Mass shootings keep happening. Mental illness is the easy answer but not the cause. Almost monthly we read about horrific shootings in Las Vegas, Orlando, or small towns in Texas and California. The subsequent finger pointing continues as to why these shocking killings keep occurring. Whether you are for additional gun control laws or against, we clearly need to have a reasoned discussion about the root causes of these shootings. These discussions need to be predicated on one fact: we must not equate these shootings with mental illness. It is too facile to claim as did the President that “mental health is your problem here,” or that “Guns don’t kill people—the mentally ill do,” as did Ann Coulter. These statements are inaccurate and fail to recognize how complicated and nuanced the intersection between gun violence and mental illness is, because data show that the nexus is actually quite small.
Although the image of a lone psychopathic mass shooter is an easy narrative to adapt to understand gun violence, the reality is that persons with mental illness are far more likely to be the victims of violence than the perpetrators. According to the Department of Health and Human Services, persons with severe mental illness are 10 times more likely to be the victims of violent crime than the general population. For instance, people with schizophrenia are 14 times more likely to be victims of violent crime than they are to be the perpetrator. Convenient as it is blame the violence on mental illness, doing so risks further stigmatization of mental illness and subsequent failure for persons who need mental health care to seek treatment.
The number of deaths in our country from gun violence is staggering. The Annals of Epidemiology estimated that 32,000 persons die from gun violence in our country annually; an additional 74,000 persons are injured. Approximately 62 children under the age of 14 years are killed daily in our country; a University of California-Berkeley study reports that another 17,000 children (from birth to age 19) are injured. Yet, the vast majorities of these deaths are not related to mass shootings, which are defined by the FBI as shootings in which four or more persons are killed. According to Every Town for Gun Safety, less that 1% of firearm fatalities reported to the FBI in 2012 were related to a mass shooting.
Under a Federal law from the 1960s written when mass institutionalization for persons with mental illness was common, those persons who have been involuntarily committed due to mental health issues are prohibited from buying a gun. The names of these persons must subsequently be submitted to the National Instant Criminal Background Check System, which would cause them to fail a background check. But there is a fallacy with this protocol. Believing that all mass shooters are mentally ill loners is convenient, but these individuals are not necessarily being identified before a shooting. As noted by Dr. Jeffrey Swanson, a researcher from Duke University who studies mental illness and gun violence, “although no one would argue that they were not deeply psychologically disturbed, the fact is that killers including Jared Loughner, James Holmes, Aaron Alexis and Elliot Rodger had never been involuntarily committed for their mental health issues and thus could legally purchase firearms.” The reality is that less than 5% of the 120,000 gun-related killings in our country between 2001-2010 were committed by someone diagnosed with a mental illness, according to the National Center for Health Statistics.
According to Dr. Swanson, a history of violent behavior is a far better predictor of future violence than mental illness. Dr. Swanson and his group surveyed 9,282 people from February 2001 to April 2003 to determine the proportion of people with impulsive angry behavior who own or carry guns. They determined that one in 10 adults with access to guns has anger or impulsive behavior issues. These respondents were likely to meet diagnostic criteria for a host of mental disorders, including depression, PTSD, intermittent explosive disorders, and a range of personality disorders in addition to possessing histories of domestic violence and drug or alcohol abuse. Yet, only 8 to 10% of these persons were ever involuntarily hospitalized for a mental health problem. Thus, these persons were never placed on criminal background check records leaving them free to own and carry weapons.
There is one area where there is a strong linkage between death and gun violence, and that is suicide. Persons with mental illness are far more likely to harm themselves than others, and roughly half of gun fatalities are the result of suicide. According to Dr. Swanson, “If you want to back out all the risk associated with mental illness that’s contributing to the 300,000 people killed by gunshot wounds in the last ten years, you could probably reduce deaths by about 100,000 people. Ninety five percent of that reduction would be from suicide. Only 5% would be from reducing homicide.” Thus it is imperative that we ensure that those persons with diagnosed mental illness, especially with depression, receive treatment.
We need to ensure that persons with mental illness receive appropriate medical health, but in so doing, we are not going to significantly reduce mass shootings. Gun-related shootings are increasingly problematic in our country and the political polarization of how to respond to them is exponentially rising. But in our discussion, we must ensure that any policies that are developed must be based on sound epidemiological principals as per Dr. Swanson. “Fixing mental health,” in and of itself a desirable goal, but it will not in turn “fix” gun violence. We need to develop better policies focusing on those individuals most at risk of committing violence. By focusing solely on mental illness as the cause, we risk further stigmatizing those in our society with mental disorders and possibly precluding them from receiving help.
