi-polar disorder live full and productive lives with the help of lithium and other drugs, others have ended catastrophically. Virginia state senator, Creigh Deeds, spoke out eloquently after his bi-polar son Gus stabbed him, then killed himself. Although the elder Deeds never saw the violence coming, he had endeavored to get his son help, but “the system failed my son,” as Deeds described it. No psychiatric bed could be found in time for Gus, who was released from emergency custody with fatal consequences.

Vester Flanagan’s situation was profoundly different to Gus Deeds in two key areas. He was black. And he was gay. We do not know whether Flanagan, 41 at the time he died, suffered racial or homophobic discrimination. We can certainly assume, given the era in which he grew up, that he must have encountered it. While being black and gay are not relevant to Flanagan’s fatal actions, they may well have had a bearing on whether or not he sought or received the medical help he needed.

As a black, gay man, and one suffering already from a sense of persecution brought on by his mental illness, Flanagan may have been up against a hostile medical environment even if he had considered psychiatric help. And it is an environment which sadly persists today.

As both speakers and members of the audience at a recent LGBT health forum at George Washington University in Washington, DC repeatedly articulated, cultural competency is still far too often lacking in doctors‘ offices and at hospitals. Too many medical practitioners are ill-informed, do not know how to talk to or treat LGBT patients, and may even shun them altogether. Just take a look at some of the state Religious Freedom Restoration Acts which allow hospitals to turn away LGBT patients.

A high-profile example of this was the case of married lesbian couple, Krista and Jami Contreras of Michigan — who spoke at the recent unveiling of the Equality Act on Capitol Hill. When they turned up with their newborn daughter for her first pediatric visit, their handpicked doctor, Vesna Roi, had chosen not to treat their child.

Roi’s decision was based on so-called religious principles, but a general lack of cultural competency in dealing with lesbian or gay patients remains far too widespread. (The problem is even more acute for transgender patients as too few doctors have been trained in how to address them, let alone treat their unique medical needs.)

Audience members at the GWU health forum emphasized how much more comfortable they felt with a doctor “who looks like me” or who was also gay or even trans. But a black, gay doctor, is, even today, unlikely to advertise himself in this way, making him hard for the Flanagans of the world to find.

We may never know how early Flanagan’s symptoms began to manifest or whether he or anyone around him recognized his crying need for treatment. According to a cousin, Guynell Flanagan, who talked to reporters at the British newspaper, The Daily Mail, “when I knew him as a child he wasn’t like that.” She also insisted that Flanagan’s sexuality was well known to his family and not a problem with them. “The whole family knew he was gay. We accepted him,” she told the Mail. “He’s not the only one in the family who’s gay and personally I couldn’t care less.”

Doctors who might not “care less” about their gay patients need to be trained from the outset, insists Naseema Shafi, deputy executive director at Whitman-Walker Health, a Washington DC community health center specializing in HIV/AIDS care and lesbian, gay, bisexual and transgender care. The center conducts its own cultural competency training but, Shafi says, “medical schools have a responsibility” to train their graduates who must also “be open to hearing from patients.”

Flanagan may not have been heard. Or he may never have asked. And the answer to these questions, if they come at all, will come too late for his victims. But it’s important to recognize that our health system continues to underserve minorities, whether racial or sexual. And, according to Dr. Ilan Meyer, the problem is systemic.

“We need to be concerned about quality health care beyond LGBT,” said Meyer during the GWU forum. Meyer is an American psychiatric epidemiologist, author, professor, and a senior scholar for public policy and sexual orientation law at the Williams Institute of UCLA.

“It is not even just about providers who don’t know about LGBT health or attitudes,” Meyer continued. “It’s about the structures for patient-doctor intervention. It’s about the ability of providers to spend time with their patients. They spend just three minutes with a patient and the problem starts right there. It’s a bigger problem and a larger debate that is not LGBT specific.”

Thanks to the idiotic stranglehold on Capitol Hill by the gun lobby, there will be more shootings by more Vester Flanagans. But there will also be more black, gay patients with nowhere to go, the ones without the guns, and without the headlines. They will not commit atrocities. They will simply suffer neglect, stigma and, in many cases, economic depravation that will exclude the option of psychiatric help.

As Mara Kiesling, founding executive director of DC’s National Center for Transgender Equality, put it so succinctly during her remarks at GWU: “We need to do more better, faster and now.”

Photo Credit: Breitbart.com