WASHINGTON – After the mass shootings in El Paso, Texas, and Dayton, Ohio, that killed 31 people and injured 50 others in less than 24 hours, President Donald Trump attributed the deaths to “a mental illness problem.” Other Republicans and the National Rifle Association followed suit.
“These are people that are very, very seriously mentally ill,” Trump told reporters on the tarmac as he returned to Washington on Aug. 4, the day of the Dayton attack. He reiterated those comments in the Oval Office on Tuesday, adding "it's not the gun that pulls the trigger, it's the people."
This sort of rhetoric is all too familiar for Bryan Barks, 27, who was diagnosed with bipolar disorder at age 19 and now works at the Coalition to Stop Gun Violence.
“I remember sitting in my bedroom in college, reading about the latest mass shooting, hearing people blaming mental illness, and thinking, ‘They are talking about people like me! They are talking about people I know! I'm not violent. The people I know with mental illness aren't violent,” she said.
Despite pushback from mental health professionals and advocates, a narrative about mental illness remains embedded in the conversation about violence. Over the last several weeks, Democrats and Republicans alike have invoked inadequate mental health care as a contributor to the epidemic of gun violence.
In his Aug. 5 address to the nation, Trump said that “mental illness and hatred pull the trigger, not the gun.” A statement from the NRA later that day lauded “the President’s call to address the root causes of the horrific acts of violence that have occurred in our country.”
A few days later, on the Mike Lupica Podcast, New York Gov. Andrew Cuomo called Trump's statement “the worst line in modern political history” and suggested the president should fire the speechwriter who wrote it.
“No, it’s not mental illness,” Cuomo said. “It’s a person who is seriously mentally ill with an extraordinarily dangerous gun. That’s the problem.”
Yet days earlier, Cuomo released a pledge to “Make America Safer” that – in addition to passing an assault weapons ban, universal background checks, and red flag laws – calls on the federal government to “create a mental health database.”
New York currently has a version of this legislation on the books as a part of its SAFE Act, passed in 2013. The law requires all mental health providers to report individuals who pose a potential danger to themselves or others to the county. A county-level mental health professional evaluates the information and passes it on to the state’s Division of Criminal Justice Services to check if the individual has ever applied for or received a firearms license. If they have, the information is passed to county-level licensing officials who have the right to revoke the license.
“This has been on the books in New York since 2013 and to date more than 135,000 reports from mental health professionals have led to more than 98,000 people deemed a danger to themselves or others have been prevented from owning guns,” Rich Azzopardi, a senior adviser to Cuomo, wrote to USA TODAY in an emailed statement.
There are similar laws on the books in California and Illinois, requiring psychotherapists to report mentally ill people who demonstrate violent behavior to the state, according to the Giffords Law Center to Prevent Gun Violence. Connecticut also has a law requiring psychiatric hospitals to report all individuals who have voluntarily admitted themselves for mental health care; they are prohibited from owning a firearm for six months.
Dr. Arthur Evans, the CEO of the American Psychological Association, understands why a near-majority of people believe mental illnesses deserve “a lot” of the blame for shootings.
“When I talk to people about this issue, they'll say, ‘Well, if someone did this, they would have to be – and they'll use a colloquial term – out of their mind, crazy, insane,” Evans said. “It's hard for people to understand how someone could do such a horrific act who is not mentally ill. But the reality is that people do horrific acts for a variety of reasons.”
But experts and researchers like Dr. Jeffery Swanson – a professor of psychiatry at the Duke University School of Medicine and a leading expert on mental health and gun violence – say that isn’t the case.
Swanson found that if providers could cure schizophrenia, bipolar disorder and major depression, overall violence would go down by only about 4%.
“We know that mental illness occurs at roughly equal rates all around the world. But the incidence of gun violence is very different. It’s much higher in the U.S.,” said Angela Kimball, the acting CEO of the National Alliance on Mental Illness. The difference, she said? “Access to guns.”
Michael Stone, a forensic psychiatrist at the Columbia College of Physicians, keeps his own database of mass shooters and concluded about two out of 10 suffer from serious mental health issues.
“People with mental illness are far more likely to be the victims of violence than the perpetrators,” Kimball said. “Twenty-three times more likely to be a victim of violence than the general population.”
Likewise, a 2018 report from the FBI on 63 active shooter assailants found that 25% had been diagnosed with a mental illness.
Given the weak connection between gun violence and mental illness, advocates and professionals alike said they think the database that Cuomo is pushing for is an ineffective solution to gun violence -- and might do more harm than good.
“I believe creating this kind of database is a horribly misguided policy for several reasons,” Evans said. “One is that I don't think it will help with what people are trying to accomplish. But the other is that it reinforces stigma in a way that it can be very harmful.”
“It won't stop gun violence. Instead, we're very worried that it may stop people from getting the help they need,” Kimball said. Put simply, “Who wants to be on the government database?”
