Guns and Mental Illness: A Second Look

On the day of the mass murder in Newtown I wrote a column, too quickly. That's how I deal with overwhelming, unbearable feelings. Some people cry. Some call their friends. Some go to vigils. I write, fast. To get at least a tiny illusion of closure, I had to finish the piece and post it right away.

On the day of the mass murder in Newtown I wrote a column, too quickly. That's how I deal with overwhelming, unbearable feelings. Some people cry. Some call their friends. Some go to vigils. I write, fast. To get at least a tiny illusion of closure, I had to finish the piece and post it right away.

I did have an important point to make: "Mental health reform is as important as gun reform." And I came up with what I thought was a clever slogan to reinforce the point: Guns, all by themselves, don't kill people. Mentally or emotionally disturbed people with guns kill people.

But after the piece was posted I had time to think more carefully. And the more I thought the more I regretted such a hasty, sweeping generalization. A few of the commenters on my piece pointed out the error, and the danger, of linking mental/emotional disturbance to violence in such a simplistic way. I thank them for that.

Now I can say more precisely what I should have said then: A gun, all by itself, doesn't walk into a public place and start shooting at strangers. There's a high likelihood -- though no certainty -- that it's a mentally ill or emotionally disturbed person with a gun who has killed those people.

Although even one such event is one too many, it's important to recognize that mass murders are a tiny, almost infinitesimal portion of all the incidents of gun violence in America. The large majority of gun violence is perpetrated by people that the professionals would deem sane.

Those are just two of the points made in a fine article by Dr. Richard Friedman, who took his time and did his homework before he wrote. He cites the research to show that "only about 4 percent of violence in the United States can be attributed to people with mental illness."

That's because "the vast majority of people with psychiatric disorders do not commit violent acts." Though young psychotic male who are intoxicated with alcohol are at a high risk of doing violence, "most individuals who fit this profile are harmless." Even those who are harmful are driven mostly by drink: "Alcohol and drug abuse are far more likely to result in violent behavior than mental illness by itself."

So my earlier column was an unintended example of a huge problem facing those with mental/emotional disturbance. Even among those of us trying to improve public behavioral health services, it's too easy to fall prey to false stereotypes that create fear and misunderstanding.

That's one big reason we, as a society, are failing so badly in helping those with mental/emotional disturbance. The old-fashioned impulse to isolate them, to keep them away from the rest of us who are deemed "normal," is still far too common. We don't isolate them physically as much as we used to (though physical isolation is still a problem). But emotionally and culturally the distancing may be as great as ever. It happens, in a word, by stigmatizing.

Huge amounts of money flow to research on cancer, heart disease, and many other physical illnesses because they do not carry any stigma. But there is still enormous stigma attached to mental and emotional conditions, because they are met with so much unnecessary, unjustified fear. So we still know far too little about those conditions. More knowledge would dispel some of the fear. Yet it's hard to get adequate funding for the urgently needed research.

In fact it's hard to get much public attention at all for the ongoing social crisis in mental/emotional health. Only an act of unimaginable violence, it seems, can get the nation thinking about taking some action. If that's the only way to get public attention to the issue, it's better than not raising the issue at all. I've been glad to see the public spotlight begin to shine, at least a bit, on this problem. Hopefully the president's call for public dialogue will be taken seriously and make that light shine brighter.

But if we pay attention to the behavioral health crisis only in the context of violence, it's far too easy to reinforce the stereotype that the mentally ill and emotionally disturbed are all potentially violent or dangerous.

That prejudice is, unfortunately, driving the newly energized public debate about mental illness and legal access to guns. There's a growing clamor for tighter restrictions. Many people simply say that anyone with a history of mental illness should be barred from having a gun. Perhaps they don't stop to think how that would carve irrational stigma into the stone of law.

Perhaps they don't know that it's already carved into the laws of many states -- and of the federal government, which prohibits selling or giving a gun to anyone who "has been adjudicated as a mental defective [whatever that means!] or has been committed to any mental institution."

In the wake of the Aurora shooting, the head of the National Alliance on Mental Illness made a more reasonable suggestion: "Change the law -- thoughtfully and carefully -- in a way that is not only overly broad, but also avoids unfair, damaging discrimination." One good example is a report just released by a panel in Maryland, advising that a judge should have to find clear evidence that someone with behavioral health problems is dangerous before they can be barred from getting a gun.

Of course we need tighter restrictions on legal gun access for everyone. But no one should be singled out merely because they've had, or perhaps still have, mental or emotional health problems. Discrimination is just as wrong in gun laws as it is in jobs, housing, or anywhere else.

Discrimination is especially dangerous in gun laws because it reinforces the prejudice that anyone who has mental or emotional difficulties is inherently dangerous and ought to be avoided. As long as that prejudice prevails, we are likely to go on ignoring this enormous social problem.

If we ever have a truly humane, comprehensive, well-funded public program for helping everyone with mental/emotional problems, we probably will reduce mass killings and, to a lesser degree, all forms of violence. But that will be a very small piece of the much larger gain for our whole society. When the most seriously troubled people among us have their troubles eased, we all benefit.

Our work is licensed under Creative Commons (CC BY-NC-ND 3.0). Feel free to republish and share widely.