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‘Mental illness’ is a broad term, not a divining rod to violence

The article on Massachusetts firearms laws and the reporting of mental health information provided a useful discussion of this complex issue (“A Mass. hedge in FBI gun checks,” Page A1, Jan. 28). However, as a psychiatrist, I am concerned with the repeated references to “mental health history” and “mental illness,” as if these are precise terms that point us to people at high risk for gun-related violence.

First, the term “mental illness” is broad and could apply equally to a person diagnosed with well-controlled, adequately treated panic disorder or to a person with a severe psychotic disturbance and concomitant substance abuse who refuses to accept treatment.

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Second, it is worth repeating that “mental illness” per se is not strongly associated with risk of violence and accounts for a small proportion of violent crime, including gun-related violence.

That said, I believe that a history of violence directed against oneself or others — whether accompanied by psychiatric illness or not — should be a reportable factor that restricts access to firearms.

Indeed, while no one can predict who will become violent, it is fair to say that a person with a history of two serious bar fights would be at higher risk for future violence than someone with an unspecified mental illness.

Dr. Ronald Pies


The writer is affiliated with Tufts University and Upstate Medical University.

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