Severe mental illness and firearm access: Is violence really the danger?

In response to a spate of mass shootings, national debate over the root of America's gun violence epidemic has centered on mental illness. Consequently, calls have been made to legislatively restrict firearm access among individuals with mental illness to reduce gun violence. While there is a link between mental illness and suicide, a dearth of empirical evidence exists to inform public policy on the link between firearm access and mental illness. The current study addresses this gap by exploring the nature of firearm-related risk among disordered individuals as compared to others from the same communities. We examined a subsample of the MacArthur Violence Risk Assessment Study, including 255 recently discharged psychiatric patients and 490 census-matched community residents. We conducted binomial logistic regressions to explore the impact of firearm access and patient status on violence and suicidality. In total, 15.3% reported firearm access, 23.5% violence, and 21.5% suicidality. Multivariate analyses revealed that, in the context of firearm access, patients were no more likely to perpetrate violence (OR=0.588; 95% CI=0.196-1.764) but were significantly more likely to report suicidality (OR=4.690; 95% CI=1.147-19.172). These results indicate that firearms constitute a serious risk factor for suicide, not violence, for disordered individuals. Thus, legislative efforts to reduce firearm-related risk among disordered individuals should focus on self-harm, not violence. Moreover, claims that mental illness is a principal cause of gun violence may reduce help-seeking among individuals at high risk for suicide. Researchers should devote further attention to addressing these claims empirically.