Don’t blame mental health for shootings

GOP pivots towards mental health, video games and rates of interpersonal gun violence in urban centers like Chicago in the wake of mass carnage are both disingenuous and tiring. They show a complete lack of understanding about gun violence in America and an even greater lack of conviction in addressing it.

Violence prevention, as a field of research, policy and programming is broken into broad categories that help frame and guide prevention approaches. These categories include: interpersonal violence, self-directed violence or suicide, elder abuse, gender-based violence (often called “violence against women” in the U.S.), violence against children, youth violence, and collective violence (or war). These categories can be further subdivided into more specific forms such as gang violence, intimate-partner violence (domestic violence), child sexual abuse, etc. Although there is some overlap across forms, the risk factors — the pathways toward each form of violence — are different. And, as you might surmise, the approaches to prevention for each are likewise different.

“Gun violence” is actually at least four different categories of violence: interpersonal violence (the gun violence we see in urban centers), self-directed violence or suicide, intimate-partner violence, and mass violence. To be sure, there are general gun violence prevention measures that would yield results across categories, but each form of gun violence will require tailored, multi-pronged policy and programming to address the unique risk factors involved.

Capitulating on one form by practicing “whataboutism” in regard to another (say by talking about interpersonal gun violence in Chicago after a mass shooting in El Paso or Dayton), does little to offer meaningful solutions to either problem, and focusing on any one “cause” or solution will not be effective. For instance, when mental health is discussed by politicians as both the root cause and potential cure-all for gun violence — especially in the context of mass violence — it should signal to every American that these politicians needs better policy advisers.

In terms of policy approaches to gun violence prevention, “mental health” typically means restricting access to firearms among those with a diagnosed mental health condition or increasing access to health care — the latter of which is something we should value and advance in the U.S. generally.

This is an effective prevention approach in the context of suicide; we know that nine out of 10 individuals who attempt suicide have an underlying mental health condition. We also know that nine out of 10 people who survive a suicide attempt will go on to die of other causes — indicating some degree of recovery. However, evidence shows that 85 to 90% of people who attempt suicide with a firearm will succeed in ending their lives. Guns are highly effective killing machines; it is what they have been explicitly designed for. And guns account for more suicides in America than all other means or methods combined. Reducing access to more lethal means, such as guns, among those who are at risk of suicide due to mental health will categorically saves lives.

But this approach will not be nearly as effective in preventing interpersonal gun violence or episodes of mass shootings. There simply isn’t an evidentiary basis for connecting mental health to the perpetration of interpersonal violence. In fact, individuals with a mental health condition are far more likely to be victims of violence than perpetrators. And while the exact number of perpetrators of mass gun violence who suffered from a mental health condition is unknown (they are often killed during the attack itself and are thus never diagnosed), estimates range from 20 to 60% of all perpetrators. The problem is that the majority of these perpetrators are unknown to the mental health system prior to their attacks, meaning they would not have been prevented from purchasing a firearm even if restrictive legislation based on mental health status were passed.

And besides, even if we were 100% effective in restricting access to firearms among those with a mental health condition, we would only reduce violent crime in this country by 4%. Meaning we would further stigmatize a population that already faces a high degree of marginalization with minimal impact on interpersonal or mass gun violence.

And this is but one example of the complex, multi-faceted nature of gun violence in America. Like all problems that are complex and multi-faceted, it demands complex and multi-faceted solutions. And we need to start demanding our politicians be committed to passing and funding all of them if we are serious about solving gun violence in America.