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Wednesday Sep 18, 2019

Don't Blame Mental Illness for Mass Shootings

In a misguided attempt to curb mass shootings, the administration wants to study whether monitoring people with mental illnesses(www.washingtonpost.com) could help predict violence. The proposal, which likely would violate the Fourth Amendment, focuses on using technology such as phones and smartwatches to detect whether people with mental illnesses are about to turn violent.

[crime scene tape]

This approach is consistent with the narrative that quickly emerges after every mass shooting in the United States: "Maybe he was mentally ill."

Then Republicans call for mental health reform.

Democrats quickly agree that we need mental health reform (independent of mass shootings) while calling for gun reform.

And then nothing happens.

Again.

Through Sept. 17, there have been 301 mass shootings in the United States(www.gunviolencearchive.org) this year. That's more than one a day.

The week after 31 people were killed in mass shootings in Ohio and Texas last month, the president proclaimed, "Mental illness and hatred pull the trigger, not the gun."(abcnews.go.com)  

As family physicians, we are no strangers to mental health care. In fact, my most common diagnoses (after "health maintenance") are anxiety and depression. Every day, I see patients who are struggling with sleep, appetite, concentration and energy. These are hallmarks of mental health issues. Committing a mass shooting is not.

That's why it's important for family physicians to combat the persistent myth that mental illness is a leading factor in mass shootings. This is unsupported by evidence.

Study(psychiatryonline.org) after study(www.sciencedirect.com) has demonstrated that people with mental health issues commit only a miniscule percentage of mass shootings and account for less than 1% of annual gun homicides. According to a study based on Swedish data published in the American Journal of Psychiatry, only 3%-5% of violent crimes are perpetrated by someone with a mental illness.(ajp.psychiatryonline.org) In fact, people with serious mental illnesses are more likely to be the victims of violence.(www.ncbi.nlm.nih.gov) And the vast majority of gun deaths in America are from suicide, meaning those with mental illness are far more likely to harm themselves than others.

Blaming mental illness only serves to further stigmatize patients who have mental health issues as inherently dangerous. And it deflects attention from a real predictor of mass shootings: easy access to guns.

By blaming mental illness or video games (which, it should be noted, are also not proven influencers in mass shootings(www.vox.com)), politicians beholden to gun lobby groups avoid a discussion about gun reform.

The administration's idea to try to predict mass shootings through monitoring those with mental illnesses oversimplifies the complexities of human behavior. Ninety-seven percent of mass shooters are male.(www.statista.com) The overwhelming majority are white.(www.statista.com) Beyond that, mass shooters share weaker links. They have beliefs ranging from misogyny(www.researchgate.net) to white supremacy. Some are seeking revenge. Many have a history of domestic violence.(www.vox.com)  

All this, but a glaring statistic remains: Americans are 10 times more likely to die from gunfire(www.businessinsider.com) than are citizens of other high-income countries with similar rates of mental health issues.

Pursuing specific solutions to gun violence is also difficult. The 1996 Dickey Amendment has hindered research about gun violence at the CDC, leading to a paucity of evidence-based data. But here's what we do know: We need to stop scapegoating mental illness every time someone commits mass murder.

Patients with mental health issues are as diverse as those without. Stripping away rights from people with conditions ranging from depression to ADHD to bipolar disorder to anxiety to substance abuse is tantamount to outright discrimination.

As I started writing this, I realized I wouldn't be able to say anything that has not already been said because legions of doctors and other health professionals have also spoken out about the mental health-mass shootings myth. But I'm adding my voice to the mix because this country has a growing problem with gun violence,(www.pewresearch.org) and we have to stop being too afraid to address it.

Natasha Bhuyan, M.D., is a board-certified family physician in Phoenix. You can follow her on Twitter @NatashaBhuyan.(twitter.com)

Read other Fresh Perspectives posts by this blogger.

Posted at 12:12PM Sep 18, 2019 by Natasha Bhuyan, M.D.

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