“I think we have a long way to go in terms of brain science to really understand [those] distinctions,” adds Ron Honberg, a senior policy advisor at the National Alliance on Mental Illness
But when the news reinforces these easy narratives, as McGinty’s study shows it often does, that can have serious consequences. Other research shows that reading stories about mass shootings by people with mental illnesses makes people feel more negatively toward the mentally ill. This only heightens stigma, which could lead to more people going untreated.
“Do we not risk creating further barriers?” Honberg asks. “People [may] feel like, ‘Oh my gosh, if I get identified as having a psychiatric diagnosis, people are going to draw certain conclusions.’ It’s hard enough to get people to seek help when they need it.”
Shootings seem to inevitably lead to people calling for better mental health screenings for guns, or for better mental health care generally. Which would be great, lord knows we need it. But again, better mental health care is not going to have much of an impact on interpersonal violence.
This is a misframing of the issue. There is a compelling reason to adjust policy to better keep some seriously mentally ill people from accessing guns. It’s not because they might hurt others, but because they might hurt themselves.
Though big, scary mass shootings get the most attention when it comes to gun violence, 60 percent of deaths caused by firearms are suicides. And another new study in this same issue of Health Affairs emphasizes that suicide, not homicide, is the major public health problem for mentally ill people with guns. In it, Swanson and his colleagues looked at 81,704 people getting public health services for schizophrenia, bipolar disorder, or major depressive disorder in two large Florida counties. They tracked these people’s death records, as well as whether they were barred from owning guns.
In that group, the rate of people who died by suicide was four times higher than that of the general population. The violent crime rate was just under two times higher. But consider that this is a group of people receiving government care, who “might have other risk factors for violence, including poverty and social disadvantage, unemployment, residential instability, substance use problems, history of violent victimization, exposure to neighborhood violence, or involvement with the criminal justice system,” the study reads. So you can’t reasonably attribute the higher violent crime rate in this group to mental illness alone.
Maybe also because many people in the group likely lived in poverty, they were less likely to commit suicide by gun than the general population (perhaps they could not afford one). But 72 percent of the people who did kill themselves with a gun were “legally eligible to purchase a gun on the day they used a gun to end their life,” Swanson says. “That suggests a problem with the criteria we have for identifying people at risk.” And the 28 percent who were not allowed to purchase guns managed to find one anyway, so the laws we do have are not perfectly enforced.