Our Gun Problem Is More Than a Mental Health Problem

On Feb. 2, the U.S. House of Representatives voted to roll back a gun law that would block some people with mental illness from purchasing guns. The law relied on the Social Security Administration to report to the FBI people who were receiving disability benefits for mental health disabilities, which would cause the names of those people to pop on a background check if they tried to purchase a gun. It is likely that the change in the law will sail through the Republican-controlled Senate and be signed by President Trump.

Reactions by gun-control advocates to the change in law tend to emphasize how the law change endangers public safety. As The Hill reported, “Rep. Elizabeth Esty (D-Conn.) accused Republicans of weakening the background check system.” Esty stated, “The House charged ahead with an extreme, hastily written, one-sided measure that would make the American people less safe.”

But is Esty right?

Media Obsession with Mass Shootings

In January, Esteban Santiago, a U.S. veteran with a mental illness and a history of domestic violence, gunned down 13 people in the Ft. Lauderdale airport, killing five. A few weeks ago, Santiago pleaded not guilty to all charges against him.

After the shooting, experts were full of hindsight: how did a man who had voluntarily told authorities that he was psychotic and surrendered his firearm get his firearm back a mere few weeks later (remember, this was before the rollback of the mental health gun law)? Why didn’t authorities pay attention to Santiago’s history of severe physical violence toward his intimate partner, a common indicator of future gun violence? He had a one-way plane ticket along with a gun in his luggage—more indicators that seem to have passed beneath our collective radar. And now we have yet another national tragedy on our hands.

Yet, despite the media focus on mass shootings when they occur, they make up only a minuscule number of the gun deaths in the U.S. each year. According to the CDC, in 2014, 33,599 people died of firearm injuries in the U.S. That same year, according to the comprehensive study by Mother Jones, only 18 people died in mass shootings, including the Ft. Hood and the Isla Vista shootings that year.

This isn’t to say that mass shootings aren’t horrifying events. They are. But these events, and the inevitable debates that follow, distract from what a public health crisis guns really are.

Here’s what I mean.

On the very same day as the Ft. Lauderdale shooting, Jan. 6, BBC Magazine released a story on how Japan has nearly eradicated gun violence completely. According to the story, “only six shots were fired by Japanese police nationwide [in 2015]”—six total shots. Furthermore, “In 2014 there were just six gun deaths [in Japan].”

Compare those six gun deaths to the 33,599 that occurred in the United States the same year. That’s roughly the same number of people that are killed in car accidents in the United States each year, and it accounts for 16.8 percent of all injury deaths. Guns are killing tens of thousands of people in the U.S. every year. They’re a public health crisis.

Mental Health Is a Scapegoat for Gun Violence

So where does mental health fit into the gun debate?

There’s a problem with people such as Rep. Esty pointing fingers at people with mental illness as a primary cause of gun violence toward others in the U.S.—the data doesn’t add up. Mass shootings make up less than one-half of one percent of gun homicides, according to the _Washington Post and the Gun Violence Archive. Furthermore, the law that Congress is in the process of rolling back? It only affects about 75,000 people, total.

But there’s more to it than that.

More tellingly, our gun-homicide rate here in the U.S. is about 25 times higher than other developed countries, according to the American Journal of Medicine_. But, according to Kenan M. Penaskovic, M.D., professor of psychiatry at the University of North Carolina at Chapel Hill, the “percentage of the population struggling with mental illness is the same as the rest of the world.” Logically, then, mental illness alone is not the reason that we have so many more gun homicides in the U.S.

Furthermore, Penaskovic notes, “roughly one-quarter of the population has some form of mental illness, meaning that a vast majority of those with mental illness are not violent.”

Suicide—The Major Mental Health Gun Problem

But there’s one portion of that 33,599 number that we must take a closer look at. Of that number, a large percentage—63.5 percent to be exact—died by suicide. What that number means is that a person with a gun is more likely to use that gun to harm themselves that to harm someone else.

But it is exceedingly difficult to find talk of suicide in the national debates surrounding gun control. Mental health often does take center stage, but often in a fashion that is abhorrent, with the NRA insisting that gun violence is perpetrated by crazies who just need to be locked up. After the Navy Yard shooting in 2013, on Meet the Press Wayne LaPierre of the NRA said, “if we leave these homicidal maniacs on the street … they’re going to kill. They need to be committed is what they need to be. If they are committed, they’re not at the Naval Yard.” On the other side of the aisle, we have Rep. Esty, also scapegoating people with mental illness for harming others with guns.

But even when mental health is approached in a respectful, non-ableist fashion, the vastness of our gun-suicide epidemic is often overlooked. Rarely does someone take the stage to plea for the lives of those who die by their own hand.

Dr. Penaskovic sees a strong connection between mental health, guns and suicide: “what is clear is that a majority of gun deaths are suicides. A significant majority of those dying from suicide suffer from some form of depression.” In this way, mental health has a massive effect on gun violence: over 10 thousand people kill themselves with guns in the U.S. every year. So, if you insist on proving how mental illness drives gun violence, that is the statistic you are looking for.

The problem is, self-harm doesn’t whip up the fear and frenzy required to blame a small group for a gun violence epidemic they didn’t cause.

Although it is unlikely that we’ll see meaningful change under the current administration, we asked Dr. Penaskovic how he would advise politicians on guns and mental health. “My wish would be that politicians address and fund mental health because it improves lives and reduces suffering,” he says. “I am concerned that associating a mass shooter with mental illness distracts from the bigger and more common firearm issues of suicide, intimate partner violence and accidental deaths.”

Our gun problem is not a mental health problem, but people with mental illness are dying from guns—by their own hand. That is a real public health issue. Guns rarely give a person a chance to regret or change their mind if they are contemplating suicide. Suicide-by-gun is usually—starkly—final.

Katie Rose Guest Pryal, J.D., Ph.D., is a novelist, journalist and former law professor. Her most recent book is Chasing Chaos: A Novel.