Charleston shooting

Why Disarming the 'Mentally Ill' Is Not a Sensible Response to Mass Shootings

The dragnet would ensnare many harmless people without having a significant impact on gun violence.

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Georgetown University

After the 2012 massacre at Sandy Hook Elementary School in Newtown, Connecticut, Wayne LaPierre, the National Rifle Association's executive vice president, sought to counter calls for gun control by recommending people control instead. Specifically (or not so specifically), LaPierre recommended  "an active national database of the mentally ill" to identify and thwart the next mass shooter. Last week, as I note in my column today, Sen. Lindsey Graham (R-S.C.) suggested something similar in response to the massacre at Charleston's Emanuel AME Church: a surveillance system to "track people" who are "not quite there" so "they can be deterred or stopped." President Obama was even more ambitious, imagining a system that "prevents a 21-year-old who is angry about something, or confused about something, or is racist, or is, you know, deranged from going into a gun store" and buying a weapon.

In short, if you are "mentally ill," "not quite there," "angry," "confused," "racist," or "deranged," the Second Amendment does not apply to you. It seems fair to ask, then, whether the Second Amendment applies to anyone. Something like half of all Americans qualify for a psychiatric diagnosis at some point in their lives, and I suspect the "angry" or "confused" portion approaches 100 percent.

In a recent Journal of the American Medical Association essay, Georgetown law professor Lawrence Gostin argues that such proposals for preventing troubled individuals from obtaining guns are misbegotten, requiring a dragnet that will ensnare many harmless people without having a significant impact on gun violence:

Historically, society has stereotyped persons with mental illness as dangerous, believing that restraining their liberty or rights would solve social problems. But the evidence does not support this position….

Although most mass killers are mentally ill, only a small minority of persons with mental illness is violent. Overall, only about 4% to 5% of overall violent crime can be attributed to persons with mental illness. At the same time, it is exceedingly difficult to predict violence based on a psychiatric diagnosis: psychiatrists' predictions of violence are no better than chance….

It is true that mental illness can be a risk factor for violence, but often only with comorbidities, such as alcohol or drug abuse. The latter are far more powerful predictors of violence than the diagnosis of mental illness. Still more powerful is a history of violence, particularly threatening or using a lethal weapon such as a firearm.

These data suggest that the legislative response to the Isla Vista murders ["gun violence restraining orders" based on the fears of cops, relatives, or roommates] deals with the problem of gun violence only at the margins. At the same time, the response reinforces deep and historical stereotypes of persons with mental illness as irrational and dangerous.

Gostin does think there should be a more systematic effort to enter information about people who have been involuntarily committed (who are already barred from owning guns) into the FBI's National Instant Criminal Background Check System. He says that makes sense because "civil commitment standards incorporate danger to self or others," although applying those standards involves the highly fallible judgments of the same mental health professionals Gostin already has said are unreliable. One might also object, on libertarian grounds, to Gostin's assumption that suicide prevention should receive the same priority as murder prevention.

Gostin himself prefers "broader gun control measures" that aim to reduce the general availability of firearms. "What has long been understood in public health is that changing behavior is notoriously difficult," he writes. "What is far more effective is to change the environment. In this case, limiting access to firearms would prevent many gun injuries and deaths—not just in mass shootings but also, more importantly, on the streets in every major city in the United States."

The trick, as always, is limiting access to guns in such a way that it will incommode criminals without treading upon law-abiding citizens' Second Amendment rights. That is also notoriously difficult.