Deah Shaddy Barakat, 23, a University of North Carolina dental student; his wife, Yusor Mohammad Abu-Salha, 21; and her sister, Razan Mohammad Abu-Salha, 19, a student at North Carolina State University, were young and talented, but now they are dead – shot in the head by an angry man with a handgun.
News that the Chapel Hill, N.C., shooter, Craig Stephen Hicks, had frightened neighbors with his rages and had a cache of 14 firearms sounded familiar to us. Our new research study, soon to be published in Behavioral Sciences and the Law, shows a distressingly large number of seriously angry people with guns – often multiple guns – living in our communities, and a legal system ill-equipped to prevent such tragedies. But it also suggests some steps that could be taken to reduce the toll.
The study, coauthored by us, Ronald Kessler of Harvard, and others, estimates that over 10 percent of the adult population in the U.S. exhibits impulsive angry behavior and has firearms at home.
A smaller proportion (1.6 percent) are angry and carry guns outside the home. They are mostly young to middle-aged men who get so angry that they smash and break things, lose their temper and get into physical fights. And they have guns.
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Are these angry people with guns “mentally ill”? That depends on what you mean by the term.
Many of them do meet criteria for a psychiatric disorder as defined broadly in the American Psychiatric Association’s diagnostic manual. But only a tiny fraction suffers from a major mental illness such as schizophrenia, which impairs thought and perception of reality. Rather, our study finds that angry people with guns are at elevated risk for a range of fairly common conditions including personality disorders (maladaptive patterns of relating to others), alcohol abuse, anxiety, post-traumatic stress, and (almost by definition) a malady that psychiatrists call “intermittent explosive disorder.”
Americans remain deeply divided over the politics of gun control, but there may be some common ground here: The angriest of the people in our study should not have access to guns.
The question then becomes, what is the fairest and most effective way to keep firearms out of the hands of people who are recognizably, dangerously, impulsively angry? And if people like this do tend to have diagnosable mental health problems, what are the chances that our current legal restrictions on guns will apply to such individuals?
Chances are slim. Evidence from our study suggests that existing mental-health-based firearms restrictions would fail to identify most of these angry people with guns.
Most of them lack any history of involuntary commitment, which is the primary criterion used by the law to prohibit people who have a mental illness from buying or possessing a gun. Fewer than 2 in 10 of these angry people have ever been admitted to a hospital for any mental health or substance abuse problem.
That means that at least 8 out of 10 of them could legally buy a firearm, unless they happened to have some other gun-prohibiting record such as a felony criminal conviction.
Where does that leave us? Given constitutional protection and the cultural entrenchment of private gun ownership in this country, it is likely that firearms, including handguns, will remain widely accessible for the foreseeable future.
Neither can we solve the problem by restricting the liberties of people with serious mental illness. They’re not the issue. Even if we could cure schizophrenia, bipolar disorder and major depression, about 96 percent of violent acts in our country would still occur.
Maybe an approach to gun restriction that is based on actual risk would do a better job of keeping guns from our angriest fellow citizens.
Evidence-based indicators of risk that could be used include histories of violent behavior (e.g., misdemeanor assault convictions), multiple DUIs, or being the subject of a domestic violence order of protection. Many states’ laws let domestic abusers keep their guns until temporary restraining orders become permanent, even though evidence suggests that this period presents particularly high risk to a potential victim.
Perhaps it’s time, too, for states to pass “dangerous persons” gun removal laws, like Connecticut and Indiana already have, or a “gun violence restraining order” law like California recently enacted. Such laws give family members and law enforcement a tool to get guns out of the hands of risky people immediately.
The Chapel Hill shooting, like its predecessors, haunts us with many “what ifs.”
What if the U.S. Supreme Court had not decided that the Second Amendment confers a right for every person to have a handgun for their personal protection? While academically interesting, that question is unlikely to get us anywhere.
A more productive question is this: What if a law had allowed the shooters to be legally separated from their guns on the basis of a recognized pattern of impulsive, angry, threatening behavior? The memory of all the victims should demand an answer.
Jeffrey Swanson is professor of psychiatry and behavioral sciences at Duke University School of Medicine. Paul Appelbaum is professor of psychiatry, medicine and law at Columbia University and past president of the American Psychiatric Association.