GUNSMass Shootings Often Put a Spotlight on Mental Illness, but Figuring Out Which Conditions Should Keep Someone from Having a Gun Is Not Easy

By Arash Javanbakht

Published 15 November 2023

Mental illness again became a central theme after the mass shooting in Maine on Oct. 25, 2023, in which records suggest that the shooter had a history of serious mental health issues. The relationship between mental illness and guns, and risk mitigation, is complicated, and the majority of people with mental illness do not seek treatment.

Every time the country is shaken by a tragic mass shooting and the loss of innocent lives, mental illness and its role in the actions of the mass shooter come under scrutiny.

Mental illness again became a central theme after the mass shooting in Maine on Oct. 25, 2023, in which records suggest that the shooter had a history of serious mental health issues. Months before the tragedy, the family of gunman Robert Card, as well as Army Reserve staffers, had contacted law enforcement expressing high levels of concern about his mental health and noting his access to guns.

Since 1999, 19 states along with the District of Columbia have passed legislation, commonly known as red flag laws, that allow law enforcement and other people in a person’s life to petition for removal of firearms when there are imminent safety concerns about a gun owner. However, reports suggest that this law is rarely used.

Maine, though, has what’s known as a yellow flag law. It requires reporting to local law enforcement that a person poses an imminent threat, but it then relies on the police to take the person into custody, order a mental health evaluation and request a court order to have that person’s guns removed. The yellow flag law was not used in Card’s case.

The relationship between mental illness and guns, and risk mitigation, is complicated. Specifically, there is no clear and uniform consensus on who should determine when to restrict access to firearms – should it be a psychiatrist, an independent forensic psychiatrist, a committee of psychiatrists or a judge? The majority of people with mental illness do not seek treatment.

In that light, it might make sense to mandate a psychiatric examination into the background check process for purchasing a gun. As severe mental illness can start at any point in life, will gun owners need periodic psychiatric assessment, akin to a vision exam for renewing a driver’s license? If so, who will pay for the visits?

I am a trauma psychiatrist who regularly deals with the outcome of gun violence, whether in victims or first responders. In my book “Afraid: Understanding the Purpose of Fear and Harnessing the Power of Anxiety,” I have examined mental health issues related to gun violence and the social consequences of mass shootings.