Mental health can become the scapegoat for lax gun laws in the US

Nothing speaks of heartbreak more profoundly than a child-sized coffin. But multiply that heartbreak by 19, and we are approaching the level of grief that upended Uvalde, Texas. The Robb Elementary School was the site of America's latest mass shooting. The gunman, a lone teenager, with an AR-15, a military-style assault rifle, killed two teachers and 19 children, aged between 7 and 10.

Even before the shooter's last spent shell casings had hit the ground, speculation about his motives and mental health had begun. Such theorising, however, is unnecessary and distracting. These increasingly frequent mass shootings are related to US gun laws. In many states, owning a gun can be easier than owning a dog, The Economist reported.

According to census data, the US represents 4.4 per cent of the world's population but accounts for more than 30 per cent of the world's mass shootings. The US also ranks number one globally for civilian gun ownership, with 42 per cent of the world's guns in American hands. A study published in the journal Violence and Victims in 2016 established a clear link between the frequency of civilian gun ownership and the rate of mass shootings worldwide. More guns generally equal more mass shootings, even after considering societal levels of violence, for example, homicide rates.

More guns and more mass shootings become a vicious cycle. US gun sales data suggest a significant surge in the purchase of firearms after each mass shooting, with some people keener than ever to protect their families. The increase in gun sales, statistically speaking, makes the next mass shooting even more likely. More guns means more mass shootings.

FBI data confirms this trend, with the annual rate of mass shootings increasing sharply over the past two decades. It is also worth noting that gun-related suicide is more common than gun-related homicide in the US. So tackling the gun problem could be a big win on several fronts.

Despite all the evidence indicting lax gun laws, there will still be those who point the finger at mental health. Certain sections of the media will no doubt publish psychological autopsies on the shooter, with experts attempting to retrofit a plausible diagnosis. Anybody who can kill 19 unarmed, innocent elementary school children and two teachers is, by definition, not in their right mind. However, mental health problems exist everywhere; frequent mass shootings don't.

In some instances, mental health becomes the scapegoat for lax gun laws. In the wake of mass shootings, there is often talk of beefing up mental health laws. For instance, in the wake of the Sandy Hook Elementary school shooting in 2012, in which 27 people died, Ann Coulter, a conservative commentator, asserted that "Guns don't kill people – the mentally ill do." Such provocative statements are dangerous, ill-founded, and only serve to stigmatise mental health problems. With reference to the Robb Elementary shooting Texas Governor, Greg Abbott, said: "We as a state, we as a society, need to do a better job with mental health."

Society has generally become more accepting of people experiencing mental health problems such as depression and anxiety. However, our attitudes towards people with severe and enduring mental health issues, such as psychosis/schizophrenia, have not followed suit.

A study reported in the Journal of the American Medical Association last year looked at trends in US public stigma between 1996 and 2018. The authors note that public attitudes towards people diagnosed with schizophrenia have become more negative. For example, people diagnosed with schizophrenia were increasingly stereotyped as being violent. Is this rise in stigma an unintended consequence of mass shootings, and how they are framed by politicians and the media?

The notion that people with mental health problems automatically pose an elevated risk of violence to society is an inaccurate and enduring myth. Only a tiny minority of people with severe mental health problems commit or have the potential to commit violence toward others. Furthermore, identifying such at-risk individuals is, at present, difficult bordering impossible.

George Szmukler, emeritus professor of Psychiatry and Society at King's College London, used sophisticated statistical analysis to predict violence among psychiatric patients. Unfortunately, when the predictive model was used to identify those who were likely to be involved in extreme acts of violence, it was close to useless, getting it wrong 97 times out of 100. This issue of "false positives" has profound implications for civil liberties. For example, how many non-aggressive patients is it acceptable to detain to perhaps prevent one violent incident?

Focusing on mental health in the wake of a mass shooting is a problematic distraction. Advocating for greater control over psychiatric patients might make us feel safer, but we won't be safer. Instead, tighter gun control and the cultivation of more compassionate and caring societies will help reduce the risk of such tragic incidents.

The time for decisive action (reasonable gun control) was in 2012, after child-sized coffins containing the 21 children of Sandy Hook Elementary school were being interred or incinerated. Ten years later feels too late, but late is better than never. I sincerely hope that this time there will be decisive action to reduce the number and type of guns in the hands of civilians in the US.