“This is a political choice that we make, to allow this to happen every few months in America.” —President Barak Obama, October 1, 2015
Jonathan M. Metzl and Kenneth T. MacLeish published “Mental Illness, Mass Shootings, and the Politics of American Firearms” in the 105th volume of the American Journal of Public Health, February 2015.
Why the study? Political responses to mass shootings in the U.S. tend to focus on the causal relationship between mental health and gun violence. Some recent responses have gone as far as to require mental health professionals to report “dangerous patients” so that authorities can confiscate their firearms. Even though the authors agree that mental illness was a factor in many mass shootings and that addressing it is important, their research aims to challenge the oversimplification of claims about gun violence that frame the discussion so that the problem of everyday gun violence in the U.S. is obscured.
Results of the study? The authors point to 4 assumptions that underlie political responses to gun violence as they relate to mental health: (1) mental illness causes gun violence, (2) a psychiatric diagnosis can predict gun crime, (3) the unhinged acts of mentally ill loners cause shootings, and (4) gun regulation will not stop mass shootings. Even though each of these claims could be true in a particular case, the research as a whole (1970-2014) shows that
- Oversimplification creates stereotypes in the vast, diverse population of persons with mental illness
- How mental illness is understood after mass shootings highlights broader cultural issues and anxieties (like race and class)
- Those broader issues are obscured when the mentally ill are scapegoated
- Mass shootings tend to inaccurately represent all gun crime
- “Mental illness” inaccurately represents a violent threat rather than a medical designation.
Quick summary? The study consists of a review and analysis of over 40 years of research in psychiatry, psychology, public health, and sociology related to gun violence and mental health. The review and analysis also included the authors’ own primary source historical research on race/ethnicity, violence, mental illness, and US gun culture. Framing the discussion about gun violence as a mental illness issue distracts attention away from “community-level everyday violence and the widespread symptoms produced by living in an environment engulfed by fear of guns and shootings.” The inherent promise that mental health professionals can solve gun violence also places the responsibility for prevention squarely on their backs. Ultimately, the argument that gun control won’t stop another mass shooting mistakenly assumes that that is the goal of gun control policies.
- Everyday violence disproportionately affects lower-income areas and communities of color and causes widespread anxiety disorders and traumatic stress symptoms
- Little specific evidence supports the assumption that people with mental illness are more likely than anyone else to commit gun crimes.
- Mass shootings occur too infrequently to create statistical models for predictability, which are the core of effective public policy interventions.
- Only about 4% of violence in the U.S. can be attributed to people who are diagnosed as mentally ill
- The risk that individuals diagnosed with serious mental illness will be assaulted is exponentially greater than the risk they will do the assaulting.
- Childhood abuse, binge drinking, and self-identifying as male are all much more predictive risk factors for serious violence than mental illness
- Higher household firearms ownership correlates directly with rates of homocide
- In 2005, after Florida passed the “stand your ground” law, interpersonal conflicts that resulted in fatal shootings jumped by 200% .
- The 21,175 suicides each year in the U.S. correlates with the high availability of guns
- “Psychiatrists using clinical judgement are not much better than chance at predicting which individual patients will do something violent and which will not.”
- With this knowledge, news consumers can be more critical of causal oversimplifications about gun violence
- With this knowledge, advocates can present more sophisticated arguments for or against gun regulation
- With this knowledge, journalists can offer context-rich accounts of gun violence and its potential causes
Jonathan M. Metzl, M.D., Ph.D. is with the Center for Medicine, Health, and Society and the Departments of Sociology and Psychiatry at Vanderbilt University, Nashville, TN. Kenneth T. MacLeish, Ph.D. is with the Center for Medicine, Health, and Society and the Department of Anthropology at Vanderbilt University. Correspondence should be sent to Jonathan M. Metzl, Director, Vanderbilt Center for Medicine, Health, and Society, 2301 Vanderbilt Place, Nashville, TN 37235 (e-mail: firstname.lastname@example.org).