Mental health professionals encourage everyone to reach out for help when they need it, but stigma surrounding mental illness is often a major deterrent, especially for veterans, soldiers, law enforcement officers and others who believe that getting help might cost them their careers.
“If we start creating databases, and putting that kind of information in databases that are not controlled by people in the healthcare system, it really reinforces and makes it more difficult for people to reach out for help,” Evans said.
Imagine being hospitalized for mental health reasons, and while receiving treatment, finding out that will be memorialized in a government registry, disability rights activist Emily Ladau said.
“This is an incredibly invasive and unproductive way to try to monitor people and assume that that's somehow going to prevent gun control, especially because mental health is such a sensitive issue for people already,” she said.
For Barks, the suggestion of a database is “insulting” and “scary.”
“It's a violation. It suggests that my personal health information should be available and can be used to discriminate against me,” she said. “Having a mental illness is not a crime. I am not violent. There is no need for a database of those with mental illness.”
She’s not alone in that view point – in fact, it’s shared by a Democratic presidential hopeful, Massachusetts Rep. Seth Moulton. Moulton went public about his experience with post traumatic stress disorder earlier this year, despite potential ramifications for his political career.
Moulton told USA TODAY that he feels uncomfortable with the prospect of having his medical information in a database, and believes it is a “fundamental invasion of privacy that no American should have, unless they're a criminal.” He compared it to a database of individuals who have AIDS or other infectious diseases.
“It is completely screwed up that we have databases of people who seek mental health care and not of people who own guns,” he said. “That's totally backwards.”
Moulton shared activists’ concerns that creating a database will increase stigma and discourage people from seeking treatment.
“We should be encouraging people to get help, not scaring them away,” he said.
On top of its potential negative impacts, Evans believes this sort of database is unnecessary.
“Mental health professionals already have a duty to warn and the duty to protect people. So if a person is suicidal or homicidal, you have an ethical and legal obligation to make sure that that person gets help,” he said. “Creating a debate database doesn't really change that.”
An existing federal law, the Gun Control Act of 1968, already dictates that any individual who is “adjudicated as a mental defective or has been committed to any mental institution” may not own a gun -- though states do not reliably share this information with the federal government, since it is voluntary, the Giffords Law Center reports.
Evans also fears an added database misconstrues the nature of mental illness. Under the SAFE Act in New York, psychiatric care providers must report individuals who are a danger to themselves or others. But such circumstances can be temporary, Evans said.
“People get better. Once you have a mental illness, it doesn't mean that you're going to be in that state for the rest of your life,” he said. “The notion that, because you had one episode where you may have been a danger to yourself doesn't mean that you should be in a database where that follows you for the rest of your life.”
Nothing in the statute addresses how long the state will maintain the mental health records it accrues as a result of the legislation.
Activists also identified a number of logistical issues with this sort of registry, including concerns about data breaches.
“There's pretty significant concerns around digital security,” Kendall Brown, a disability rights advocate, said. Once a database is created, there is always a “potential risk of that database getting into the wrong hands, which has implications of potential violence [and] permanently harming people with mental illnesses' job opportunities.”
No attempt on the data has occurred in the past six years, nor has there ever been one on the federal involuntary confinement database in the decades since 1968, per state officials.
Brown also expressed concern about racial and gender biases in such a database.
“People of color, especially black people and women, are much more likely to be labeled as pathological whenever they're experiencing trauma, so the database would almost certainly be discriminatory in that way,” she said.
Azzopardi dismissed these and other concerns and said that none have come to pass in the past six years.
“These same predictions from these same advocates were floated when this law was passed and they were proven to be completely unfounded,” Azzopardi wrote. “The data shows this law is working, is fully compliant with HIPAA and is helping to keep New Yorkers safe.”
Though gun control policies are intended to aid mass shooting survivors, they might become the very individuals whose information could end up on a mental health database, suggests Azza Altiraifi, a research associate on disability at the left-leaning think tank Center for American Progress.
“Governor Cuomo is suggesting this as a way to end gun violence and support people who have been calling for meaningful gun violence prevention measures, and it is actually that population that is going to be harmed because they fall within the groups of people that would be tracked by such a database,” she said. “We are criminalizing the very people that were trying to support.”
All stakeholders seem to agree that the worst case scenario is increased gun violence – and some fear that could come of the creation of a federal mental health database as Cuomo has called for.
“There are already existing examples of how perpetuating the stigma around mental illness can actually lead to further violence,” Brown said.
She recounted the story of the Oklahoma City bomber, Timothy McVeigh, who saw combat in the Army in the Gulf War. After he was discharged, he attempted to seek help from a veterans’ mental health clinic under a fake name, wanting to remain anonymous. He was denied treatment, and eventually he bombed a federal building and killed 168 people.
“The stigma that it would perpetuate could potentially have the exact opposite result that Governor Cuomo is aiming for,” Brown said.
This article originally appeared on USA TODAY: Trump says gun deaths are a mental health problem, experts say link overstated