What if, in response to the recent mass shooting in El Paso and Dayton, President Trump suggested we get men “off the street,” arguing they are responsible for mass violence. After all, he could reason, men are responsible for approximately 95% of the acts of mass violence. Such an approach would surely be met with public outrage, as it is preposterously overly-broad, immoral, and unconstitutional. The proposal would be rightly ridiculed as illogical, because only an extremely small fraction of males commit mass shootings.
Yet in the wake of El Paso and Dayton, President Trump has essentially suggested something equally outrageous and unconstitutional, by suggesting this be done to people with “mental illness.” In arguing that a legitimate response to mass violence is to “start building institutions again” to get people with mental health conditions “off the street,” the President simply ignores the facts – that the vast majority of individuals with mental health diagnoses are not violent, and mental health diagnoses are not useful predictors of future violence. Instead, factors such as a history of violence and childhood trauma are more likely indicators to predict future gun violence. The President’s proposal has not been met with the public ridicule it deserves because it exploits deeply-rooted but erroneous stereotypes and fears of people with mental health conditions.
The vast majority of individuals with mental health conditions are unlikely to engage in violence, and those that do are often doing so for the same reasons that the general population engages in violent behavior. The public perception of gun violence being connected to mental health conditions is fueled not by epidemiological evidence, but by news coverage of events. Threats of involuntary confinement is an extreme overreaction which adds fuel to these misconceptions and is also unconstitutional. Too few people in this country with mental health conditions have access to quality treatment, and many feel shame, fear, and a reluctance to seek help. Creating fear that seeking treatment could result in involuntary confinement or other serious consequences will neither help improve access to mental health treatment nor reduce gun violence in the U.S.
The President has found a convenient scapegoat, and purposefully distracted us from the fact that gun violence is a leading cause of death and a significant source of injuries and is a significant public health issue. Exposure to gun violence impacts the health and well-being of those exposed, including the physical and mental health of children, and their ability to perform well in school. It is the second leading cause of death for U.S. children and teens, and the leading cause of death for black children. While gun violence affects everyone in the U.S., it has a disproportionate impact on young adults, males, and racial and ethnic minorities.
Instead of targeting individuals with mental health conditions, firearm-related deaths and injuries should be treated as a public health issue, with a multidimensional approach that uses lessons learned from other public health crises, such as tobacco use, to develop and implement effective interventions. Public health approaches to violence have already proven successful in reducing injuries, shootings, and deaths and should be expanded. Prevention does not require predicting who will be violent. As the American Public Health Association explains “Just as aviation safety regulations make air travel safer for everyone, common-sense measures to prevent gun violence make communities safer for everyone”
It’s tempting to write off the President’s statements, however misguided, as unlikely to materialize. But such statements do real harm to people who have been wrongfully subjected to centuries of discrimination and stigmatization. Those who embrace his rhetoric will further target and blame people with mental health conditions for gun violence. The consequences could not only set our country on a path towards adopting outdated and dangerous discriminatory and unconstitutional policies of the past but also lead to more violence towards people with mental health conditions. We should not return to such a dark time.
