We can't blame mental health problems for every massacre, but we can blame guns

Making it harder to access lethal means might not prevent every tragedy, but it would undoubtedly reduce the rate

TOPSHOT - Ethan Avanzino grieves beside a white cross for his friend Cameron Robinson, one of 58 victims of Sunday night's mass shooting, on the Las Vegas Strip just south of the Mandalay Bay hotel, October 6, 2017 in Las Vegas, Nevada.
On October 1, 2017 Stephen Paddock killed at least 58 people and injured more than 450 after he opened fire on a large crowd at the Route 91 Harvest country music festival. The massacre is one of the deadliest mass shooting events in US history. / AFP PHOTO / Robyn Beck
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Mental health problems exist everywhere; frequent mass shootings don’t.

In the absence of any known or assumed ideological or personal motivation behind a mass shooting, the massacre pundits will all too frequently reach for the mental illness sound bites. For sure, the mental health status of 64-year-old Stephen Paddock, who murdered 59 in Las Vegas last week, has already been tabled for discussion. The speculation varies widely, from the ideas about paranoid delusions to affectionless psychopathy (anti-social personality disorder). However, the mental health status of Paddock, whatever it was, didn’t kill 59 people and cause injury to hundreds more. Guns and bullets did.

The idea that people with mental health problems pose an elevated risk of violence to society is an inaccurate and enduring myth. According to the US census bureau, the US represents about 5 per cent of the world’s population but accounts for more than 30 per cent of the world’s mass shootings. Mental health problems exist everywhere; frequent mass shootings don’t.

To further dispel the myth that people with mental health problems pose a violent threat, consider the data reported in the British Journal of Psychiatry in 2006. This study suggests that about 5 per cent of all people incarcerated for murder in England suffer from a severe mental illness, which means 95 per cent of murderers are "mentally well". Even this 5 per cent figure is hugely misleading, especially when we consider that people with severe mental health problems (psychosis) are also far more likely to be vulnerable to issues with alcohol and narcotics, perhaps having self-medicated for years prior to receiving professional help. When this factor is taken into consideration, it becomes even harder to identify a relationship between severe mental health problems and homicide or violence.

A similar study was undertaken in Sweden. This study, however, had the additional advantage of being longitudinal, looking at the risk for homicide and violent crimes among 3,743 people with severe mental health problems over a 30-year period. At first glance, the findings from this study suggest that having a severe mental health problem increases the odds of being involved in a homicide or violent crime. Among those experiencing severe mental illness, about 8 per cent were convicted of a violent crime during the 30-year period covered by the study, while only 4 per cent of the healthy controls were similarly convicted. However, as in the UK study, once the researchers controlled for drug and alcohol use, the difference between the groups vanished. The drugs and alcohol use predict violent crimes; mental health problems don’t.


Read more on the Las Vegas tragedy


George Szmukler, emeritus professor of psychiatry and society at the Institute of Psychiatry, Psychology and Neuroscience at King's College London, employed sophisticated statistical models in an attempt to predict violence among psychiatric patients. When the predictive model was used to try and identify those likely to be involved in extreme acts of violence, it was close to useless, getting it wrong 97 times out of 100.

In his book, Doctoring the Mind, Richard Bentall, professor of clinical psychology at Sheffield University, writes: "More vigorous efforts to control unappreciative psychiatric patients might make us feel safer, but it seems unlikely they would actually make the world a safer place." What would make the world a safer place, is tighter gun control, drugs control and the cultivation of more compassionate and caring societies.

It is also worth considering that the majority of US gunshot fatalities are self-inflicted. In the US, suicide is more common than homicide, and the most common method of suicide is by gun. It is a well-established principle in suicide prevention that easy access to lethal means is a factor that increases the risk of completed suicides. Making it harder to access lethal means might not prevent every tragedy, but it would undoubtedly reduce the rate.

Dr Justin Thomas is an associate professor at Zayed University

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