- Most people with serious mental illnesses will not perpetuate a violent crime.
- Media coverage of gun violence is more likely to include mental health considerations when perpetrators are white or LatinX compared with Black.
- Debates about the association between gun violence and mental illness detract from other actionable items to improve mental health care.
By Katie E. Hale, Ph.D., and DeJuan White, MD
The day before, an 18-year-old man killed 19 fourth graders and two teachers. He injured 17 more.
The week before that, another 18-year-old gunned down 10 shoppers at a grocery store targeting Black people, and someone else shot five Taiwanese congregants at a church.
In the month since then, scores more mass shootings have occurred. A renewed conversation about gun control, individual rights, mental health, racism, and violence has swept our families, communities, and government.
In conversations about mental health and gun violence, our roles as mental healthcare professionals can be tricky. We spend our days caring for people navigating mental illness and feel very protective of this population. We dedicate a lot of resources to advocating for the destigmatization of mental health diagnoses, better access to treatment, and effective policy.
So, when these conversations arise, we feel defensive. We want to point to all the research that demonstrates the overwhelming majority of people with mental illnesses, including serious mental illnesses like psychotic disorders, major depressive disorder, and bipolar disorder, will never perpetrate a violent crime (Swanson, 2021).
We want to highlight the glaring disparity between the representation of the US population among all human beings (>5 percent) and our share of global mass shootings (31 percent; Lankford, 2016), which the prevalence of mental illness cannot come close to reconciling.
We want everyone to understand that when alcohol use, child abuse, unemployment, and underserved neighborhoods are accounted for, there is no added risk of violence among those diagnosed with mental illness (DeAngelis, 2021).
But stopping there would be disingenuous. You’d be hard-pressed to find a mental health professional who would say perpetrators of mass shootings and gun violence are mentally well. There is an honest and complex conversation to be had about mental health and gun violence. This includes staggering statistics about how many of our children (let alone all Americans) are dying of gun violence related to suicide, substance use, domestic violence, and neglect (Goldstick et al., 2022).
These deaths far outnumber those from mass shootings. This complex conversation must also include honesty about the policy choices that leave individuals, families, and communities in a constant state of stress and crisis – poor job quality standards, unaffordable medical and mental health care, childcare deserts, unsafe environments, and lack of gun safety measures are just a few.
Further, there are glaring racial disparities in the conversation itself. Mental health is not typically the focus of conversation when discussing gun violence in the Black community. This is compounded by the already significant stigma surrounding mental health for Black people. In the media, white and Latinx people are more likely to have mass shootings connected to mental health than Black people (Duxbury et al., 2018).
The difference in the believed motives of mass shootings for separate racial groups impacts the community’s response and favors non-Black offenders. The belief that acts are rooted in a mental health condition leads to a desire to engage the offender in mental health evaluation and treatment. In contrast, the lack of this belief promotes criminalization and harsher sentences. An honest conversation must include the racist underpinnings of these disparities.
So far, by focusing the conversation narrowly on whether mental health is to blame, we have been, at worst, dishonest or, at best, incomplete. It is dishonest for a lawmaker to speak about the importance of mental health when they have a decades-long voting record of underfunding or defunding mental health services and other supports necessary for thriving.
It is dishonest for law enforcement to tout mental health rhetoric when they continue implementing policies and adopt practices that treat those in mental health crises as violent criminals. And, it is dishonest for any of us to bemoan a broken healthcare system that does not prioritize access to quality care for all people, indiscriminate of their background, when we do not organize our time, energy, and voting power around fixing it.
Here are some actions all of us might take to get more honest and act with integrity regarding mental health and gun violence:
- Support laws and policies that fund equitable access to evidence-based mental health care in schools, communities, and states.
- Encourage everyone struggling mentally and/or emotionally to get help from a licensed healthcare professional. This will require familiarity with available resources in your area. It also means coming to terms with diagnoses and/or treatments that can feel uncomfortable.
- Work to destigmatize mental health by speaking up in social circles, workplaces, and our communities so that struggling people feel more comfortable seeking help. This should involve challenging the narrative that people committing gun violence often have serious mental disorders.
- Support research exploring how to improve broader contextual factors associated with mental health and gun violence, including poverty and adverse childhood experiences. Be present to individuals and communities in their grief about gun violence and acknowledge the complexities.
We will continue to send our kids to school, grocery shop, and worship with our communities. And we will keep the faith that there are enough of us willing to have honest conversations that lead to meaningful change.
Through this honesty, we will be better able to protect our children, neighbors, marginalized communities, and those struggling with mental illness.
DeAngelis, T. (2022, July). Mental illness and violence: Debunking myths, addressing realities. Monitor on Psychology, 52(3). https://www.apa.org/monitor/2021/04/ce-mental-illness
Duxbury, S. W., Frizzell, L. C., & Lindsay, S. L. (2018). Mental Illness, the Media, and the Moral Politics of Mass Violence: The Role of Race in Mass Shootings Coverage. Journal of Research in Crime and Delinquency, 55(6), 766–797. https://doi.org/10.1177/0022427818787225
Goldstick, J. E., Cunningham, R. M., & Carter, P. M. (2022). Current Causes of Death in Children and Adolescents in the United States. The New England Journal of Medicine, 386(20), 1955–1956. https://doi.org/10.1056/NEJMc2201761
Lankford A. (2016). Public Mass Shooters and Firearms: A Cross-National Study of 171 Countries. Violence and Victims, 31(2), 187–199. https://doi.org/10.1891/0886-6708.VV-D-15-00093
Swanson J. W. (2021). Introduction: Violence and Mental Illness. Harvard Review of Psychiatry, 29(1), 1–5. https://doi.org/10.1097/HRP.0000000000000281