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Gun Violence and Mental Illness

Edited by Liza H. Gold, M.D., and Robert I. Simon, M.D.

  • ISBN 978-1-58562-498-0
  • Item #62498

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Perhaps never before has an objective, evidence-based review of the intersection between gun violence and mental illness been more sorely needed or more timely. Gun Violence and Mental Illness, written by a multidisciplinary roster of authors who are leaders in the fields of mental health, public health, and public policy, is a practical guide to the issues surrounding the relation between firearms deaths and mental illness. Tragic mass shootings that capture headlines reinforce the mistaken beliefs that people with mental illness are violent and responsible for much of the gun violence in the United States. This misconception stigmatizes individuals with mental illness and distracts us from the awareness that approximately 65% of all firearm deaths each year are suicides. This book is an apolitical exploration of the misperceptions and realities that attend gun violence and mental illness. The authors frame both pressing social issues as public health problems subject to a variety of interventions on individual and collective levels, including utilization of a novel perspective: evidence-based interventions focusing on assessments and indicators of dangerousness, with or without indications of mental illness.

Reader-friendly, well-structured, and accessible to professional and lay audiences, the book:

  • Reviews the epidemiology of gun violence and its relationship to mental illness, exploring what we know about those who perpetrate mass shootings and school shootings.
  • Examines the current legal provisions for prohibiting access to firearms for those with mental illness and whether these provisions and new mandated reporting interventions are effective or whether they reinforce negative stereotypes associated with mental illness.
  • Discusses the issues raised in accessing mental health treatment in regard to diminished treatment resources, barriers to access, and involuntary commitment.
  • Explores novel interventions for addressing these issues from a multilevel and multidisciplinary public health perspective that does not stigmatize people with mental illness. This includes reviews of suicide risk assessment; increasing treatment engagement; legal, social, and psychiatric means of restricting access to firearms when people are in crisis; and, when appropriate, restoration of firearm rights.

Mental health clinicians and trainees will especially appreciate the risk assessment strategies presented here, and mental health, public health, and public policy researchers will find Gun Violence and Mental Illness a thoughtful and thought-provoking volume that eschews sensationalism and embraces serious scholarship.


  • Contributors
  • Foreword
  • Introduction
  • Acknowledgments
  • Part I: Defining the Problems
  • Chapter 1. Gun Violence and Serious Mental Illness
  • Chapter 2. Firearms and Suicide in the United States
  • Chapter 3. Gun Violence, Urban Youth, and Mental Illness
  • Chapter 4. Mass Shootings and Mental Illness
  • Chapter 5: School Shootings and Mental Illness
  • Chapter 6: Mental Illness and the National Instant Criminal Background Check System
  • Chapter 7. Mental Illness, Dangerousness, and Involuntary Commitment
  • Chapter 8. Accessing Mental Health Care
  • Part II: Moving Forward
  • Chapter 9. Structured Violence Risk Assessment: Implications for Preventing Gun Violence
  • Chapter 10: Decreasing Suicide Mortality: Clinical Risk Assessment and Firearm Management
  • Chapter 11: Treatment Engagement, Access to Services, and Civil Commitment Reform: Would These Strategies Help Reduce Firearm-Related Risks?
  • Chapter 12: Preventing Gun Violence: Decreasing Access to Firearms During Times of Crisis
  • Chapter 13: Relief from Disabilities: Firearm Rights Restoration for Persons Under Mental Health Prohibitions
  • Chapter 14: Decreasing Gun Violence: Social and Public Health Interventions
  • Appendix
  • Resources


