A Mental Health Expert Weighs in on Gun Violence and Mental Illness

Mar 29, 2018

For this KSMU Sense of Community report on firearms, we reached out to Ron Honberg, Senior Policy Advisor for the National Alliance on Mental Health, to talk about the relationship between mental illness and gun violence.
Credit (Logo design courtesy National Alliance on Mental Health)

Whether it’s Colombine High School, Sandy Hook, Virginia Tech, Orlando, Las Vegas, or last month’s tragedy in Parkland, Florida, when you hear news reports of mass shootings or other violent acts involving firearms, what’s the first thought that comes to your mind?  Ron Honberg is Senior Policy Advisor for NAMI, the National Alliance on Mental Illness, an organization dedicated to raising awareness, and providing support and education, about mental illness and mental health issues. Mental health advocates and professionals like Ron Honberg are trying to fight the commonly-held perception that there is a strong link between serious mental illness and gun violence.

“I certainly understand that when something horrific happens, people react with horror and they say, ‘nobody in their right mind would do something like this!’” Honberg says. “But the fact is that, overall, the contribution of mental illness to violence, including gun violence, is quite low in this country.  A significant number of those don’t involve mental illness—at least serious mental illness.” When he mentions “serious” mental illness, Honberg says he’s “talking about conditions like schizophrenia, bipolar disorder, major depression, that have a significant impact on an ongoing basis—or on an intermittent basis at least-- on a person’s personality, their perceptions of the world around them, their state of mind.”

Having established those points, let’s look at some statistics.  According to figures published by the National Center for Health Statistics, “fewer than 5% of the 120,000 gun-related killings in the United States from 2001 to 2010 were perpetrated by people diagnosed with mental illness."  The Annals of Epidemiology published an article in 2015 by one of the most respected researchers in the mental-health field, Dr. Jeffrey Swanson of Duke University's Department of Psychiatry and Behavioral Sciences, who noted that the various studies that have been conducted by groups such as the National Institute of Mental Health and The National Epidemiologic Survey on Alcohol and Related Conditions, have come up with slightly differing figures, due in part to sampling and methodological differences between the various studies. But they are all generally in the same ballpark:  approximately 3 to 5 percent of gun killings were related to serious mental illness.  Swanson notes that while this is “a statistically significant RELATIVE risk,” it still represents “a low ABSOLUTE risk of violence in people with serious mental illness.”

Despite the low documented percentages of mentally ill persons committing gun violence, Dr. Jeffery Swanson notes in his article in Annals of Epidemiology that “a 2013 national public opinion survey found that 46% of Americans believed that persons with serious mental illness were ‘far more dangerous than the general population.’”  As Ron Honberg of NAMI says, “There are so many negative stereotypes associated with mental illness and mental health treatment.  We really need to be careful not to reinforce those, particularly when they’re not based in fact. Our efforts in this country to try to zero in on those people who should not have guns should be based on science and evidence.”

Honberg feels the so-called “Red Flag” laws that have been enacted by several states including Connecticut, California, Washington and Oregon, are a step in the right direction.  “Red Flag” laws allow for courts to be petitioned to temporarily remove guns from people who seem to pose a danger to themselves or others.  The New York Times reported last month that 18 more states and the District of Colombia are considering such laws. Ron Honberg is in favor of the new laws because they represent “an approach that is at least based on some current observation of the individual by someone who is close to them—someone who is in a position to know.”

But Honberg says he alarmed by some of the ideas floating around that call for a national database reporting anyone who has ever received mental-health treatment.  In fact, he declares, “It scares the wits out of me to think that we would be calling for widespread reporting of people who get mental health treatment.  Are we going to ask a psychologist, a psychiatrist, a social worker, to submit the names of all their patients to some sort of database?  That would have a significant deterrent (effect) on people’s willingness to seek help when they need it.  Moreover, we would be removing guns, potentially, from law enforcement officers—some of whom may seek mental health care.”

Now, we’ve been talking here about mental illness and its relationship to gun violence against other people.  What about gun violence towards one’s self—suicide by gun? The Centers for Disease Control and Prevention reported in 2010 that suicides accounted for 61 percent of all firearm fatalities in the United States.  And that’s a figure Ron Honberg of NAMI finds especially troubling.  “We know,” he says, “that a significant percentage of people who attempt suicide do, in fact, have mental illness or significant mental health conditions. That’s an area that we really haven’t done a lot of work on.”

There are proposals to reduce gun suicide, according to Honberg, including voluntarily relinquishing firearms when a person feels especially “vulnerable” to suicidal thoughts. Ultimately, though, says Honberg, “The real solutions lie in better mental health care.  We want to create a culture in this country that is more accepting of mental health care.”