Stop blaming mental illness for mass shootings

It’s about the guns.

By Dylan Matthews@dylanmattdylan@vox.com  Updated Feb 20, 2018, 10:18am EST

A familiar pattern plays out after every mass shooting in the US.

First, advocates of gun control point out, accurately, that taking guns off the streets and limiting who can buy them will save lives. Then opponents of gun control argue that there are no regulations that can stop a determined shooter, and that what we really need is to address mental health. Then liberal gun control advocates insist they too want better mental health care, and that Republican gun control opponents are hypocrites because they oppose expanding access to health insurance that would help people get it.

But the convenient cries of “mental health” after mass shootings are worse than hypocritical. They’re factually wrong and stigmatizing to millions of completely nonviolent Americans living with severe mental illness.

The share of America’s violence problem (excluding suicide) that is explainable by diseases like schizophrenia and bipolar disorder is tiny. If you were to suddenly cure schizophrenia, bipolar, and depression overnight, violent crime in the US would fall by only 4 percent, according to an estimate from Duke University professor Jeffrey Swanson, a sociologist and psychiatric epidemiologist who studies the relationship between violence and mental illness.

“People with mental illness are people, and the vast majority aren’t any more of a risk than anyone else,” Swanson says.

That doesn’t mean, he says, that we can’t do more to identify people at risk of committing gun violence and prevent them from getting guns — particularly if they are a danger to themselves or others. But portraying mass shootings as a mental health problem misrepresents the evidence.

Mental illness isn’t a major cause of gun murder, or mass shootings
The data on mental illness and violence is somewhat tricky to wrap your head around at first. People with severe mental illnesses — particularly schizophrenia and bipolar disorder — do have an increased risk of violence compared to the general population. But the absolute risk they pose is not high (being male or having a substance abuse issue are both bigger risk factors), and the vast majority of people with severe mental illness aren’t violent.

Mentally ill people are far, far likelier to be the victims of violence (including violence committed by police) than the perpetrators. And because a distinct minority of the population has schizophrenia or bipolar, mental illness doesn’t contribute much at all to the overall violent crime problem.

A study conducted from 1980 to 1985 illustrates these complicated dynamics well. The Epidemiologic Catchment Area (ECA) study, sponsored by the National Institute of Mental Health, conducted an ongoing survey of about 10,000 people in five different urban areas (Baltimore, St. Louis, Raleigh-Durham, New Haven, and Los Angeles), asking, among other things, diagnostic questions to see if respondents met criteria for mental illnesses, and if respondents had hit, punched, pushed, shoved, or otherwise violently attacked someone.

Before the ECA study, attempts to study mental health and violence typically started either in psychiatric hospitals or in the criminal justice system. Those methods have obvious problems: Scouring hospital wards only catches people who’ve been diagnosed and chosen or forced to get help, and scouring prisons doesn’t give you a representative sample of the mentally ill either. By using a general household survey, the ECA study avoided those biases.

Read more
https://www.vox.com/policy-and-politics/2017/11/9/16618472/mental-illness-gun-homicide-mass-shootings