Wednesday, February 28, 2018

Blaming Mass Shootings on Serious Mental Illness Has Harmful Effects, Says APA Past President

In the two weeks since a 19-year-old opened fire at Marjory Stoneman Douglas High School in Parkland, Fla., killing 17 students and faculty members, there has been much talk by politicians about the need to address untreated serious mental illness in the United States.

In an article published today in JAMA Psychiatry, APA Past President Renée Binder, M.D., and Matthew Hirschtritt, M.D., M.P.H., both of the University of California, San Francisco, wrote that while political rhetoric focusing the blame for mass shootings on individuals with serious mental illness may be “politically expedient,” such an approach “stigmatizes an already vulnerable and marginalized population, fails to identify individuals at the highest risk for committing violence with firearms, and distracts public attention from policy changes that are most likely to reduce the risk of gun violence.”

Binder and Hirschtritt summarized several studies that suggest serious mental illness is not a specific indicator for risk of violence. The article notes that such studies have found that people with mental illness are three times more likely to be victims than perpetrators of violence and only 4% of criminal violence in the United States can be attributed to people with mental illness.

Multiple factors other than serious mental illness contribute to violence risk, Binder and Hirschtritt wrote, including being male, young, having a history of perpetrating violence or being a victim of violence, and unlawful use of firearms. Certain triggers, including intoxication and severe stress, have also been shown to increase the risk of gun violence in people with and without mental illness.

“Addressing the risk of future mass shootings requires addressing a wide range of individual, community-level, and national and state policy factors, including decreasing access to guns, especially during periods of heightened violence risk,” they wrote. “Likewise, identifying and assisting those with serious mental illness requires the investment of resources and coordination of services, including supportive case managers, law enforcement and emergency personnel, and mental health clinicians.”

Psychiatrists should work to counter the perception that mental illness is the primary cause of gun violence, Binder told Psychiatric News. “I believe that psychiatrists have a role in advocacy and education. We have a responsibility in terms of educating people that guns are very dangerous, should be safely stored, and should be taken away from dangerous people,” she said. “Most people with mental illness will never commit a mass shooting, and this rhetoric leads to increased shame, societal reduction, stigmatization, and problems in gaining stable employment and housing.”

For related information, see the Psychiatric News AlertAPA Joins Other Physician Groups to Demand Action on Gun Violence.”


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