“It seems intuitive that someone who could do something terrible must be, in some sense, insane,” she writes. “But is that actually true? Are gun violence and mental illness really so intertwined?”
After a painstaking look at the research, Konnikova concludes that such a link, “is quite small and far from predictive.”
The factors that are actually linked to gun violence are much more complicated, she adds — and thus much more difficult for politicians and the public to accept, much less take action on.
Debunking two myths
Although her article describes research conducted both in the United States and abroad on the topic, Konnikova focuses on the seminal studies done by Jeffrey Swanson, now a medical sociologist and professor of psychiatry and behavioral sciences at Duke University:
When Swanson first analyzed [in the 1980s] the ostensible connection between violence and mental illness, looking at more than ten thousand individuals (both mentally ill and healthy) during the course of one year, he found that serious mental illness alone was a risk factor for violence — from minor incidents, like shoving, to armed assault — in only four per cent of cases. That is, if you took all of the incidents of violence reported among the people in the survey, mental illness alone could explain only four per cent of the incidents. When Swanson broke the samples down by demographics, he found that the occurrence of violence was more closely associated with whether someone was male, poor, and abusing either alcohol or drugs — and that those three factors alone could predict violent behavior with or without any sign of mental illness. If someone fit all three of those categories, the likelihood of them committing a violent act was high, even if they weren’t also mentally ill. If someone fit none, then mental illness was highly unlikely to be predictive of violence.
“That study debunked two myths,” Swanson said. “One: people with mental illness are all dangerous. Well, the vast majority are not. And the other myth: that there’s no connection at all. There is one. It’s quite small, but it’s not completely nonexistent.”
In 2002, Swanson repeated his study over the course of the year, tracking eight hundred people in four states who were being treated for either psychosis or a major mood disorder (the most severe forms of mental illness). The number who committed a violent act that year, he found, was thirteen per cent. But the likelihood was dependent on whether they were unemployed, poor, living in disadvantaged communities, using drugs or alcohol, and had suffered from “violent victimization” during a part of their lives. The association was a cumulative one: take away all of these factors and the risk fell to two per cent, which is the same risk as found in the general population. Add one, and the risk remained low. Add two, and the risk doubled, at the least. Add three, and the risk of violence rose to thirty per cent.
The studies by Swanson — and other researchers — do, however, indicate one type of violence for which mental illness is predictive: suicide.
“Mental illness, Swanson has found, increases the risk of gun violence when that violence takes the form of suicide,” writes Konnikova. “According to the [Centers for Disease Control and Prevention], between twenty-one and forty-four per cent of those who commit suicide had previously exhibited mental-health problems — as indicated by a combination of family interviews and evidence of mental-health treatment found at the scene, such as psychiatric medications — while between sixteen and thirty-three per cent had a history of psychiatric treatment. As Swanson points out, many studies have shown an even higher risk of suicide among the mentally ill, up to ten to twenty times higher than the general population for bipolar disorder and depression, and thirteen times higher for schizophrenia-spectrum disorders.”
The biggest predictor
Although mental illness may not be a strong predictor of gun violence, research by Swanson and others has uncovered a factor that is: past violence.
“If Swanson had his way,” writes Konnikova, “gun prohibitions wouldn’t be based on mental health, but on records of violent behavior — not just felonies, but also including minor disputes.”
“There are lots of people out there carrying guns around who have high levels of trait anger — the type who smash and break things,” Swanson told her. “I believe they shouldn’t have guns. That’s what’s behind the idea of restricting firearms with people with misdemeanor violent-crime convictions or temporary domestic-violence restraining orders, or even multiple D.U.I.s.”
“We need to get upstream and try to prevent the unpredicted: how to have healthier, less violent communities in the first place,” he added.
Mental illness “is easy to blame, easy to pinpoint, and easy to legislate against in regards to gun ownership,” writes Konnikova. “But that doesn’t mean that it is the right place to start in an attempt to curtail violence. The factors responsible for mass violence are messy, complex, and dynamic — and that is a far harder sell to legislators and voters alike.”
You can read her article on The New Yorker’s website.