Is there a real connection between mental illness and violence, especially gun violence?

Mental illness is a frequent scapegoat for politicians, organizations, and groups who support easy access to guns.

Are individuals with mental illness more prone to violence than the general population? Or are people with mental illness more likely to be victims of violence?

What does the research say?

Quick bibliography:

**created June 2022**

*Anestis, M. D., & Daruwala, S. E. (2021). The association between beliefs about the centrality of mental illness in gun violence and general firearm beliefs and behaviors. Psychology of Violence, 11(4), 364-375. [Cited by]

“Objective: The tendency to blame gun violence on mental illness may limit the implementation of evidence-based gun violence prevention efforts. We examined the extent to which the belief that gun violence is a mental health problem (vs. access to firearms) is associated with views about firearms and openness to means safety. 

Method: In 2 samples, U.S. firearm owners completed a survey on Amazon’s Mechanical Turk. In Sample 1 (n = 201, Mage = 36.79), participants endorsed that gun violence is either a mental health problem or a gun problem. In Sample 2 (n = 308, Mage = 38.47), participants endorsed a degree to which gun violence is a mental health problem or a gun problem. 

Results: In both samples, the belief that gun violence is a mental health problem was associated with less belief in an association between firearm ownership or storage and suicide risk, greater belief that individuals thwarted in an effort to use a specific method for suicide will find an alternative method (i.e., means substitution), and less openness to changing firearm storage practices to prevent suicide.

Conclusions: Firearm owners who attribute gun violence purely or predominantly to mental illness may be more likely to endorse inaccurate beliefs and unsafe behaviors with respect to firearms. Targeting this misconception is a vital goal for the field to focus on to shift how Americans think about and promote gun violence prevention.”

*Lu, Y., & Temple, J. R. (2019). Dangerous weapons or dangerous people? The temporal associations between gun violence and mental health. Preventive Medicine: An International Journal Devoted to Practice and Theory, 121, 1-6. [PDF] [Cited by]

“Despite the public, political, and media narrative that mental health is at the root of gun violence, evidence is lacking to infer a causal link. This study examines the temporal associations between gun violence (i.e., threatening someone with a gun and gun carrying) and mental health (i.e., anxiety, depression, stress, PTSD, hostility, impulsivity, and borderline personality disorder) as well the cross-sectional associations with gun access and gun ownership in a group of emerging adults. Waves 6 (2015) and 8 (2017) data were used from a longitudinal study in Texas, US. Participants were 663 emerging adults (61.7% female) including 33.6% self-identified Hispanics, 26.0% white, 27.0% Black, and 13.4% other, with an average age of 22 years. Multivariate logistic regression indicated that, individuals who had gun access were 18.15 times and individuals with high hostility were 3.51 times more likely to have threatened someone with a gun, after controlling for demographic factors and prior mental health treatment. Individuals who had gun access were 4.74 times, individuals who reported gun ownership were 5.22 times, and individuals with high impulsivity were 1.91 times more likely to have carried a gun outside of their homes, after controlling for prior gun carrying, mental health treatment, and demographic factors. Counter to public beliefs, the majority of mental health symptoms examined were not related to gun violence. Instead, access to firearms was the primary culprit. The findings have important implications for gun control policy efforts.”

*McGinty, E. E. (2018). Mental illness and gun violence: Disrupting the narrative. Psychiatric Services, 69(8), 842-843. [PDF] [Cited by]

“Mental illness receives prominent attention in the U.S. dialogue on gun violence, despite evidence showing that most people with mental illness are never violent and most gun violence is not caused by mental illness (“violence” refers here and throughout to interpersonal violence, not suicide). Messages linking mental illness with violence increase social stigma, which contributes to low treatment rates and other negative outcomes among people with mental illness. Nonetheless, mental illness continues to be a central topic in gun violence debates such as the one prompted by the February 2018 mass shooting at Marjory Stoneman Douglas High School in Parkland, Florida. Why does the narrative of mental illness as a major cause of gun violence persist, and how can it be disrupted?”

*Peterson, J. K., Densley, J. A., Knapp, K., Higgins, S., & Jensen, A. (2022). Psychosis and mass shootings: A systematic examination using publicly available data. Psychology, Public Policy, and Law, 28(2), 280-291. [Cited by]

“Mass shootings are often blamed on serious mental illness. This study assesses the role of psychosis in contributing to mass shootings along a continuum. The role of psychosis is compared with other motivations for mass shootings including employment issues, interpersonal conflict, relationship issues, hate, and fame-seeking. Perpetrators motivated by psychosis are also compared with other perpetrators on several well-established risk factors for violence. It is hypothesized that a mental health history is common among mass shooters, but symptoms of psychosis only directly motivate mass shootings for a minority of cases. A dataset of 172 mass shooters was created, coded on 166 life history variables using publicly available data. The entire dataset and codebook are publicly available. The findings show that symptoms of psychosis played no role in 69% of cases, but psychosis may have played a minor role in 11% of cases, a moderate role in 9% of cases, and a major role in 11% of cases. Perpetrators motivated by psychosis were similar to mass shooters with other motivations in terms of demographics and common risk factors for violence. The role of serious mental illness in mass shootings is complex. The data indicate that access to mental health care may help prevent mass shootings in a minority of cases, but this is far from the only solution to mass shootings.”

*Rueve, M. E., & Welton, R. S. (2008). Violence and mental illness. Psychiatry, 5(5), 34-48. [PDF] [Cited by]

“Violence attracts attention in the news media, in the entertainment business, in world politics, and in countless other settings. Violence in the context of mental illness can be especially sensationalized, which only deepens the stigma that already permeates our patients’ lives. Are violence and mental illness synonymous, connected, or just coincidental phenomena? This article reviews the literature available to address this fundamental question and to investigate other vital topics, including etiology, comorbidity, risk factor management, and treatment. A psychiatrist who is well versed in the recognition and management of violence can contribute to the appropriate management of dangerous behaviors and minimize risk to patients, their families, mental health workers, and the community as a whole.”

For additional research on the causes of gun violence, please search Science Primary Literature (database).

Questions?  Please let me know (engelk@grinnell.edu).