Change how we talk about gun violence and mental health

We must change how we talk about gun violence and mental health.

After a mass shooting, news reports commonly describe the shooter as “psychotic” or “mentally disturbed.” A popular misconception holds that individuals living with mental illness are largely responsible for incidents of mass gun violence and for a large share of community violence. These claims are mostly made without evidence and before any psychiatric history is known, leading to solutions that stigmatize millions of Americans and do little to increase safety. Dialogue and solutions need to be fact-based.

When someone with a mental health disorder engages in violent behavior, there is a tendency to extrapolate that to other people with the same or similar disorders, disregarding the millions of people with a mental health condition who have never been violent. In fact, people with mental illness are more likely to be victims than perpetrators of violence. 

Violence has many contributing risk factors. Mental illness alone is very rarely the cause. Only about 4% of interpersonal violence in the United States is attributable to mental illness alone. If we were to somehow “cure” mental illness nationwide, we would still be left with 96% of all interpersonal violence.

Gun violence prevention policies that focus disproportionately on a mental health diagnosis fuel prejudice toward and fear of people living with mental illness, who might then avoid mental health services. Policies and programs should instead focus on evidence-based, behavioral risk factors for future violence, such as past violent behavior, the perpetration of domestic violence, and toxic stress.

Risk factors associated with mass shootings include a perpetrator’s stressful economic circumstances and high level of social disadvantage, lack of support to cope with early-life trauma, ongoing resentment or smoldering anger against individuals or groups perceived to be hostile or threatening, aberrant constructions of masculinity, and being young, male and impulsive, all of which are exacerbated by the disinhibiting effects of substance intoxication and easy access to a semiautomatic firearm. Mass killers do not fit a single profile and certainly no pattern of insanity; most have never been diagnosed with a serious psychiatric disorder.

Mass shootings account for less than 1% of firearm homicides and tend to be committed by those with issues besides diagnosable mental illnesses. In New York State, red flag laws allow family members and police officers to seek civil restraining orders to temporarily remove guns from people who pose an imminent risk of harming themselves or others. These orders can significantly reduce the risk factor for firearm suicide, which account for more than half of all suicide deaths.

As a society, we need human service programs that include wraparound support for struggling individuals and families. We must better engage with young people; schools have a captive audience. Parents and other adults must be part of the solutions, and teach children to be more supportive of each other. This can be as simple as asking someone if they are OK. What fuels gun violence is anger, a lack of opportunity, and feeling alienated and isolated. Let’s help people feel connected.

Misinformation contributes to discrimination that has a real and negative effect on people’s lives. When lawmakers base policy on fear and prejudice — when they focus narrowly on removing guns from people with mental illness and ignore issues like firearms access and safe storage — the results endanger civil rights and fail to make our communities safer. Let’s step up, challenge myths and misinformation, and demand real solutions.