OK, What About Mental Health?
Terry H. Schwadron
May 31, 2022
It’s unlikely, but just possible that this time enough Republican senators will relent to public pressure to coalesce around a bill that inches towards controlling guns.
Obviously, we all recognize that there is substantial pressure building around age limits for legal assault-style gun purchase and ownership or a training requirement or a slight push in background checks. Senate Minority Leader Mitch McConnell has directed Sen. John Cornyn (R-Texas) to talk to Democrats Chris Murphy of Connecticut and Kyrsten Sinema of Arizona about some sliver of bipartisan agreement.
We all recognize that whatever might result politicly will be so tiny as to have little practical impact on school safety other than to provide Republicans cover to say they did something about gun violence even though their heart was not in it.
Whatever it is should happen quickly, however, since studies by writers for fivethirtyeight.com show these urges to fix something rising after mass shootings tend to fade as soon as media coverage turns to new events.
Instead, Republicans across the board point to mental health lapses as more important than the availability of guns. But outside of so-called “red flag” laws, which seem to be spotty at best among states and full of practical holes towards identifying specific individuals who should not be allowed to buy guns, there seems little concerted effort in Congress to expand access to mental health.
Generally, the same Republicans who oppose any efforts towards gun safety or perceived restriction on gun ownership also oppose federal spending on expanding health access overall.
What Do Mental Health Officials Say?
So, what exactly would opponents of rethinking gun policies do about mental health, other than magically assuming that the cases of specific individuals — by pattern lonely, aggrieved, anti-social young men — will be identified before the next mass shooting by a teacher, a parent, a friend or actual mental health professional.
The Educational Fund to Stop Gun Violence reminds us that about one in five Americans have a diagnosed mental illness each year, as do citizens of other countries without gun violence. The gun homicide rate in the U.S. is nearly 25 times higher than other high-income countries and the firearm suicide rate is nearly 10 times that of other high-income countries. Overall rates of gun deaths are 11.4 times higher in the U.S. as compared to other high-income countries, a recent study says.
These are mental health advocates telling us that we should be cautious about any argument asserting that mental illness is a cause of gun violence. Indeed, research consistently shows that most people living with mental illness, including those with serious mental illness, are not violent towards others, they say. In fact, people with mental illness are more likely to be victims of interpersonal violence than perpetrators.
Even among the subset of those with serious illness, estimated at 4%, there are times of elevated risk of violence. Past violence behavior is seen as the best way to measure pending dangers.
The way we talk about gun violence — and the laws that we support — should be based on facts, not falsehoods. To be effective, we must focus on dangerous behavior — not genetics and not diagnoses,” the group says. ”Focusing on mental illness as the cause of gun violence stigmatizes millions of Americans and does not actually address the root cause of the gun violence problem — easy access to guns.”
Look for Violent Acts
The Rand Institute reviewed studies linking gun violence and mental illness in 2018, though its focus was more on suicide than mass shootings. The basic message is that in many such studies, “it is not clear whether these associations are attributable to a causal effect of access to mental health care” or other factors, like proximity to care. Even when mental health care is available, there are numerous reasons why individuals might not access services, the study noted.
Again, they suggest caution in believing that government support for more mental health services will necessarily result in fewer instances of violence.
Hate is not a mental illness, argued an article in Psychology Today. It outlined a certain bias in post-shooting discussion about race and mental illness.
Gun violence is seen as an urgent, complex and multifaceted problem requiring more than slogans about either guns or mental health. In 2013, the American Psychological Association commissioned a report towards reducing the incidence of gun violence — whether by homicide, suicide, or mass shootings — nationwide.
The problem they note is that mental illness necessarily must be focused on individuals. Effective prevention of violence occurs along a continuum that begins in early childhood with programs to help parents raise emotionally healthy children and ends with efforts to identify and intervene with troubled individuals who are threatening violence, the association said.
From a public policy viewpoint, mental health professionals say we need to focus on gun violence prevention based on evidenced risk of violence rather than on mental illness. They advise against gun removal laws, like extreme risk protection orders, based on mental health diagnoses, and more on personal history of violent behavior, domestic violence, and risky alcohol use.
It makes more sense from this point of view to insist that guns be held in safe storage, for example, than denied because of red-flag laws. Gun prohibitions thus make more sense for those in high-risk groups — domestic violence offenders, persons convicted of violent misdemeanor crimes, and individuals with mental illness who have been adjudicated as being a threat to themselves or to others. Of course, to determine this, you need more comprehensive background checks and more study of gun violence, both targets of congressional inaction.
None of this is new. But I don’t hear any of this in any congressional action under discussion.
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