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Dr Pies is Editor-in-Chief Emeritus of Psychiatric Times, and a Professor in the psychiatry departments of SUNY Upstate Medical University and Tufts University School of Medicine. He is the author of The Judaic Foundations of Cognitive Behavioral Therapy; a collection of short stories, Ziprin’s Ghost; and, most recently, a poetry chapbook, The Heart Broken Open.
Acknowledgments: I wish to thank James L. Knoll IV, MD; Garen J. Wintemute, MD, MPH; and David Hemenway, PhD, for their helpful comments on this essay; however, the positions advocated here reflect my own views.
Why should psychiatrists care about firearms regulation?
The reason that might first come to mind—the putative role of mental illness in several recent mass shootings—is actually the least important. (As I write, reports of a new mass shooting in Wisconsin are trickling in). Aurora, Colorado-type mass shootings—horrific though they are—actually amount to a minuscule percentage of gun-related deaths in the US. There are more compelling reasons why psychiatrists should be involved in the gun control debate.
First, psychiatrists are experts in assessing risk factors for suicide, and gun possession is a major risk factor for completed suicide. The US has a firearm- suicide rate almost 6 times higher than comparison countries.8 One study of handgun possession in California found that, in the first week after the purchase of a handgun, the rate of firearms suicide among purchasers is about 57 times as high as the adjusted rate in the general population.9
These extraordinary rates of gun-related killing cannot be written off as artifacts of faulty study methods or misinterpretation of the data. For example, the claim that other high-income countries have higher overall homicide rates than the US, owing to non-gun-related homicides (via stabbings, blunt objects, etc) is not borne out by the best available data.
Thus, the following Table4 shows overall intentional homicide rates and intentional gun-related homicide rates in the US and 3 other high-income countries for 2009* (The United Nations Office on Drugs and Crime defines “intentional homicide” as “...unlawful death purposely inflicted on a person by another person”). It also shows percentage of homicides from firearms.
Source: UNODC (United Nations Office on Drugs and Crime)
What about the relationship of gun ownership, firearms laws, and violent crime in the US? Of course, proving causal connections (vs mere associations) between gun regulations and violent crime rates is exceedingly difficult, given the multitude of confounding variables. Yet one myth that continues to be proffered by those who oppose any regulation of firearms is that gun ownership decreases crime rates and “keeps people safe.” In truth, there is little credible evidence to support these claims, and considerable evidence against them. Thus, a recent review in the New England Journal of Medicine concluded that:
murder than countries with stricter laws. One Australian observational study compared mass murders before and after 1996, the year of a widely publicized mass murder in Tasmania. Australia quickly enacted gun law reforms that included removing semiautomatic, pump-action shotguns and rifles from civilian possession. In the 18 years before the gun laws, the Australian authors reported 13 mass shootings. In the 10.5 years after the gun law reforms, there were none.”14
1. Firearms offenses. Scotland.
3.Statistical Bulletin Crime and Justice Series: Homicide in Scotland, 2009-10
9. Wintemute GJ, Parham CA, Beaumont JJ, et al. Mortality among recent purchasers of handguns. N Engl J Med. 1999; 341(21):1583-1589.
10. Miller M, Hemenway D. Guns and suicide in the United States. N Engl J Med. 2008;359:989-991.
11. Wintemute GJ. Guns, fear, the Constitution, and the public’s health. N Engl J Med. 2008;358:1421-1424.
12. Violence Policy Center. States with higher gun ownership and weak gun laws lead nation in gun death.
16. Main F. Chicago gangs don’t have to go far to buy guns. Chicago Sun-Times. Aug 26, 2012.