Las Vegas Shooting: Why Mental Illness Is a Poor Target for Gun Violence

Las Vegas experienced the worst mass shooting in recent history this week. Stephen Paddock fired an automatic weapon into a crowd of people at a country music festival. It left nearly 60 dead and over 500 injured. Many people have been speculating as to why Paddock would do something so horrible. We are still unclear on motive as of date, but one of the running theories is that Paddock might have been mentally ill. Although Paddock did not show any signs of mental illness before, his father, Benjamin Hoskins Paddock, was a psychopathic robber. There is an argument to be made that psychopathy and other mental disorders have a genetic component to it. Even if it is not the sole factor, it would not be a surprise if mental illness played a role in it. In response to the Las Vegas shooting, Speaker of the House Paul Ryan advocated for mental health reform. The National Rifle Association (NRA) has also taken this approach in the past of addressing mental health over gun control. Most Americans think that mental illness is a major cause of mass shootings (Gallup). Since there plausibly will be a conversation about mental illness and gun ownership in the weeks to come, I might as well ask the question: how much would addressing mental illness affect rates of violence?

The argument for addressing mental health reform in response to mass shootings goes something like this. A normal, mentally stable individual would not commit such an act. In mass shootings, the percent of shooters with mental illness range from 11 percent to 22 percent. By addressing mental illness and better providing access to mental health facilities, we can better prevent gun violence in the United States. Here are a few issues I take with the argument:

1. We like to focus on mass shootings as representative of gun violence in America, but the truth is that mass shootings account for a small fraction of gun violence in the United States. Historically, mass shootings have accounted for 1.2 percent of gun homicides. Let's not forget that gun homicides only account for about a third of gun deaths, which means that mass shootings only account for about 0.4 percent of gun deaths. 
2. Between 2001 and 2010, only 5 percent of gun homicides were committed by those with a mental illness (Metzl et al., 2015). Most gun violence is caused by something other than mental illness (Swanson et al., 2015). Since most people who are violent do not have a mental illness, it has to make one wonder about efficacy of targeting mental illness.
3. According to one epidiomelogical study, eliminating the adverse effects of mental illness would only reduce violence by 4 percent (Swanson et al., 2015). Much like most people who are violent don't have a mental illness, most people with a mental illness are not violent. Only about 4 percent of people who have mental illness are violent (Swanson et al., 2014; Stuart, 2004).
4. This assumes that we can target the dangerous individuals through better mental health access. There is research that shows that risk prediction works better for low-risk individuals than high-risk individuals (Fazel et al., 2012).

The criminal use of firearms is a violation of the nonaggression axiom. Protecting citizens against rights-violating actions can easily be construed as a legitimate role of the government, even for those who advocate for limited government. The libertarian Cato Institute believes that using mental health reform could help individuals, provided that the mental health assistance applies to those who could legitimately cause harm and also make sure that civil rights are protected in the process. The APA agrees that the intervention should be specifically targeted for those who possess behaviors for increased likelihood of violence, as opposed to generally targeting those who need mental health treatment. Plus, voluntary mental health treatment is more cost-efficient in the long-run.

My issue with trying to target mental illness to lower gun violence is that it lacks a coherent risk-identification strategy. Additionally, most violent people don't have a mental illness and most people with mental illness don't commit violence. The connection between mental health and violence is tenuous at best (Metzl and MacLeish, 2015). I am worried about further stigmatization of mental illness when mental health access is just as important, and in some cases more important, than physical health. I am also worried that such a targeting would discourage individuals from getting treatment for mental health issues, which would cause all sorts of social costs. Pouring all those resources into a major mental health reform effort to lower violence would be low-yield and ineffective. Mental health reform should take place, but given the lack of correlation between mental illness and gun violence, mental health reform and gun reform should be analyzed and enacted separately.