25 Jun Blaming Mental Illness for Mass Shootings? Not So Fast.
It seems like there’s one thing everyone agrees on after a mass shooting: The shooter must have been mentally ill. But what if the assumption is wrong?
Jonathan Metzl, a professor of psychiatry, sociology, and medicine, health, and society at Vanderbilt University, argues that mental illness is often a scapegoat that lets policymakers and the public ignore bigger, more complicated contributors to gun violence. Metzl, who reviewed the research on mass shootings and mental illness in a paper for the American Journal of Public Health, points to studies that show people with mental illness are more likely to be victims — not perpetrators — of violence, and that very few violent acts — about 3 to 5 percent — are carried out by the mentally ill. And while mental illness can be a contributor to some violent behaviors, other factors— such as substance abuse, poverty, history of violence, and access to guns — are much stronger predictors of violence and shootings.
For example, some studies have found that people with schizophrenia are more likely to commit violent acts. But other research has found that this propensity toward violence is almost entirely due to substance abuse, a common problem among people with schizophrenia who are self-medicating. And substance abuse — particularly when it involves alcohol — can make someone much more likely to commit violent crime.
But the focus on mental illness after mass shootings lives on. In a 2013 Gallup poll, 48 percent of Americans said failure of the mental health system was “a great deal to blame” for mass shootings, compared with 40 percent who cited easy access to guns, 37 percent who cited drug use, and 29 percent who cited the spread of extremist viewpoints on the internet. This may reflect, Metzl suggested, the inability of many Americans to understand why somebody sane would attack and kill strangers.
To dive deeper into the issue, I spoke with Metzl about the research and his thoughts on mass shootings. This interview has been edited for length and clarity.
The limited connection between mental illness and mass shootings
One is that there’s no real way of predicting a mass shooting. Mass shootings are very often statistical anomalies. The trouble people get into a lot of times is that they think, “Oh, he must have been crazy or something, and a psychiatrist should have been able to see him before and predict it.” That’s a complete miss, unfortunately.
As an aggregate group, people with mental illness are less likely than the general population to shoot other people, and they are far more likely [to be] victims of violence rather than perpetrators of violence. So I think this intense psychological profile of mass shooters as a way of preventing other mass shootings is really the wrong path to go down, even though it’s understandable.
Point number two is that there is research that shows a certain proportion [up to 60 percent] of mass shooters do have some kind of psychiatric or psychological symptoms. As an aggregate group, mass shooters are very often young, white, paranoid men who’ve had histories of depression and possibly sometimes psychosis. So at least there are profiles that can allow you to aggregate some of these mass shooters into particular groups.
But there are a lot of other factors that aren’t linked to mental illness that are equally predictive if not more predictive: access to firearms, substance use or abuse, and past history of violence or arrests. These are all far more predictive than a diagnosis of mental illness — and they’re more preventive in the long run.
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