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Abstract
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Since 2000, more than 1.5 million people in the United States have been injured by a firearm, and a half-million have died. This total surpasses the combined U.S. military combat death toll of World Wars I and II. Of these gun deaths, 59% were suicides, and 37% were homicides (1). Mass shootings accounted for less than one-tenth of 1% (2). Still, the national conversation about gun violence tends to focus on senseless rampages by troubled young men while public officials pay lip service to an oversimplified, gun-ignoring solution: “fix mental health.” The mental-illness-and-mass-shooting narrative, as curated by the media, can perpetuate public misunderstanding and impede serious, broad-based efforts to both prevent gun deaths and improve mental health care.
The mass shooter represents people’s worst nightmares—random, unpredictable gun violence and “insanity” in one package. A public mass shooting is an existential threat to everyday life that seems to demand a defensive response from the community. But the extraordinary sense of threat finds expression in an overgeneralized narrative, often scapegoating “the mentally ill” for the complex problem of gun violence...
Mental health stakeholders are understandably concerned about preventing fearmongering and discrimination directed against people with psychiatric disabilities and about protecting civil rights. They also have a strong argument for reinvestment in and reform of an underperforming public behavioral health care system to remove barriers and improve access to services. But they are loath to be painted into a corner of defending disability rights in terms that are too easily distorted as “giving guns to the mentally ill” and justifying the need for better mental health services mainly as a way to stop public massacres. Advocates for people with mental illness would prefer a dialogue about rights, inclusion, and unmet needs in any other context—such as access to housing, employment, or parity in health insurance coverage—but are mired in a national conversation about gun rights and mental illness with mass shootings as the backstory.
Perhaps mental health stakeholders should take the lead in bringing suicide to the fore as a crucial, underacknowledged dimension of firearm mortality. Although there is lingering social stigma and moral approbation associated with suicide, there is also a growing public understanding that most suicides (unlike most homicides) result from a serious mental illness for which the person bears no blame.
By the numbers, suicide is a public health problem that is twice the size of the homicide problem—13.4 versus 6.1 deaths per 100,000 people in 2016—and the number of suicide decedents dwarfs the number of mass shooting victims ...
Language: en |