When a lone gunman opened fire on an elementary school in Newtown, Conn., in 2012, we immediately searched for a reason. What could make a person commit such a heinous act? As often happens after a mass shooting in America—typically defined as a crime in which four or more people are shot at one event—the discussion turned almost immediately to mental illness. To some extent this makes sense; what else but some type of mental problem could drive a person to massacre children? And it’s true that many of the mass shootings that occurred in the US over the last several years, including the Newtown shooting, were committed by assailants who had a history of mental illness. Improve mental health care, the argument goes—or even just keep mentally ill people away from guns—and our country’s epidemic of gun violence will decline.
But there’s a big problem with blaming this country’s epidemic of gun violence on mental illness: The evidence overwhelmingly doesn’t support it.
Gun violence by the numbers
On average, an estimated 32,514 people die from gun violence in the United States each year and an additional 75,962 people are injured by firearms. Between 2007 and 2011, an average of 62 children under age 14 were killed every single day. There are over 17,000 children (age infant to 19) who are shot by firearms per year, whether intentionally, accidentally, or otherwise. In fact, American children are “sixteen times more like likely to be killed in unintentional shootings than their peers in other high income countries.” And gun-related deaths are expected to exceed automobile-related deaths in 2015. To put a point on it, 89 people die in America every day from gun violence. Want an even crazier statistic? In 2015, on average, a toddler in America shot someone once a week.
Mental illness and gun violence
There is little evidence to support the idea that individuals diagnosed with a mental illness are any more likely to commit a crime of gun violence than anyone else. According to the National Center for Health Statistics, fewer than 5 percent of the 120,000 gun-related killings in the U.S. between 2001-2010 were carried out by individuals diagnosed with a mental illness. And the fact that one person with a mental illness committed a mass shooting does not make that person representative of others with that type of mental illness. Many common mental health diagnoses—including anxiety, depression, and attention deficit disorder—have no correlation with violent behavior at all.
Nonetheless, some states have moved to limit or ban access to firearms for people diagnosed with certain mental illnesses. But there is little evidence that this will have much impact on firearm violence as a whole. In fact, even in the case of mass shootings—which, by the way, account for only a small percentage of gun-related deaths and injuries in the U.S.—statisticians and researchers have been unable to really establish whether mental illness can be blamed as the cause, nor whether it can be predictive of future mass shootings. Yet limiting the conversation about gun violence to the small subset of people who are mentally ill seems to be more politically and socially acceptable than discussing the issue of gun control more broadly.
What does predict gun violence?
Mental illness may not be a good predictor of gun violence, but there are many other factors that we know increase the risk of firearm death and injury. For one thing, we know that guns and drugs do not mix. Alcohol and substance abuse “increase the risk of violent crime by as much as 7-fold, even among persons with no history of mental illness,” according to an extensive review article in the American Journal of Public Health.In fact, the incidence of gun violence for a person diagnosed with severe mental illness increased significantly only when that individual was also suffering from substance abuse or chemical dependence. This is particularly disturbing when you consider the recent move in some states, including South Carolina and Ohio, to allow concealed weapons in bars and restaurants serving alcohol.
Access to weapons is another known predictor of gun violence. For instance, having a gun in the home is statistically associated with an increased risk of firearm homicide and suicide in that home. In addition, states with lax gun control laws and higher rates of gun ownership have “disproportionately high numbers of deaths from firearm-related homicides,” according to the AJPH review. Domestic abuse plays an important role in gun violence as well. In a study looking at femicide (female homicide deaths) in the U.S., access to firearms was strongly associated with the death of a woman by her abusive partner. Other research has found that the presence of a gun in a domestic violence situation increases the risk that a woman will be murdered by 500 percent.
Stemming the tide of gun violence
Mental illness alone cannot bear the blame for the high rate of gun violence in the United States. Not only is there a lack of evidence linking the two, but the focus on mental illness only serves to heighten the stigma surrounding mental health problems, while doing nothing to limit the overall availability of guns. For this reason, public health or political policies that aim to tackle gun violence simply by looking at the mental health system will fail. Rather, there needs to be a comprehensive approach that includes commonsense gun control. For instance, universal background checks—which are currently required for all gun purchases in only eight states—would help keep guns out of the hands of domestic abusers or felons. In fact, a recent study published in Epidemiologic Reviewsthat examined 130 other studies of gun violence in 10 different countries found compelling evidence that background checks and safe storage requirements (such as child safety locks, loader indicators, and storing firearms unloaded)are associated with lower rates of domestic abuse fatalities and accidental deaths in children.
Bottom line: The typical toddler that accidentally gains access to an unlocked firearm and kills himself or his family member is not suffering from a mental health problem. Rather, he is suffering from growing up in culture that often seems to be more interested in protecting access to guns than in the safety of our kids and families. The fact is that most of the gun violence in America has very little to do with mental illness, and mental illness is not a good predictor of gun violence. While mental illness is an important public health concern, attempting to curb the rising tide of gun violence in the United States requires being brave enough as a country to place the blame elsewhere.
Also see The Shot No Child Should Get.