Opponents of gun control argue that better attention to mentally troubled individuals will do more to prevent mass shootings than restricting access to firearms to the general population. But our columnist argues that there is little evidence supporting mental illness as a critical factor in acts of tragic violence.
To the rest of the world and even to many US citizens, gun ownership in America seems to be out of hand. About one-third of Americans own a gun, with another 10 percent reporting they live in a home with guns. It’s believed that there are enough guns for every American to have one, so that means many own more than one.
How many guns do you need? One to protect your home, maybe one to carry with you for self-defense. If you’re a hunter or sports shooter, two or three long guns might seem reasonable, especially if they are suited for different purposes.
According to a Pew Research survey in 2017, two-thirds of American gun-owners have at least two firearms, and 29 percent own five or more. Three percent own 17 apiece, according to one analysis of an unpublished study by Harvard and Northeastern University researchers.
The Las Vegas shooter Stephen Paddock had even more, two dozen or so, with a dozen bump stocks. Half of those he amassed in a year. Do you need a gun a month? Should that be a red flag?
Not in the United States, home of the Second Amendment to the Constitution: the right to bear arms.
When a mass shooting takes place, Second Amendment defenders such as the National Rifle Association (NRA) say it’s not a problem of guns, but of mental illness. Psychologists point out that mental illness is a far better predictor of self-harm or victimization, not harm against others.
But what if the gun ownership, the gun love, is a sign of mental illness itself?
Is the multiple-gun owner a compulsive collector, a hoarder? Probably not.
One difference between a collector and a hoarder is that collectors are choosy. They take care of their collection, display it attractively, and take pride in showing it to others. A hoarder is less or not at all selective; he or she just crams the items into whatever cubbyhole is available, and piles them in sinks, bathtubs and other spaces that serve another purpose but can no longer be used for that purpose. (One example: a book collector displays his books in a bookcase; a book hoarder piles them in his bathtub.)
By this definition, most firearm collectors are not hoarders. I don’t know of any gun enthusiasts who throw their weapons in a pile or in a sink. Most keep them clean, oiled, polished and either displayed on a rack or kept in a gun safe.
What if they have enough ammunition for an army? Not necessarily.
Some of these people do seem paranoid, afraid of jack-booted government thugs or a civilization-ending natural disaster. One site —that says you need at least 2,000 rounds of ammunition per caliber of firearm: 1,000 with which to practice, and 1,000 for when (not if) the national power grid goes down—warns that 200 million Americans will die when (not if) the nationwide power grid goes down.
But the nonpartisan firearm information site The Trace, no great fan of the NRA, explains that there can be perfectly reasonable reasons to “hoard” ammo for reasons of supply and price, not because it’s preparation for a mass shooting or rebellion.
Are gun enthusiasts actually mentally ill? Not according to Psychiatry Online, which says the idea that gun violence and mental illness are closely linked is a myth.
“It should be noted that there is no established causality between mental illness and gun violence,” DJ Schuette, a self-described “responsible gun owner “who admits to suffering from depression and anxiety, told The Marshal Project.
Schuette keeps his gun in a gun safe to which only his wife has access. He’s not worried that he’ll harm others so much as that he might take his own life, which is a far more common outcome. Of the approximately 37,000 US gun deaths in 2016, 22,000 were suicides. Fewer guns would make those deaths less likely because suicide attempts by other means—drowning, hanging, poison, wrist-cutting—are not as often successful.
Despite the lobbying by the NRA, other “Second Amendment Firsters” and politicians, mental illness is not a good predictor of whether someone will engage in violence with guns. It happens, but is rare. To the extent that modern psychiatry and neurology can determine (often post-mortem), most shooters—even mass shooters—are not mentally ill.
“The large majority of people with serious mental illnesses such as schizophrenia, bipolar disorder, and severe depression are not inclined to be violent,” according to a study by Jeffrey W. Swanson. Even when they do commit acts of violence, it is is more likely to the result of some other factor such as substance abuse.
Take Stephen Paddock. A thorough autopsy found nothing to suggest he was mentally ill due to a brain tumor or stroke or early onset dementia, although “an abnormally high number of tiny deposits” that are sometimes associated with neurological disease were found scattered on the surface of his brain.