    Renee Binder, M.D.
    Emma C. McGinty, Ph.D., M.S.
    Daniel W. Webster, Sc.D., M.P.H.
    Matthew Miller, M.D., M.P.H., Sc.D.
    Catherine Barber, M.P.A.
    Deborah Azrael, Ph.D.
    Carl C. Bell, M.D., D.L.F.A.P.A.
    James L. Knoll, IV, M.D.
    George D. Annas, M.D., M.P.H.
    Peter Ash, M.D.
    Marilyn Price, M.D., C.M.
    Patricia R. Recupero, J.D., M.D.
    Donna M. Norris, M.D.
    Eric Y. Drogin, J.D., Ph.D.
    Carol Spaderna, LL.B. (Hons.)
    Robert L. Trestman, Ph.D., M.D.
    Fred R. Volkmar, M.D.
    Daniel C. Murrie, Ph.D
    Debra A. Pinals, M.D.
    Josh Horwitz, J.D.
    Anna Grilley, M.S.P.H.
    Kelly Ward, J.D.
    Donna Vanderpool, M.B.A., J.D.
    Shannon Frattaroli, Ph.D., M.P.H.
    Shani A.L. Buggs, M.P.H

About the Authors

Liza H. Gold, M.D., is Clinical Professor of Psychiatry at Georgetown University School of Medicine in Washington, D.C.

Robert I. Simon, M.D., is Clinical Professor of Psychiatry at Georgetown University School of Medicine in Washington, D.C., and Chairman Emeritus of the Department of Psychiatry at Suburban Hospital in Bethesda, Maryland.

On a subject of immense current interest, great emotional heat, yet little sound research, this book breaks new ground in presenting a nonpolarized, nonpolitical, and nonpolemical analysis of both the real and perceived associations between firearms deaths and mental illness. From a host of perspectives, the known-to-be-weak connection between the two elements is analyzed in terms of the best current research and most practical public health approaches. Edited by two leading forensic psychiatrists, this book is a beacon in a dark place.—Thomas G. Gutheil, M.D., Professor of Psychiatry, Harvard Medical School

A major achievement. Flat out, the best book about this complex subject that has yet been published. If only it were to be read and taken seriously by politicians and media rabble-rousers. Congratulations to Profs. Gold and Simon for a superb work.—Michael Perlin, Professor Emeritus of Law, New York Law School

Gun Violence and Mental Illness looks beyond the inflammatory social and political rhetoric that all too often surrounds discussions of gun violence in the United States. This important, multidisciplinary volume presents evidence-based analyses and risk assessment strategies for mental health clinicians, trainees, and those interested in finding more effective interventions to decrease the costs of the serious public health problems of gun violence and mental illness.—Jason Matejkowski, PsycCRITIQUES, Vol. 61, No. 19, Article 2, 5/9/2016

This book is a major achievement edited by two leading and well respected forensic psychiatrists. It was copyrighted in 2016 and is an excellent compendium of the current state of our knowledge in the area of the relationship of gun violence and mental illness. The playing field is ever changing. I hope that new editions will be issued with regularity. The questions it addresses are complex, difficult, and emotionally charged, but critical. This book is also an invaluable resource for all mental health professionals, general physicians, public health officials, politicians, reporters, and others, in understanding the complex connection of mental illness and gun violence. It is a very timely analysis of these subjects.—Elissa P. Benedek, M.D., Journal of the American Academy of Psychiatry and the Law Online, 9/1/2016

Dr. Gold and her coeditor Dr. Simon have produced a wonderful reference that summarizes (largely statistical) information already well known to many mental health and law enforcement professionals, but far too often ignored by politicians, the media, bloggers, and Internet trolls. The book is a fine addition to the professional literature, a well-written and well-organized arrow for the quivers of psychologists and psychiatrists who strive to place our patients in an accurate context amid public clamoring for scapegoats and easy targets.—William H. Reid, M.D., MPH, Journal of Psychiatric Practice Vol. 23, No. 1, 01/01/2017

Given the frequency with which the general public is exposed to acts of firearms violence and the sweeping generalizations many use when suggesting causes for these events, it should not be surprising that the scapegoat often becomes those with mental illness — a population often unable to advocate for themselves and often misunderstood by policymakers. This book astutely addresses misconceptions about gun violence and mental illness, though not in a preachy manner. This is a worthy addition to the field and unique in its approach and scope. It is difficult to believe anyone reading this will not learn something useful. It is well worth the read.—Steven T. Herron, M.D., Doody's Book Review

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