An extensive new study by two Vanderbilt University researchers challenges common assumptions about gun violence and mental illness that often emerge in the aftermath of mass shootings.

When a mass shooting occurs, there seems to be a familiar narrative that untreated mental illness is the primary cause for the terrifying act. But a new study published in the American Journal of Public Health by Dr. Jonathan Metzl and Kenneth T. MacLeish finds that an isolated focus on mental illness is misguided.

“Gun discourse after mass shootings often perpetuates the fear that ‘some crazy person is going to come shoot me,’” said Metzl, the study’s lead author. “But if you look at the research, it’s not the ‘crazy’ person you have to fear.”

Mentally ill not violent

In the article, “Mental Illness, Mass Shootings and the Politics of American Firearms,” Metzl and MacLeish analyze data and literature linking guns and mental illness over the past 40 years. They found that despite societal pre-conceived notions, most mentally ill people are not violent.

“Fewer than 5 percent of the 120,000 gun-related killings in the United States between 2001 and 2010 were perpetrated by people diagnosed with mental illness,” they write.

Four myths arise after mass shootings

Their research uncovered four central myths that arise in the aftermath of mass shootings:

Mental illness causes gun violence.

Psychiatric diagnosis can predict gun crime before it happens.

U.S. mass shootings “prove” that we should fear mentally ill loners.

Because of the complex psychiatric histories of mass shooters, gun control “won’t prevent” mass shootings.

They stress that all four of these are incorrect, though understandable, assumptions.

“Our research finds that across the board, the mentally ill are 60 to 120 percent more likely than the average person to be the victims of violent crime rather than the perpetrators.”

Misdirected blame

Metzl and MacLeish find that the focus on mental illness after horrific, yet statistically rare, mass shootings misdirects people from the bigger issues tied to preventing gun deaths in the United States.

“There are 32,000 gun deaths in the United States on average every year, and people are far more likely to be shot by relatives, friends or acquaintances than they are by lone violent psychopaths,” Metzl said.

“We should set our attention and gun policies on the everyday shootings, not on the sensational shootings, because there we will get much more traction in preventing gun crime.”

Mental health screening can’t prevent gun crime

The presumed link between mental illness and gun violence has led to calls for mental health screening for gun owners. But the authors find that psychiatric diagnosis is in and of itself not predictive of violence.

“Even the overwhelming majority of psychiatric patients who fit the profile of recent U.S. mass shooters – gun-owning, angry, paranoid white men – do not commit crimes,” Metzl and MacLeish write.

“Basing gun crime-prevention efforts on the mental health histories of mass shooters risks building ‘common evidence’ from ‘uncommon things,’ all while giving mental health providers the untenable responsibility of preventing the next massacre.”

Signs to predict gun violence

The authors detail how focusing solely on mental illness ignores those factors that do predict gun violence more broadly:

Drug and alcohol use

History of violence

Access to firearms

Personal relationship stress

“People are far more likely to be shot by relatives, friends, enemies or acquaintances than they are by lone violent psychopaths,” according to Metzl and MacLeish’s research.

Mental health systems

The authors argue in the paper that lawmakers and voters should pay much more attention to mental health systems such as access to mental health care, medication and health insurance.

“In a way, it is a failure of the system often that becomes represented as a failure of the individual,” Metzl said.

Race, gender and anxiety

The authors also delve into to the ways that responses to mass shootings reflect cultural anxieties about race and gender.

“The rhetoric in which people are accumulating guns in the present day has a lot to do with the fear of the unknown stranger. ‘Somebody could come attack me or my family, so we need to protect ourselves.’ And that rhetoric is most common among suburban white men,” Metzl said.

The authors uncover how the political and racial strife in the 1960s led some African Americans to push for their constitutional right to own and carry guns, while some white Americans at the time, including the National Rifle Association, pushed for stricter gun control laws.

“The gun rights statements of the Black Panthers and other black power groups in the 1960s reads almost exactly the same as the pro-gun rhetoric of the Tea Party today,” Metzl said. “Both groups argued that they’re protecting themselves from government tyranny and have a constitutional right as individuals to bear arms.”

Yet Metzl adds that in the ’60s, American society rushed to pathologize “black culture” while restricting gun rights, while in the present day our narratives locate the problem on individual white brains while at the same time encouraging further gun ownership.

Metzl and MacLeish teach at the Center for Medicine, Health and Society at Vanderbilt, an innovative multidisciplinary center that studies the social and societal dimensions of health and illness. Its scholarship, teaching and wide-ranging collaborative projects explore medicine and science in an array of cultural contexts, while at the same time fostering productive dialogue across disciplinary boundaries.

The paper will be published in the February issue of the American Journal of Public Health.