Why We Shouldn’t Blame Gun Violence on Mental Illness

Why We Shouldn’t Blame Gun Violence on Mental Illness

Experts weigh in on the factors really at play.

Every time another mass violence incident occurs in the US, we point fingers and blame it on mental illness. This blame is misdirected and oversimplifies the problem.

According to Art Caplan, PhD, director of Medical Ethics at NYU School of Medicine in New York City, people with mental illness are not likely to harm others using firearms. “There are lots of people with mental illnesses. Many are not in any way violent. Some are afraid to come out of the house. Others are so dysfunctional it’s impossible for them to hurt anyone,” he says. “That said, whenever mass violence takes place, we immediately pronounce the person who did it as mentally ill, with or without a psychiatric diagnosis.”

The best available research suggests that, in the US, about 4 percent of all firearm violence directed at other people is caused by mental illness, says Beth McGinty, PhD, assistant professor at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland. (This figure stands in stark contrast to available numbers for violence directed toward oneself, as some 60 percent of all firearm deaths are suicides.)

Someone who is experiencing an acute psychotic episode as part of schizophrenia, for example, may feel threatened by unknown entities and these symptoms may lead them to be violent towards others, says Dr. McGinty. However, she says, this is rare. “Most people with these types of disorders are never violent towards other people.”

Why we scapegoat mental illness
Mental illness is easy to blame, says Dr. Caplan, because most of us think, “Well, you’d have to be crazy to go in and shoot up a school or shoot up a church."

Caplan says blaming gun violence on mental illness doesn’t hold people accountable for what they do. “If you’re just a hate-filled bigot, you may not be mentally ill and you may kill people because of your hatred, not because of an illness.” Furthermore, committing a violent crime involves a certain level of planning and coordination. “You need to have enough coherence to follow through on what’s often a fairly complicated plan,” he says. Some people with serious mental illness, such as schizophrenia or psychosis, may not have that capacity.

“It’s very reasonable and true to say that anyone who conducts a mass shooting or other type of violence directed at another person is not mentally well,” says McGinty. “We would not describe them as someone who has good mental health. Does that mean they have a mental illness that can be treated in the mental health treatment system? Not necessarily. They could have high levels of stress, have a lot of anger or have impulsivity issues that contribute to mental unwellness that are not necessarily meeting the definition for mental illness.”

If it’s not mental illness, then what is it?
“The answer is, it’s a whole bunch of things,” McGinty says. “It’s not usually a single risk factor.” Other risk factors, such as alcohol abuse, are strongly associated with interpersonal firearm violence. In fact, alcohol and certain drug use may raise the risk of violent crime by as much as seven times, according to one Swedish study. Involvement in illegal drug markets is also a significant risk factor. Being male and having a history of childhood abuse predicts violence, as well.

There are other upstream socioeconomic risk factors as well, McGinty says, such as poverty, lack of employment, few educational opportunities and stressful life situations. “Anger and impulsivity are also personality traits very strongly associated with an increased risk of gun violence,” she says. "We usually see multiple risk factors all interacting with one another in perpetrators."

How to address gun violence
Caplan and McGinty say that improving the mental health system would help millions of people and is the right thing to do. However, McGinty says, even if we had a perfect mental health system, and everyone who needed help received it, it would only reduce interpersonal gun violence in the US by about 4 percent. “It’s not an effective solution to the firearm problem.”

One option, McGinty says, is to enact policies that restrict firearm access to people who exhibit dangerous behavior, such as making violent physical or emotional threats. In fact, California, Washington and Oregon already have Gun Violence Restraining Orders (also called Extreme Risk Protective Orders) and several other states are currently considering them. Family members, intimate partners or law enforcement can petition civil courts to temporarily restrict firearm purchases—or remove firearms from someone's possession—based on concern the person will harm himself or others.

These laws are new so we don’t know yet if they’re effective. However, McGinty says they’re promising and they don’t wait for something bad to happen. You can learn more about where your state stands on these laws at the Giffords Law Center to Prevent Gun Violence.

Another approach is to keep people with a history of domestic violence from access to guns. According to Everytown for Gun Safety, approximately 50 women in the US are killed every month by a male intimate partner with a gun. In fact, Everytown reports most mass shootings actually occur at home, and involve family members.

McGinty says although assault weapons are disproportionately used in mass shootings, the vast majority of firearm violence occurs with handguns. “To have really meaningful reduced rates of overall gun violence in the US, policies need to limit handgun possession among people at high risk of violence.”

How to get help for a mental illness
Though most people with a mental illness will never become violent, it's important to seek help if you or someone you love is dealing with one. Speak with your doctor or a mental health professional, who can help with a diagnosis and begin treatment. For more information and support, visit the National Alliance on Mental Illness online, call their helpline at 800-950-6264, or, if it's a crisis situation, text NAMI to 741741. The National Suicide Prevention Lifeline can help, as well, whether or not you're having thoughts of suicide. Call 800-273-TALK (8255) any time to talk to a counselor.

Medically reviewed in May 2018.

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