Expert Commentary

Gun violence, mental illness and firearms background checks: Research and insights

2016 collection of research that offers insight on the link between gun violence and mental illness and the effectiveness of laws that ban certain people from buying firearms. 

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Immediately following reports that a South Florida man shot dozens of people in an Orlando nightclub in June 2016, journalists and the public began to question his mental state and mental-health history. Within days of the massacre, news agencies nationwide were reporting details about Omar Mateen’s childhood, adolescence and adulthood – including behavioral problems in elementary school and his most recent online searches for information about anti-psychosis medication.

As journalists have scrutinized Mateen’s life history, this latest tragedy – characterized as the worst mass shooting in U.S. history – has prompted legislators to demand stricter gun control measures and question the effectiveness of existing state and federal laws that aim to keep firearms away from individuals with mental illnesses.

Media professionals who report on these controversial issues should seek out the latest academic research in these areas and read it and understand it. Peer-reviewed research can ground journalists’ coverage and allow them to differentiate facts from myths and scientific evidence from assumptions.

For many years, scholars have explored the possible ties between mental illness and violence. They have found that most people with a serious mental illness are not violent, that mental illness is not a strong risk factor for homicide. A 2014 study published by the American Psychological Association noted no predictable pattern linking criminal conduct and mental illness symptoms over time. According to the National Center for Health Statistics, fewer than 5 percent of gun-related deaths between 2001 and 2010 were caused by individuals diagnosed with a mental illness.

Below, Journalist’s Resource has pulled together a sampling of research and reports that we hope will offer reporters crucial insights and also reveal new angles worth investigating:



Gun background checks and mental illness 


“Gun Violence, Mental Illness, And Laws That Prohibit Gun Possession: Evidence From Two Florida Counties”

Swanson, Jeffrey W. Health Affairs, June 2016, Vol. 35. doi: 10.1377/hlthaff.2016.0017.

Abstract: “Gun violence kills about 90 people every day in the United States, a toll measured in wasted and ruined lives and with an annual economic price tag exceeding $200 billion. Some policy makers suggest that reforming mental health care systems and improving point-of-purchase background checks to keep guns from mentally disturbed people will address the problem. Epidemiological research shows that serious mental illness contributes little to the risk of interpersonal violence but is a strong factor in suicide, which accounts for most firearm fatalities. Meanwhile, the effectiveness of gun restrictions focused on mental illness remains poorly understood. This article examines gun-related suicide and violent crime in people with serious mental illnesses, and whether legal restrictions on firearm sales to people with a history of mental health adjudication are effective in preventing gun violence. Among the study population in two large Florida counties, we found that 62 percent of violent gun crime arrests and 28 percent of gun suicides involved individuals not legally permitted to have a gun at the time. Suggested policy reforms include enacting risk-based gun removal laws and prohibiting guns from people involuntarily detained in short-term psychiatric hospitalizations.”


“State Progress in Record Reporting for Firearm-Related Background Checks: Mental Health Submissions”
Goggins, Becki; Gallegos, Anne. Report from the U.S. Bureau of Justice Statistics, March 2016.

Abstract: “Over the past ten years, states have made vast progress in providing firearm prohibiting mental health information to the National Instant Criminal Background Check System (NICS) Index. The passage of the NICS Improvement Amendments Act (NIAA) in 2008 was a turning point in reporting; in addition to the approximately 250,000 federally-submitted mental health records, the NICS Index went from holding just over 400,000 state-submitted mental health records to over 3.8 million state-submitted records in July of 2015. This report provides an overview of legislation and reporting mechanisms for mental health information, the challenges states face in reporting, strategies that have been implemented to overcome the challenges, and finally, data that illustrate the improvements that have been accomplished over the past decade in this area.”


“Preventing Persons Affected by Serious Mental Illnesses from Obtaining Firearms: The Evolution of Law, Policy, and Practice in Massachusetts”
Silver, James; Fisher, William H.; Silver, Emily. Behavioral Sciences & the Law, 2015, Vol. 33. doi: 10.1002/bsl.2170.