However, in an article earlier this month (at least in part hawking his own 2007 book on the subject), Grant Duwe wrote, “peer-reviewed research has shown that individuals with major mental disorders (those that substantially interfere with life activities) are more likely to commit violent acts, especially if they abuse drugs. … [At] least 59 percent of the 185 public mass shootings that took place in the United States from 1900 through 2017 were carried out by people who had either been diagnosed with a mental disorder or demonstrated signs of serious mental illness prior to the attack.”
Maybe the difference in the two opinions is that Duwe qualifies his conclusion to include “demonstrated signs” of mental illness, which seems a little vague. The results of at least one survey concluded that “half of all Americans will qualify for a psychiatric diagnosis at some point in their lives, while a quarter of them do in any given year.”
Not even all gun enthusiasts like the idea of blanket mental illness restrictions on gun ownership. These are better predictors, according to Dr. Renee Binder, former president of the American Psychiatric Association. A history of drug or alcohol abuse is “stronger indicator of risk” than mental illness, he said. Though he added that, like mental illness, substance abuse is more associated with being a victim of gun violence than a perpetrator.
In an essay, Brandon Smith questions ” WHO gets to decide who is mentally ill and why they are mentally ill? Will this be done by a jury of our peers? Or, by an unaccountable and faceless bureaucracy? Will the guidelines for mental illness be strict and specific, or will they be broad and wide open to interpretation?
“Once a person has been labeled mentally defective, will they have the ability to appeal the decision, or will the label haunt them for the rest of their lives?”
At the same time, Smith suggests that psychotropic pharmaceuticals are the cause of mass shootings, because “at least 35 school shootings and/or school-related acts of violence have been committed by those taking or withdrawing from psychiatric drugs” and “psychotropic drugs are proven to influence violent and even homicidal behavior in people.”
Without case studies detailing the shooters’ pre-drug-use behavior, it is just as likely that an underlying mental illness that was inadequately medicated led to the shootings.
Paddock was “withdrawing” from the anti-anxiety medicine Valium at the time of the shootings. His physician suspected he might have a bipolar disorder, but he refused to take antidepressants for it. More meds might have prevented this mass shooting.
If mental illness isn’t the cause, maybe it’s substance abuse? Alcohol, yes. Drugs, maybe a little, if the abuser also has a mental illness.
“Alcohol was a more important predictor of future violence than prior violence was,” according to Garen Wintemute, the director of the Violence Prevention Research Program at the University of California, Davis, who conducted a longitudinal study which found that a gun owner convicted of a crime involving alcohol, most often driving under the influence,was almost 33 percent more likely to commit a violent or firearm-related crime.
If we deny guns to people with a mental illness, should we deny gun ownership to anyone with a DUI, too?
Of people who abuse alcohol or drugs, 39.1 percent also have a co-occurring or comorbid mental illness. Sometimes they may be trying to self-medicate the mental illness with alcohol or drugs. When that’s the case, rehab for substance abuse or mental illness alone is not sufficient, and treatment at dual diagnosis treatment centers is required.
The National Comorbidity Survey Replication survey estimated that more than 25 percent of a representative sample of 9,000 adults had a mental illness in one year. Marcia Angell of Harvard Medical School cited an even more alarming survey sponsored by the National Institute of Mental Health between 2001 and 2003 that found 46 percent fit the American Psychiatric Association profile of at least one mental illness at some point in their lives.
Even if gun ownership isn’t a mental illness, gun ownership may correlate with tendencies towards anger and impulsivity. However, just over 10 percent of people who have guns in the home also have any pathological anger traits, as do 1.5 percent of those who carry guns.
The American Psychiatric Association’s Gun Violence: Prediction, Prevention, and Policy states that “Firearm prohibitions for high-risk groups — domestic violence offenders, persons convicted of violent misdemeanor crimes, and individuals with mental illness who have been adjudicated as being a threat to themselves or to others — have been shown to reduce violence.”
Even that might be a bridge too far for Americans. While other nations—Australia, Germany, Japan and the United Kingdom—have had some success with gun control, their solutions likely wouldn’t work in the US because of the Second Amendment, and the strong American belief that guns keep us safe and free.
If it’s not mental illness, drugs or the number of guns we possess, what is it? There are no easy answers. The cause of America’s gun violence problem may be in the American character. In some ways we still think we’re in the Wild West.
Stephen Bitsoli, a Michigan-based freelancer, writes about addiction, politics and related matters for several blogs. He welcomes readers’ comments.