Preventing the Unpredicted Through Smarter Gun Policies

October 22, 2016
Jeffrey Swanson at Psych Congress

A Psych Congress featured speaker on Saturday warned against placing blame for the country's scourge of gun violence on the mentally ill or weaknesses in the mental health care system.

Jeffrey Swanson, PhD, advocated for universal background checks as a means of addressing gun violence, but said policies should be based on risk of harm to self or others, not simply a mental illness diagnosis.

Equally important is reducing the “social determinants of violence,” such as childhood trauma and substance abuse, said Dr. Swanson, a Professor in Psychiatry and Behavioral Sciences at Duke University School of Medicine in Durham, North Carolina.

Jeffrey Swanson, PhD, speaks at Psych Congress on mental illness and gun violence. Credit: Carlos Pena

“I don’t think we can predict who the next mass shooter is going to be,” Dr. Swanson said. “But I think there’s a lot we can do to prevent the unpredicted.”

A small percentage of violence is attributable to serious mental illness alone, he said, citing data that show factors such as poverty, exposure to violence and substance abuse responsible for the large majority of violence towards others.

Dr. Swanson spoke in support of removing guns from people deemed to be dangerous, instead of focusing on preventing them from purchasing new firearms. Three states have risk-based pre-emptive gun removal laws, and 9 others are considering them, he said.

He presented an examination of the law in Connecticut, which he said resulted in 764 gun-removal cases from 1999 to 2013. One suicide was prevented by every 10 to 20 risk-based gun removals, he said

Dr. Swanson noted more than two-thirds of firearm-related fatalities are suicides, and mental illness is far more prevalent in those cases than in gun-related deaths overall. Ninety percent of people who attempt suicide survive, he said, but only 10 percent of those who use a firearm do.

“This is a huge public health opportunity and this is why U.S. clinicians ought to talk to people about firearms,”  Dr. Swanson told the crowd of mental health professionals. “If people try to use a firearm, they are not going to get that second chance, and suicide becomes the proverbial permanent solution to a temporary problem.”

– Terri Airov


“Thinking Carefully About Mental Illness, Gun Violence, and the Law: Balancing Risk and Rights for Effective Policy.”  Presented at the 29th Annual U.S. Psychiatric & Mental Health Congress; October 22, 2016; San Antonio, TX.