Dec 19 2012
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Preventing Gun Violence: How Laws Can Help

As the nation grapples with last week’s school shooting in Connecticut, discussions across the nation are focused on how we can reduce gun-related violence and the devastation it causes. NewPublicHealth joins that conversation today, beginning with an interview with Jeffrey Swanson, PhD, a professor of psychiatry and behavioral sciences at Duke University School of Medicine. Swanson is a member of the Methods Core of the Public Health Law Research (PHLR) program at Temple University, a project of the Robert Wood Johnson Foundation. The researchers analyze the intersection of public health and law, selecting studies for funding and providing technical assistance and support to strengthen research on law and health.

>> Read a blog post by Scott Burris, director of PHLR, on developing new laws to increase the safety of having guns in society.

An article published last year by Dr. Swanson following the shooting of Congresswoman Gabrielle Giffords and eighteen other people in Tucson, Arizona, argued that homicides committed with guns against strangers by individuals with mental disorders occur far too infrequently to allow for explanatory statistical modeling and predictability. However, improving treatment access, continuity and adherence for people with serious mental illnesses can help prevent some violent episodes, according to Swanson.

NewPublicHealth spoke with Swanson a few days after the shooting in Newtown, Conn.

NewPublicHealth: What is the role of law and public health in efforts to prevent gun and other forms of violence?

Swanson: We need to think about gun violence as a public health problem. Homicide and suicide are the second- and third-leading causes of mortality in the U.S. population ages 15-34, and firearms are involved in most violent fatalities. In theory, the law should be an effective public health tool in trying to address the problem. Law can regulate what kinds of guns are available, where they can used, by whom, and even how they are stored. But since the U.S. Constitution protects a citizen’s basic right to possess a gun, the law can’t go too far in limiting legal access to guns in the population. That means we have to focus more on trying to identify dangerous people who should not have guns. That’s very complicated, because violence is complicated and so are people. The law could be used even more effectively, though, if we had better research evidence about what features of gun laws and policies work best to protect safety while safeguarding civil rights. That’s what we’re trying to do.

NPH: What does experience tell you—will the discussion on gun control evaporate by the middle of this week, or is there a meaningful opportunity now for consideration of state and federal laws that might make it harder for more such massacres to occur?

Swanson: I work on my research and think about violence, mental illness and firearms policy all year long. But the only time the public and the national media seem to care about these issues is when there’s a horrible mass shooting. Then they move on. This time, though, it feels a bit different. I think there is a meaningful opportunity for reform in the months ahead, both on the mental health policy front and on the gun safety front.

NPH: Your research shows that mental illness is not necessarily linked to gun violence, but each of the recent cases of mass violence has been linked to a person with a history of some mental health issues. How feasible is it to identify someone as potentially violent before a shooting takes place, and might strengthening current laws, or enacting new ones, help?

Swanson: The vast majority of people with mental illness are not violent, although—in relative terms—people with mental illness are about three times more likely to commit minor-to-serious violent acts than people without mental illness. Predicting mass shootings is virtually impossible, though, because these are needle-in-a-haystack rare events. You can profile the perpetrators after the fact and you’ll get descriptions of troubled young men—which also matches the description of thousands of other troubled young men who would never do something like this.

We can’t go out and lock up all the socially awkward young men in the world. What we could do is institute universal background checks for gun purchasers; have comprehensive reporting to the National Instant Check System; ban assault weapons and high-capacity ammunition magazines; institute stricter locked storage requirements and other safety restrictions for household guns; have school-based violence prevention programs, and mental health counseling and referral services on every school and college campus; and make evidence-based mental health treatment accessible and available to those who need it.

Preliminary findings from our PHLR-funded study of gun laws’ effectiveness in Connecticut suggests that the laws may be working to some extent, but people with extensive criminal backgrounds may be undeterred by these laws.  Fully implementing the laws we have, enacting sensible new policies, and doing further research on their effectiveness, could go a long way toward what I call “preventing the unpredicted.”

Tags: Mental Health, Public and Community Health, Public health law, Violence