Renewed calls to address serious, untreated mental health issues have resurfaced following the February 14 shooting at Marjorie Stoneman Douglas High School in Parkland, Florida.

However, these calls — made by politicians, journalists, and the general public — tend to place the blame for mass shootings on the shoulders of individuals with serious mental illnesses, while glossing over larger issues of firearm access and gun control.

In a viewpoint article published in JAMA Internal Medicine,1 Matthew E. Hirschtritt, MD, MPH, and Renee L. Binder, MD, of the department of psychiatry at the University of California, San Francisco School of Medicine, highlight the issues surrounding this “blame game.”

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“Attributing mass shootings to untreated serious mental illness stigmatizes an already vulnerable and marginalized population,” wrote Drs Hirschtritt and Binder. “[It] fails to identify individuals at the highest risk for committing violence with firearms, and distracts public attention from policy changes that are most likely to reduce the risk of gun violence.”

Citing a study published in the Annals of Epidemiology, Drs Hirschtritt and Binder note that public finger pointing following mass shootings to those with mental illness can “reinforce negative public attitudes” about an already vulnerable population — despite existing epidemiological studies indicating that a majority of individuals with serious mental illness are  “never violent”2

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Drs Hirschtritt and Binder called for a multi-pronged approach to managing the aftermath of mass shootings, pointing out that the attribution of violence to individuals with mental illness is “politically expedient” — misdirecting public outcry allows lawmakers to avoid making difficult decisions related to firearm regulation and gun access.

“A more nuanced approach to reducing gun violence would address the many other behavioral characteristics associated with interpersonal violence, the association between rates of gun ownership and gun-related violence, and universal screening protocols for firearm access in clinical settings,” the investigators concluded. “Addressing the risk of future mass shootings requires addressing a wide range of individual, community-level, and national and state policy factors.”


  1. Hirschtritt ME, Binder RL. A reassessment of blaming mass shootings on mental illness [published online February 28, 2018]. JAMA Intern Med. doi:10.1001/jamapsychiatry.2018.0010
  2. Swanson JW, McGinty EE, Fazel S, Mays VM. Mental illness and reduction of gun violence and suicide: bringing epidemiologic research to policy. Ann Epidemiol. 2015;25(5):366-376.