Mental Illness and Gun Violence: Why It's Harmful to Link the Two

An 18-year-old gunman claimed the lives of 19 school children and two adults in Uvalde, Texas, on Tuesday morning. The school shooting occurred just days after another mass shooting—a hate crime at a Buffalo, New York grocery store.

The tragic loss of life in both instances amplifies a basic truth: We have a crisis of gun violence in America. And, as is commonly the case following a mass killing, mental illness is often linked to the tragedy.

That scenario played out again on Wednesday, when during a news conference on the tragedy, Gov. Greg Abbott of Texas blamed the violence on mental health issues, even though he said the shooter had "no known mental health history."

But implicating mental illness as the cause of the bloodshed is not only wrong, it's harmful, the National Alliance on Mental Illness (NAMI) said in a statement shared Wednesday. The real connection between mental health issues and gun violence is much more nuanced.

"The vast majority of people with mental health problems do not commit mass shootings," Lynsay Ayer, PhD, a senior behavioral scientist with the Rand Corporation, a nonprofit research organization for public policy improvement, told Health. In fact, they're more likely to be victims than perpetrators of violence, Ayer noted.

Here's why experts say it's dangerous to presume that mental illness is the cause of the nation's gun violence epidemic.

How Did Mental Illness Become the Scapegoat for Gun Violence?

When mass shootings occur, people naturally think it must be at the hands of someone "not in their right mind," Jeffrey Swanson, PhD, professor in psychiatry and behavioral sciences at Duke University School of Medicine, told Health. And that gets overgeneralized and reinforced in the media, he said.

While it may be true in certain instances that a mental health issue is involved, experts said that explanation doesn't line up with research examining the relationship between mental illness and gun violence.

According to Swanson, fewer than one in five perpetrators of mass-casualty shootings have a diagnosable disorder that impairs the brain's ability to reason, perceive reality, and regulate mood. "They might just be a young, angry, isolated, alienated young man who's marinating in hate and had access to this extremely lethal, lethal technology," he said.

It can be hard to tease out the person's state of mind after the fact. As Ayer pointed out, "Unless somebody already had some documented mental health problem, it's often difficult to go back retrospectively and really know objectively what was going on with their mental health."

Mental Health and Mass Shootings in America

So is there a connection between mental illness and gun violence?

A study in the American Journal of Public Health outlines assumptions that people make in the aftermath of mass shootings: one being that mental illness causes gun violence, another that a psychiatric diagnosis can predict gun crime before it happens.

After reviewing relevant literature from 1980 through 2014, the authors found that the connections between mental illness and gun violence "are less causal and more complex than current US public opinion and legislative action allow." In other words, it's not a simple cause-and-effect relationship.

For example, a number of studies suggest that laws and policies enabling access to firearms during emotionally charged moments "seem to correlate with gun violence more strongly than does mental illness alone," the authors note.

The analysis, published in 2015, is "sadly still relevant," Jonathan Metzl, MD, PhD, professor of psychiatry at Vanderbilt University and one of the authors of the paper, told Health in an email.

This year alone, there have been 213 mass shootings, defined as incidents in which four or more people were killed or injured, according to the Gun Violence Archive, a nonprofit organization. The year prior, in 2021, the group recorded 693 mass shootings.

The prevalence of mental illness in the US is no different than in other countries, Swanson noted, and yet "we have a truly exceptional homicide rate."

The Fallout: Why It's Dangerous to Link Mental Health and Mass Shootings

"Mental illness is not the problem," NAMI said in its press release, instead pointedly calling the Texas shooting "avoidable" and pinning the blame on the nation's failure to take action after each mass shooting. "Each time, nothing is done, and another tragedy ensues," the Alliance said.

Swanson agreed. By focusing exclusively on mental illness, "you might miss all the aspects of violence and determinants of violence that have nothing at all to do with mental illness," he said.

Blaming mental illness as the cause of mass violence also leads to discrimination against those who have mental disorders, NAMI said.

It's already difficult for people to get the help they need, and part of it is because they're embarrassed to seek out mental health care, Ayer said. In consistently linking gun violence to mental illness, "we risk even further stigmatizing people who may be experiencing mental health problems," she added.

NAMI ended its statement with offering help for a nation looking to address its trauma. For those looking for resources or help, you can connect to your local NAMI, or call the NAMI Help Line at 1-800-950–NAMI (6264).