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Gun Violence and Mental Illness: Myths and Evidence-Based Facts

By Joel Miller posted 10-03-2017 13:26


Our hearts go out to the families and friends whose loved ones were killed or injured in the latest shooting in Las Vegas. It is hard to imagine the incredible grief many are feeling.  

How many times are we going to start an article with those words until we address the problem of mass shootings and overall gun violence in America. As you know these events bring gun violence and mental illness into the national discussion.  We don’t know at this time why the perpetrator carried out this horrific violence or if he had a mental illness, but it again raises issues we as a society must address. 

So let’s have the conversation. These events and their media coverage reinforce the common belief that individuals with serious mental illness are violent and dangerous, especially if they have access to firearms. Some of the most common misperceptions surrounding gun violence and mental illness include: 

  • Most persons with serious mental illness, such as schizophrenia or bipolar disorder, are at high risk of committing violence toward others. 
  • Serious mental illness is one of the primary causes of gun violence in the U.S. 
  • People with serious mental illness are more likely to perpetrate violent crime than to be victims of violent crime. 

But here are the facts: 

  • Most persons with serious mental illness are never violent.  However, small subgroups of persons with serious mental illness are at increased risk of violence during certain high-risk periods, such as during a first-episode of psychosis and the period surrounding inpatient psychiatric hospitalization. 
  • People with serious mental illness are rarely violent. Only 3 to 5 percent of all violence, including but not limited to firearm violence, is attributable to serious mental illness.  The large majority of gun violence toward others is not caused by mental illness. 
  • People with serious mental illness are far more likely to be victims of violence, including but not limited to firearm violence, than the perpetrators of violent acts. 
  • Rates of violent crime victimization are 12 times higher among the population of persons with serious mental illness than among the overall U.S. population. 

And here are some suggested policy and program interventions: 

  • Firearm prohibitions should be expanded to include: 
  • More individuals with a history of violent behavior, which greatly increases the risk for perpetration of future violence toward others.   
  • Specifically, individuals convicted of violent misdemeanor crimes and those subject to ex parte domestic violence restraining orders should be temporarily prohibited from purchasing or possessing firearms. 
  • Individuals with a history of risky substance use, which heightens risk of violence toward others.   
  • Specifically, individuals convicted of multiple DWIs or DUIs and multiple misdemeanor crimes involving controlled substances should be temporarily prohibited from purchasing or possessing firearms. 

The recently developed federal Interdepartmental Serious Mental Illness Coordinating Committee should review available behavioral health resources and their effectiveness, and recommend changes to reduce barriers to accessing behavioral health care and increase integration of existing resources. 

I believe that one major misconception is that firearms policy is so polarizing that any effort to make changes at the policy level is futile.  But polling data suggests that when the dialogue about gun policy moves beyond broad statements to specific policies, broad support exists for many gun violence prevention policies like those mentioned above. 

The time is now to key stakeholders – families, communities, and government at every level come together who are committed to reducing firearms morbidity and mortality. 




02-24-2018 05:58

Mental illness Begins at a early age some born with it and some seen violent events.

Dr. Calvin Drake, 
Mental Health Counseling

01-26-2018 13:18

Much thanks to Joel Miller for his October, 2017 AMHCA blog post on gun violence and mental health. Just to say that I am of the unpopular view that anyone who perpetrates violence with a gun/firearm/weapon is by definition mentally ill. This includes, yes, socially sanctioned violence such as occurs in law enforcement and military combat. The billable DSM10 code is R45.6, Violent Behavior. I recognize that I am probably getting ahead of my skis with this view, given that R45.6 has not been in professional use long enough to have evolved into anything like the almost universally accepted major depressive disorders and opioid use disorders. My adult daughter would tell me, "It's not a thing." And I would answer, "Too bad, we can't ask the victims for their opinions."