Abstract: “A history of commitment to a mental health facility disqualifies applicants for gun licenses. Identifying such a history has become increasingly complex as the locus of confinement has become more diversified and privatized. In Massachusetts, prior to 2014, the databases used to identify individuals who would be disqualified on such grounds had not contemporaneously matched the evolution of the state’s mental health systems. A survey of Massachusetts police chiefs, who, as in many jurisdictions, are charged with certifying qualification, indicates that some have broadened the scope of their background checks to include the experience of their officers with respect to certain applicants. The survey identifying these patterns, conducted in 2014, preceded by one month significant legislative reforms that mandate the modification of the reporting into a centralized database commitments to all types of mental health and substance use facilities, thus allowing identification of all commitments occurring in the state. The anticipated utilization of a different database mechanism, which has parallels in several other states, potentially streamlines the background check process, but raises numerous concerns that need to be addressed in developing and using such databases.”


“Mental Illness and Reduction of Gun Violence and Suicide: Bringing Epidemiologic Research to Policy”
Swanson, Jeffrey W.; McGinty, E. Elizabeth; Fazel, Seena; Mays, Vickie M. Annals of Epidemiology, 2015, Vol. 25. doi:10.1016/j.annepidem.2014.03.004.

Summary: This study explores the link between mental illness and violence, including suicide, as well as the effectiveness of gun-purchaser background checks in Connecticut. The Connecticut study found differences in effectiveness between two key groups: clients of the public behavioral health care system who do not have criminal records and individuals who are involved with both the criminal justice system and the behavioral health system.


“Guns, Impulsive Angry Behavior, and Mental Disorders: Results from the National Comorbidity Survey Replication (NCS-R)”
Swanson, Jeffrey W.; et al. Behavioral Sciences & the Law, 2015, Vol. 33. doi: 10.1002/bsl.2172.

Abstract: “Analyses from the National Comorbidity Study Replication provide the first nationally representative estimates of the co-occurrence of impulsive angry behavior and possessing or carrying a gun among adults with and without certain mental disorders and demographic characteristics. The study found that a large number of individuals in the United States self-report patterns of impulsive angry behavior and also possess firearms at home (8.9 percent) or carry guns outside the home (1.5 percent). These data document associations of numerous common mental disorders and combinations of angry behavior with gun access. Because only a small proportion of persons with this risky combination have ever been involuntarily hospitalized for a mental health problem, most will not be subject to existing mental health-related legal restrictions on firearms resulting from a history of involuntary commitment. Excluding a large proportion of the general population from gun possession is also not likely to be feasible. Behavioral risk-based approaches to firearms restriction, such as expanding the definition of gun-prohibited persons to include those with violent misdemeanor convictions and multiple DUI convictions, could be a more effective public health policy to prevent gun violence in the population.”


Gun violence and mental illness


“Acts of Weapon Threat and Use Against Family Members by Persons with Psychiatric Disorders”
Labrum, Travis; Solomon, Phyllis L. Violence and Gender, 2016, Vol. 3. doi: 10.1089/vio.2015.0052.

Abstract: “Persons with psychiatric disorders (PD) are at a modestly increased risk of committing violence. Only a very small portion of general and gun-related violence by persons with PD is committed against strangers. Instead, family members and other well-known persons are the vast majority of such victims. The objective of the present analysis is, with the use of a U.S.-community-recruited sample, to examine rates of victimization of threats and acts of violence involving a gun or other weapon against family members committed by relatives with PD. Of the respondents, 10 percent and 4.5 percent reported that since their relative with PD was first diagnosed with a mental health condition, s/he has threatened them with a weapon and has used a weapon against them, respectively. With regard to the past 6 months, 4 percent and 2 percent of respondents reported that their relative with PD has threatened them with a weapon and used a weapon against them. It is imperative that research be conducted in this area indicating how we may best prevent acts of weapon threat and use against family members by this population. Additionally, it is important that the large part family members have in the victimization of gun and other weapon-related violence by persons with PD be acknowledged when developing social policies intended to prevent such victimization.”


“Mental Illness, Mass Shootings, and the Politics of American Firearms”
Metzl, Jonathan M.; MacLeish, Kenneth T. American Journal of Public Health, 2015, Vol. 105. doi: 10.2105/AJPH.2014.302242.

