A lot can change in five years. If you had asked me five years ago how we should approach the intersection of guns and mental illness, I would have said the two should never mix. I would have said all people with mental illness should be prohibited from possessing firearms. I would have used the term “dangerously mentally ill” without thinking twice.
Then, in 2013 – more than 20 years into my career – my perspective changed. In the wake of the horrific shooting at Sandy Hook Elementary School, I convened a meeting to tackle a complicated question: What does research actually tell us about the intersection of mental illness and gun violence? Those who attended the meeting established the Consortium for Risk-Based Firearm policy – a group of researchers and practitioners dedicated to developing evidence-informed policy proposals. And much of what I thought I knew about mental illness turned out to be wrong.
The researchers I work with have taught me about the actual risks of violence among those living with mental illness – specifically the lack thereof. I’ve learned that those with mental illness are more likely to be victims of violence than perpetrators. I’ve learned that only four percent of interpersonal violence is attributable to mental illness alone. I’ve learned that those living with mental illness pose a greater threat to themselves than anyone else. I’ve realized that the gun violence prevention movement focuses less on preventing suicides – nearly two-thirds of all gun deaths – than we should. And I now have a far better understanding of the discrimination, stigmatization, and even violence that people living with mental illness face. Moreover, I have come to appreciate that mental illness is part of a person in the same way that race and national origin are; diagnoses do not define individuals, but mental illness is not a choice. We can’t choose where we come from, we can’t choose what we look like, and we can’t choose whether or not to have a mental illness.
Nearly 20 percent of Americans live with a mental illness in a given year – these individuals comprise one of our nation’s largest demographics. Once you begin to view mental illness the same way you view other immutable characteristics, the daily discrimination against those who suffer becomes apparent and painful. The language you hear your friends using becomes painful. The message you hear from the press, leaders, and the public becomes painful. The things you have said in the past become painful. You are forced to confront your own biases and those of people you respect. It is uncomfortable.The laws we support should be based on research and focused on dangerous behavior – not genetics, not diagnoses.
I have felt this discomfort listening to the recent public debate about the Social Security Administration (SSA) rule that prohibited those with a mental health disability and an appointed representative payee from purchasing or possessing firearms. The policy, which Congress recently voted to repeal, was the Obama administration’s effort to keep guns out of the hands of dangerous people. President Obama deserves a lot of credit for doing everything in his power to reduce America’s gun violence epidemic. Unfortunately, by focusing the prohibition directly on a mental health disability, the rule furthered the mistaken belief that mental illness is a major cause of violence.
Research shows that mental illness alone is not a significant risk factor for interpersonal violence, and an appointed representative payee tells us nothing about additional risk of violence. Rather than focusing on mental illness, we should be looking at evidence-based risk factors for dangerousness, such as a history of violence or substance abuse.
The terms we hear from people on both sides of the aisle, such as “the dangerously mentally ill,” are misleading, damaging to the mental health community, and not based on evidence. The gun lobby, politicians, and the ill-informed media have conditioned us to associate mental illness with violence. The idea that mentally ill means violent is an alternative fact. Period.
Luckily, there are policies that can prevent dangerous people from possessing firearms without further stigmatizing those who live with mental illness. One such policy is the Gun Violence Restraining Order (GVRO), which is currently in effect in California. The GVRO allows family members and/or law enforcement officials to petition a judge to temporarily remove firearms from an individual in crisis. The policy is effective because it is based on behavioral risk factors for dangerousness rather than a mental health diagnosis alone. The policy gives loved ones the tools to protect individuals in crisis – concerned relatives can get help for a family member they know to be suicidal, a loved one who is having thoughts of harming others, a family member whose erratic behavior, violence, and co-occurring substance abuse suggest additional violence is imminent.
This policy was carefully crafted based on what the facts tell us about risk of violence; legislators who are serious about preventing gun violence should use this lifesaving, data-driven tool as an example. Washington state recently passed a law modeled after the GVRO, and other states are considering similar legislation.
Unsurprisingly, the National Rifle Association (NRA) and those legislators who pledged fealty to them also found the SSA law troubling – they find any regulations troubling. And they supported this repeal for one irresponsible reason: they want everyone to be armed, no matter who they are, what their behavior demonstrates, where they are carrying, or how they obtain their weapons. The NRA does not care whatsoever about stigmatizing those with mental illness. If they were serious about addressing the shortfalls of the SSA rule, they would have simply passed a law repealing the policy. Instead, they utilized the Congressional Review Act (CRA) – a sledgehammer of a process that has only been successfully used once in congressional history – to prevent re-visitation of this issue in the future.The NRA does not care whatsoever about stigmatizing those with mental illness.
The NRA and their congressional allies have no problem exploiting those with mental illness – they frequently blame these individuals when a horrific tragedy occurs. Officials at NRA headquarters have no interest in creating policies to identify individuals who are actually dangerous. They simply want guns in every household, in every school, in every public place. That they suddenly claim to care about stigma and scientific evidence is disingenuous and insulting, and we should remind them of their commitment to data-driven policy next time they oppose commonsense laws like domestic violence prohibitions or the GVRO.
I have worked in gun violence prevention for nearly 28 years and am well acquainted with the public health risks of easy access to firearms. I came to this issue because a close friend battling depression took her own life with a firearm. I have counseled and consoled grieving mothers, fathers, and other family members in their darkest hours. Several of my closest friends are survivors of gun violence. I have seen firsthand the devastation gun violence causes, and I understand the desire to do whatever it takes to stop the killings we see every day. But we need to create effective, data-driven laws that don’t use mental illness as a scapegoat.
We have seen such compassion, such leadership, such energy from citizens of all backgrounds who oppose President Trump’s immoral immigration ban. We recognize that discriminating on the basis of religion or national origin is wrong. We must treat mental illness the same way.
Prohibitions on gun ownership are critically important. The United States’ gun laws include far too many loopholes that allow dangerous people to do harm. But the laws we support should be based on research and focused on dangerous behavior – not genetics, not diagnoses. If we want our movement to succeed, a data-driven strategy is the only way forward.
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