In the ongoing debate about how to stop mass shootings like Columbine, Virginia Tech, and now Sandy Hook Elementary, there are two issues that are being largely ignored in favor of blaming the gun; the state of the mental health care system and the effects that violent media have on those with mental or emotional problems.

This isn't an unusual response to tragedies, according to Lisa Bahar, a licensed marriage and family therapist and licensed professional clinical counselor practicing in Dana Point, CA. She said, "A gun is a gun, how we use the gun and the intention behind having the gun is a deeper question."

Bahar went on to say that how the gun makes a person feel and what it represents are more important:

"These questions are deeper questions of how a mechanism creates an experience and how that experience is shared. The ignorance or lack of awareness is by not talking about these things, which has the potential to create insight and the test of insight in many cases is behavior change and decreasing the potential for an intense reaction emotionally with an available and known mechanism such as a gun."

"Mental health considerations are important." She added.

In the 1960s, with the advent of many of the staple psychiatric drugs that are still in use today, a program of de-institutionalization began, which closed many psychiatric hospitals in favor of community based care options. What resulted was the downward spiral into the cannibalized system we have today, where un-qualified nurses or assistants are diagnosing serious mental illness and "regular monitoring" consists of 15-minute medication checks every few months.

According to Dr. David Reiss, M.D., a psychiatrist who spent time assisting in Newtown after the Sandy Hook shooting, the mental health care system needs some improvement. He said that what is needed is "improved identification of the severely mentally ill within the population, improved monitoring by mental health professionals and improved, humane, safe environmental containment of the severely mentally ill."

Dr. Reiss also said that parents need to be more responsible when it comes to the media that their children and teens are allowed to see.

He isn't alone in this sentiment. In fact, there is a mountain of evidence that suggests that exposure to violent media in the form of television, movies, and video games can have a profound impact on children, teens, and young adults who have mental or emotional  problems.

According to Dr. Holly Parker, a psychology department faculty member at Harvard University, multiple studies suggest that violent media can have a desensitizing effect on people and that this effect can be seen in violent or delinquent behavior two years later.

Some studies went so far as to find that those who already have social, mental, or emotional problems are more prone to act out violently and that boys are more likely to experience aggression after playing violent video games. This could explain why nearly everyone who has gone on a shooting rampage since 1996, such as was seen at Sandy Hook, has been male. In addition, nearly all were obsessed with violent media as well as having exhibited violence previously.

"When a child is playing a video game where shooting, killing, and violence wins the prize, the player associates positive feelings with violence which thus becomes associated with pleasure." says psychotherapist Edie Raether.

She continued, saying that the "Dark Knight killer" reported feeling like he was in a video game when he killed twelve people in Aurora, CO. For those with mental or emotional problems, this can lead to disaster.

Dr. Parker pointed out that, currently, it is nearly impossible to know when or if a mentally unstable person will become violent and that in most cases they are not:

"Scientific evidence shows that only a very small number of people with mental illness ever go on to commit violence. If anything, people with mental illness are more likely to be victims rather than perpetrators of violence."

She said that mental illness or violent media alone will not cause someone to become violent:

"There are likely going to be multiple factors that come together and lead to mass violence, like a perfect storm."

Dr. Reiss agrees with Dr. Parker. He said that a mentally stable person isn't going to be enticed to gun violence. However, the mentally unstable could be, especially when combined with constant exposure to violent media.

In some cases, Dr. Reiss argues that the constant news coverage of natural disasters or previous tragedies, such as the Sandy Hook shooting, could do the trick as well.

Since violence by the mentally or emotionally unstable is difficult to predict, those who are seriously mentally ill have been prohibited by federal law from owning a firearm since 1968.

Currently, there is a database in place, linked to the national background check system used for firearms purchases, that catalogs those who have been adjudicated as mentally ill and therefore not legally allowed to own a gun.

The system had been in place on a voluntary basis for years, but after the 2007 Virginia Tech shooting, legislation was passed that required states to submit their records. The problem is that states are running into a number of problems in doing so. As a result, the database doesn't contain enough records to make it effective.

So what can be done to stop the violence? That depends upon who you ask. Gun control advocates say that stricter controls, or banning guns altogether is the answer, but statistics don't bear this out. In fact, the opposite seems to be true. However, the mental health experts interviewed did have some ideas.

When informed of the existing mental health database, all of the mental health experts interviewed agreed that this system needs to be strengthened, which is something that even gun rights advocates can get behind.

In addition, experts agree that the mental health care system needs work. Some ideas included better information for the community at large about mental illness, less obstacles to obtaining care, and more research to better determine who could become violent in the future.

Dr. Reiss said that rating systems can act as a guide when it comes to violent media. He acknowledges that society will never be able to purge all forms of violent media, but that better education on the negative effects and limits for children, teens and young adults, especially those with mental or emotional problems, would go a long way.

Ultimately, he believes that everyone, from parents to video game companies must accept responsibility for this.

Raether sums it up like this: "We must not address this problem with an either/or action plan, but accept that it is a complex problem requiring a multitude of changes where rights and responsibility go hand in hand. "