title: Mental illness and reduction of gun violence and suicide: bringing epidemiologic research to policy.
abstract: OBJECTIVE
  This article describes epidemiologic evidence concerning risk of gun violence and suicide linked to psychiatric disorders, in contrast to media-fueled public perceptions of the dangerousness of mentally ill individuals, and evaluates effectiveness of policies and laws designed to prevent firearms injury and mortality associated with serious mental illnesses and substance use disorders.
  
  
  METHODS
  Research concerning public attitudes toward persons with mental illness is reviewed and juxtaposed with evidence from benchmark epidemiologic and clinical studies of violence and mental illness and of the accuracy of psychiatrists' risk assessments. Selected policies and laws designed to reduce gun violence in relation to mental illness are critically evaluated; evidence-based policy recommendations are presented.
  
  
  RESULTS
  Media accounts of mass shootings by disturbed individuals galvanize public attention and reinforce popular belief that mental illness often results in violence. Epidemiologic studies show that the large majority of people with serious mental illnesses are never violent. However, mental illness is strongly associated with increased risk of suicide, which accounts for over half of US firearms-related fatalities.
  
  
  CONCLUSIONS
  Policymaking at the interface of gun violence prevention and mental illness should be based on epidemiologic data concerning risk to improve the effectiveness, feasibility, and fairness of policy initiatives.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC. Electronic address: jeffrey.swanson@duke.edu.
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Swanson
authors.affiliation: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: E Elizabeth
authors.initials: EE
authors.lastname: McGinty
authors.affiliation: Department of Psychiatry, University of Oxford, Oxford, England.
authors.forename: Seena
authors.initials: S
authors.lastname: Fazel
authors.affiliation: Department of Psychology, University of California at Los Angeles, Los Angeles, CA; Department of Health Policy and Management, University of California at Los Angeles, Los Angeles, CA.
authors.forename: Vickie M
authors.initials: VM
authors.lastname: Mays
mesh_terms: D016021:Epidemiologic Studies; D005260:Female; D005389:Firearms / Q000331:legislation & jurisprudence*; D006801:Humans; D015994:Incidence; D008297:Male; D008402:Mass Media; D001523:Mental Disorders / Q000453:epidemiology*; D028642:Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D011050:Policy Making; D011639:Public Opinion; D011640:Public Policy / Q000331:legislation & jurisprudence*; D018570:Risk Assessment; D013405:Suicide / Q000706:statistics & numerical data; D014481:United States; D014754:Violence / Q000517:prevention & control* / Q000706:statistics & numerical data; D000092864:Suicide Prevention
keywords: Firearms; Guns; Law; Mental illness; Policy; Psychiatric disorder; Risk; Stigma; Suicide; Violence