May 2 | Psychiatric News


Mental Illness Too Often Wrongly Associated With Gun Violence

By Katie O’Connor

Only 4% of the violence that occurs in the United States can be attributable to people with mental illness, yet when incidents of gun violence occur, they are almost immediately associated with psychiatric illnesses.

Words such as “psycho,” “crazy,” and “insane” are often used in media coverage of events such as mass shootings, explained Dhruv Gupta, M.D., a PGY-3 psychiatry resident at the Icahn School of Medicine at Mount Sinai Hospital. That media coverage perpetuates a stigma that people with mental illness are inherently dangerous, a problem that Gupta and his colleagues addressed during the session “Why Blaming Violence on Mental Illness Is Misleading: A Call for Multifaceted and Evidence-Based Strategies to Reduce Gun Violence.”

Gupta was joined by Alisa Gutman, M.D., Ph.D., the founder and medical director of the Philadelphia Human Rights Clinic; Ahmar Mannan Butt, M.D., an adult and child psychiatrist at Broadlawns Medical Center in Des Moines, Iowa; Jessica Bayner, M.D., a child and adult forensic psychiatric fellow at the University of Pennsylvania Health System; and Muhammad Hassan Majeed, M.D., a child psychiatrist at Natchaug Hospital in Connecticut.

The presenters pointed out that people with mental illness are far more likely to be the victims of violence than the perpetrators. Research shows that of all the violence that occurs in the United States, 96% is due to risk factors other than mental illness, Gutman said. Referring to mental illness during every conversation about violence “further stigmatizes what is already a marginalized group of individuals who are suffering with severe symptoms,” Gutman said. “That’s unacceptable, and as psychiatrists, we need to take a public stand.”

There are a number of risk factors for gun violence, including being young, male, and disadvantaged and misusing drugs or alcohol, explained Bayner. “Evidence points to the fact that violence risk is better characterized by behaviors rather than diagnoses,” Bayner said. She pointed to examples of this theory being used effectively to reduce gun violence. A California law passed in 1991 that prohibits firearm ownership among people charged with a violent misdemeanor resulted in a 29% reduction in arrests for new gun and other violent crimes. Similarly, cities and states with laws prohibiting people who are subject to domestic violence restraining orders from having guns had 25% fewer intimate partner homicides.

The most prevalent question that audience members asked after the presentation was “Can psychiatrists effectively predict who may commit acts of violence?”

“It’s not for us to have a prediction that will determine all of the violence that will occur,” Gutman said. Ultimately, the people who spend time with an individual every day, such as family members, are in a better position to notice when an individual may become violent, she said.

Yet, Bayner pointed out, as of April 2020, only 19 states and Washington, D.C., had some type of red-flag law, which allows family members to petition a court to temporarily remove firearms from people deemed a danger to themselves or others.

Gun violence is a hugely complex issue, Butt said, and it requires a variety of stakeholders to address. “One discipline cannot address this multifaceted issue,” Butt said. “We need help from all disciplines, and education is the first step.” ■