Stop Stigmatizing Mental Illness and Call Gun Violence What It Is: A Public Health Crisis

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Photo Credit: Iryna Yafimchyk / Working Families via Creative Commons

It happens every time news breaks of a mass shooting. While large majorities of the public call for sensible new restrictions on guns, the organized gun lobby may offer their “thoughts and prayers,” but insist there is no legislation that possibly could have made a difference in preventing--or even limiting the scale of--the most recent carnage. Conservative commentators derail talks of common-sense gun laws with calls for the public to refrain from “politicizing a tragedy,” when in reality, these tragedies cry out for public policy responses. The aftermath of the tragic mass shooting in Las Vegas this month was no different. The irony, though, is some policymakers instead politicize mental illness to keep productive conversations about gun violence prevention from happening.

Just two days after a man used legally purchased guns and modifiers to kill 59 innocent people from his hotel suite in Las Vegas, Republican House Speaker Paul Ryan said: “Mental health reform is the critical ingredient to making sure that we can try and prevent some of these things that have happened in the past.” Meanwhile, Ryan’s own party has tried time and time again to repeal the Affordable Care Act and inflict massive cuts to Medicaid, which experts have repeatedly warned would reduce providers’ capacity to provide mental health and substance use disorder treatment for tens of thousands of Americans.

Not only that, but gun lobbyists’ “go-to” argument that mental illness is the cause of  the United States’ astronomically higher rates of mass shootings than other countries is an oversimplification at best, and a perpetuation of harmful stereotypes at worst. In reality, 60 percent of acts of gun violence in the United States are acts of suicide, and thousands more are homicides in domestic situations. But gun rights proponents use stigmatizing rhetoric around mental health to distract from conversations about mass shootings while ignoring the epidemic of suicides-by-gun that happen an average of 50 times every single day, and the constant toll of gun-related homicides. So while we should absolutely advocate for more comprehensive mental health coverage, we shouldn’t buy into harmful and deflective narratives to get there.

"Mental health stakeholders are loath to have this conversation about improving mental health care in a context driven by violence prevention, because that's not why we need mental health reform per se," Duke University psychiatry professor Jeffrey Swanson, who specializes in gun violence and mental illness, told CNN. "We need it because people are struggling with illnesses and they don't have access to care."

A Health Affairs analysis found that while mental illness is to blame for relatively few violent acts, 55 percent of news coverage of mental illness in the past two decades is related to violence. Pop culture notoriously perpetuates this misleading narrative for the sake of entertainment--from “Fight Club” to “American Horror Story”-- while portrayals of protagonists who are nonviolent sufferers of mental illness pale in comparison. Mentally ill people commit only 3-5 percent of all acts of violence in the U.S., but gun lobbyists’ popular talking points after each mass murder tragedy adds to a widespread misunderstanding of the violent tendencies (or lack thereof) of the vast majority of mentally ill people.

“If we were able to magically cure schizophrenia, bipolar disorder, and major depression, that would be wonderful, but overall [gun] violence would go down by only about 4 percent,” said Jeffrey Swanson, a professor of psychiatry and behavioral sciences at the Duke University School of Medicine, in an interview with ProPublica.

Instead of stigmatizing mental illness, doctors across the country have called for years for mass acts of gun violence to be treated as a public health issue--which could include expanding access to mental health care as just one sensible direction to take action, in concert with enacting common-sense new gun laws. In an op-ed for the Boston Globe, David Hemenway of the Harvard T.H. Chan School of Public Health says “A lesson from almost all public health successes is that it is most effective to change the environment and the product — to improve the conditions for health — rather than trying exclusively to get people to abstain from all bad behavior.” In other words, focus on ways to make people with harmful intentions less dangerous, rather than trusting that good will prevail in the end with no outside intervention.

Dr. Hemenway cites the Saint Valentine’s Day massacre and the Oklahoma City bombing in 1995 as instances where the United States responded to mass acts of violence by concrete legislation limiting civilians’ ability to access the weapons used to carry out these attacks. Now, the use of outlawed machine guns in crimes is nearly eradicated. Large quantities of the raw materials for homemade explosives, such as those used in the Oklahoma City bombing, are far less available without detection than they were in the past. After 9/11, airport security tightened dramatically, and one man’s attempt to detonate a bomb hidden in his shoes on an airplane led to airports worldwide to require passengers to take off their shoes for inspection before boarding. Each of these regulatory responses has effectively reduced the ease with which a person with criminal intent can act on their intentions. From a public health perspective, populations have been made safer in each instance.

The American Medical Association, other public health experts and even editorial boards have made similar pleas with Congress following previous mass shootings. 

As a public health and policy expert, Hemenway offers a few modest suggestions to treat gun violence as a public health issue: universal background checks, demilitarizing civilian firearms, improving gun storage and utilizing “smart gun” technology, which renders a gun locked to all but a legal owner, via fingerprint recognition or other technology. He offers some more radical solutions effective in other countries--like gun buy-backs in Australia--but he suggests such extensive measures wouldn’t be necessary to make a positive difference.

Readily available data shows gun control legislation reduces the number of gun-related deaths, and media that plays into gun lobbyists’ rhetoric are inaccurately influencing public perceptions of mental illness. Journalists have heavily chronicled The hefty checks the National Rifle Association writes to members of congress to retain influence in resisting any common-sense gun legislation. It is time for politicians to assume responsibility and face the truth: their inaction on gun control is putting their constituents at risk, and mental health is a real issue, not a convenient talking point to push a harmful agenda. It’s up to advocates and voters to see through the diversionary and damaging rhetorical pivot to mental health, and hold them accountable.

Tori Bilcik hails from Connecticut and is a recent graduate of Emerson College. She is an intern with Communications team at Community Catalyst and a freelance writer.