Abstract: “Four assumptions frequently arise in the aftermath of mass shootings in the United States: (1) that mental illness causes gun violence, (2) that psychiatric diagnosis can predict gun crime, (3) that shootings represent the deranged acts of mentally ill loners, and (4) that gun control ‘won’t prevent’ another Newtown (Connecticut school mass shooting). Each of these statements is certainly true in particular instances. Yet, as we show, notions of mental illness that emerge in relation to mass shootings frequently reflect larger cultural stereotypes and anxieties about matters such as race/ethnicity, social class, and politics. These issues become obscured when mass shootings come to stand in for all gun crime, and when ‘mentally ill’ ceases to be a medical designation and becomes a sign of violent threat.”


“The Epidemiology of Firearm Violence in the Twenty-First Century United States”
Wintemute, Garen J. Annual Review of Public Health, 2015. doi: 10.1146/annurev-publhealth-031914-122535.

Abstract: “This brief review summarizes the basic epidemiology of firearm violence, a large and costly public health problem in the United States for which the mortality rate has remained unchanged for more than a decade. It presents findings for the present in light of recent trends. Risk for firearm violence varies substantially across demographic subsets of the population and between states in patterns that are quite different for suicide and homicide. Suicide is far more common than homicide and its rate is increasing; the homicide rate is decreasing. As with other important health problems, most cases of fatal firearm violence arise from large but low-risk subsets of the population; risk and burden of illness are not distributed symmetrically. Compared with other industrialized nations, the United States has uniquely high mortality rates from firearm violence.”


Media coverage 

“Trends in News Media Coverage Of Mental Illness In The United States: 1995–2014”
McGinty, Emma E.; Kennedy-Hendricks, Alene; Choksy, Seema; Barry, Colleen L. Health Affairs, June 2016, Vol. 35. doi: 10.1377/hlthaff.2016.0011.

Abstract: “The United States is engaged in ongoing dialogue around mental illness. To assess trends in this national discourse, we studied the volume and content of a random sample of 400 news stories about mental illness from the period 1995–2014. Compared to news stories in the first decade of the study period, those in the second decade were more likely to mention mass shootings by people with mental illnesses. The most frequently mentioned topic across the study period was violence (55 percent overall) divided into categories of interpersonal violence or self-directed (suicide) violence, followed by stories about any type of treatment for mental illness (47 percent). Fewer news stories, only 14 percent, described successful treatment for or recovery from mental illness. The news media’s continued emphasis on interpersonal violence is highly disproportionate to actual rates of violence among those with mental illnesses. Research suggests that this focus may exacerbate social stigma and decrease support for public policies that benefit people with mental illnesses.”


“Common Sense or Gun Control? Political Communication and News Media Framing of Firearm Sale Background Checks after Newtown”
McGinty, Emma E.; Wolfson, Julia A.; Sell, Tara Kirk; Webster, Daniel W. Journal of Health Politics, Policy and Law, 2016, Vol. 41. doi: 10.1215/03616878-3445592.

Abstract: “Gun violence is a critical public health problem in the United States, but it is rarely at the top of the public policy agenda. The 2012 mass shooting in Newtown, Connecticut, opened a rare window of opportunity to strengthen firearm policies in the United States. In this study, we examine the American public’s exposure to competing arguments for and against federal- and state-level universal background check laws, which would require a background check prior to every firearm sale, in a large sample of national and regional news stories (n = 486) published in the year following the Newtown shooting. Competing messages about background check laws could influence the outcome of policy debates by shifting support and political engagement among key constituencies such as gun owners and conservatives. We found that news media messages in support of universal background checks were fact-based and used rational arguments, and opposing messages often used rights-based frames designed to activate the core values of politically engaged gun owners. Reframing supportive messages about background check policies to align with gun owners’ and conservatives’ core values could be a promising strategy to increase these groups’ willingness to vocalize their support for expanding background checks for firearm sales.”


Keywords: psychiatric disorder, Columbine, Virginia Tech, Aurora, Sandy Hook, Fort Hood, Luby’s shooting, Seung-Hui Cho, Dylann Roof, Adam Lanza

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