NYAPRS Note: Watch today’s 2pm livestreamed House Briefing by the Coalition for Smart Safety and the Consortium for Citizens with Disabilities Rights Task Force: Debunking the Myths: Mental Health and Gun Violence that is being presented in conjunction with Representative Jim Langevin and Representative Grace Napolitano and features Maria Town, CEO, American Association of People with Disabilities and speakers Josh Horwitz, Executive Director, Coalition to Stop Gun Violence; Jonathan Metzl, Professor, Vanderbilt University; Kelly Vaillancourt, Director of Policy and Advocacy, National Association of School Psychologists; and William Kellibrew, Director, Office of Youth and Trauma Services, Baltimore City Health Department
The House briefing will be livestreamed on National PTA’s Facebook page here: https://www.facebook.com/ParentTeacherAssociation/
Getting the Facts Straight: Facts about Gun Violence and Mental Health Disabilities
Fact: Mental health disabilities are not effective predictors of violence.
While public perceptions associating serious mental illness with violence have increased substantially in recent decades,[1] serious mental illness is not by itself a predictor of violence.[2] Only 3-5% of violence is committed by people with mental health disabilities.[3] Less than 5% of gun-related killings in the U.S. are committed by people with mental health disabilities.[4] Other factors, such as past violence, juvenile detention, physical abuse, parental arrest record, substance abuse, recent divorce, age, gender, income, and unemployment, are better predictors of violence. People with mental health disabilities are far more likely to be victims rather than perpetrators of violence.[5]
Fact: Common public misconceptions that “only a madman” would commit a mass shooting are not supported by evidence.[6]
The vast majority of mass shooters do not have a mental illness.[7] Individuals who commit mass shootings have been driven by a variety of factors, such as extreme feelings of anger and revenge, feelings of social alienation, and feelings of rejection or humiliation by peers.[8] There is no one “typology” of mass shooters.[9] Substance use and prior violence involvement, not mental health issues, are the most consistent predictors of gun violence.[10]
Fact: There is no correlation between deinstitutionalization and the number of mass shootings.[11]
The U.S. has a much higher rate of mass shootings than countries that have had similar closures of psychiatric hospitals. In fact, countries with the lowest per capita rates of psychiatric hospital beds had the lowest number of mass shootings.[12] Within the U.S., there is no meaningful correlation between the number of public and private psychiatric hospital beds per capita and the firearm homicide rate within states.[13]
The move away from long-term hospitalization and toward community-based services reflects the evolution of understandings of effective treatment and good practice, as well as compliance with the Americans with Disabilities Act. It reflects the recognition that warehousing individuals in large, congregate settings does little to improve individuals’ mental health, and that psychiatric hospitalization is effective primarily for purposes of short-term stabilization during acute episodes.
We now have an array of highly successful services that enable people with psychiatric disabilities to live in their own homes and communities — including supported housing, supported employment, mobile crisis services, and peer support services. They are more effective, less costly, and enable people to have the kinds of full and meaningful lives that cannot be had in an institution. While community-based services have not been developed in sufficient supply, the answer is to expand them, not to go back to warehousing people in state hospitals.
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[1] James L. Knoll IV & George D. Annas, Mass Shootings and Mental Illness, in Gun Violence and Mental Illness 81, 95 (Dec. 2015), https://psychiatryonline.org/doi/pdf/10.5555/appi.books.9781615371099; Jonathan M. Metzl & Kenneth T. MacLeish, Mental Illness, Mass Shootings, and the Politics of American Firearms, 105 American J. Pub. Health 240, 244 (Feb. 2015), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4318286/pdf/AJPH.2014.302242.pdf.
[2] Eric B. Elbogen & Sally C. Johnson, The Intricate Link Between Violence and Mental Disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions, 66 Arch. Gen. Psychiatry 152 (Feb. 2009), http://www.psychodyssey.net/wp-content/uploads/2011/01/The-Intricate-Link-Between-Violence.pdf.
[3] Knoll & Annas, supra note 1, at 90; Metzl & MacLeish, supra note 1, at 241, Jeffrey W. Swanson et al., Mental Illness and reduction of gun violence an suicide: bringing epidemiologic research to policy, 25 Annals of Epidemiology 366, 368 (2015), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4211925/pdf/main.pdf.
[4] Metzl & MacLeish, supra note 1, at 241.
[5] Linda A. Teplin, et al., Crime Victimization in Adults with Severe Mental Illness, 62 Arch. Gen. Psychiatry 911, 914 (Aug. 2005) (“Over one quarter of the SMI sample had been victims of a violent crime (attempted or completed) in the past year, 11.8 times higher than the [general population] rates . . . .”); Heather Stuart, Violence and Mental Illness: An Overview, 2 Journal of World Psychiatry 121, 123 (June 2003) (“It is far more likely that people with a serious mental illness will be the victim of violence,” rather than its perpetrator.).
[6] Knoll & Annas, supra note 1, at 83.
[7] Michael H. Stone, Mass Murder, Mental Illness, and Men, 2 Violence and Gender 51, 80, 84 (2015) (three quarters of mass murderers do not have a mental illness); Everytown for Gun Safety, Analysis of Recent Mass Shootings (2015), https://www.issuelab.org/resources/22702/22702.pdf (in 12% of sample of mass shooters analyzed, concerns about the mental health of the shooter had been brought to the attention of a medical practitioner, school official, or legal authority prior to the shooting).
[8] Id. at 84, 87.
[9] Knoll & Annas, supra note 1, at 86.
[10] Carissa J. Schmidt et al., Risk and protective factors related to youth firearm violence: a scoping review and directions for future research. 42 Journal of Behavioral Medicine 706 (Aug. 2019).
[11] Isabel M. Perera & Dominic A. Sisti, Mass Shootings and Psychiatric Deinstitutionalization, Here and Abroad, American Journal of Public Health, Supplement 3, 2019, Vol. 109, No. S3 (June 26, 2019), at S. 177, https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2018.304764.
[12] Id. at S. 176-177.
[13] Judge David L. Bazelon Center for Mental Health Law, The Relationship between the Availability of Psychiatric Hospital Beds, Murders Involving Firearms, and Incarceration Rates (Jan. 15, 2013), http://www.bazelon.org/wp-content/uploads/2017/04/1.16.13-Analysis.pdf.