Experts Discuss Mental llness, Risk for Violence, and Gun Ownership

An evidence-based assessment of dangerousness—not mental illness, per se—should guide public policies regarding restrictions on gun ownership, Jeffrey Swanson, Ph.D. (left), of Duke University School of Medicine said during the "Do Firearm Restrictions Prevent Suicide and Violence in People With Serious Mental Illness?" workshop at the APA annual meeting in Toronto. He was joined by Joshua Horwitz, executive director of the Educational Fund to Stop Gun Violence.

Swanson, a professor of psychiatry and behavioral science, presented evidence showing that while there are instances when those with a serious mental illness are at increased risk of violence, serious mental illness, on its own, contributes very little to overall violence towards others. (Mental illness alone carries a far greater risk for suicide.)

For instance, he showed data from a survey of public behavioral health system psychiatric outpatients with serious mental illness in five U.S. sites demonstrating that the risk of violence rose significantly when in combination with substance abuse, early victimization, and/or exposure to violence in one's current social environment.

Swanson offered these following principles to guide public policy regarding restricting access to firearms:

• Prioritize contemporaneous risk assessment based on evidence of behaviors that correlate with violence and self-harm at specific times, not mental illness or treatment history per se as a category of exclusion;


• Preempt existing gun access, rather than simply thwarting a new gun purchase by a dangerous person;


• Provide legal due process for deprivation of gun rights;


• Preserve confidential therapeutic relationships;


• Prevent the unpredictable through universal background checks, but also by reducing the social determinants of violence and investing in improved access to mental health and substance abuse services.

For more information on gun policy and mental illness, see the Psychiatric News article "Capitol Hill Gets Straight Story On Gun Violence, Mental Illness" and the Psychiatric Services article "Gun Policy and Serious Mental Illness: Priorities for Future Research and Policy."

(Image: Mark Moran)