In his address to the nation on Monday, President Donald Trump had an explanation for the pair of mass shootings that shook America in the span of a single weekend. “Mental illness and hatred pulls the trigger,” Trump said. “Not the gun.”
That sentiment echoed Trump’s initial Twitter responses to the tragedies in Dayton, Ohio and El Paso, Texas, as well as comments from other lawmakers and public figures who blamed the shootings, and others before them, on mental illness. But as death tolls climb, doctors across specialties are growing increasingly frustrated by that framing, and arguing for a stronger focus on gun control over mental health.
“It’s really just scapegoating people with mental health issues,” says Dr. Seth Trueger, an assistant professor of emergency medicine at Northwestern University. And while rates of mental health conditions such as depression, anxiety and suicidal behavior are on the rise in the U.S., Trueger says other nations have similar problems and experience far fewer mass shootings. “Other countries have the same kind of mental health issues we have, the same kind of violent video games we have, the same religiosity that we have. All that stuff is just a distraction” from the need for better gun control, he says.
That position is hardly new. Studies show that a relatively small percentage of violent crimes are perpetuated by people with diagnosed mental health issues, and that gun access—not mental health symptoms—is the primary predictor of firearm violence. As a result, an increasingly large and vocal cadre of doctors has been arguing for years that gun violence is more an issue of access and regulation than it is mental health. Groups including the American Academy of Pediatrics and the American Medication Association are active in advocating for stronger gun laws and more widespread violence-prevention programs, and the American Psychological Association regularly cautions against blaming mass shootings on mental health.
“Routinely blaming mass shootings on mental illness is unfounded and stigmatizing,” read a statement the APA issued on Aug. 4, after the Dayton tragedy. “The rates of mental illness are roughly the same around the world, yet other countries are not experiencing these traumatic events as often as we face them. One critical factor is access to, and the lethality of, the weapons that are being used in these crimes. Adding racism, intolerance and bigotry to the mix is a recipe for disaster.”
Dr. Jennifer Gunter, a San Francisco-based obstetrician/gynecologist and outspoken medical Twitter personality, was one of many doctors to voice that feeling online, in an effort, she says, to amplify the voices of mental health professionals and emergency medicine doctors on the front lines. “We all have to hold the line. This crisis affects everybody,” Gunter says. “Doctors have no reason to lie to you about this. The only skin doctors have in this game is saving lives.”
After the shootings, mental health professionals on social media also drew a distinction between white supremacy—the apparent motive for the Texas shooting—and mental illness. While it’s easy to reduce any motive for horrific behavior to mental illness, doctors say that can be an over-simplification. Instead, they say, policymakers should focus on removing the firearms that allow individuals to follow through on their plans.
When it comes to ending gun violence, improving mental health care and access may be one piece of the puzzle. But Trueger says better firearms regulation and policy should be far more pressing concerns, along with improving scientists’ ability to do research on gun violence as a public-health issue and strategies that could prevent these tragedies. That’s currently difficult, since the 1996 Dickey Amendment prohibits the use of federal funding to promote gun control.
“The perfect analogy is motor vehicles. Driving has gotten remarkably safer over the last number of decades, because we’ve studied it, we funded research for it and we’ve figured out evidence-based policies to make cars and roads safer,” Trueger says. “[Gun violence requires] the same kind of approach.”