Mental illness, violence, and gun law reform: Bringing phlr evidence to crisis-driven policy

The post-Newtown national conversation on gun violence and mental illness has brought opportunities for gun policy reform. Several states have already proposed new firearms policies. With respect to mental health, these proposals include broadening the definition of gun-disqualifying mental health records, mandating mental health professionals to report dangerous persons to authorities, expanding and strengthening involuntary outpatient commitment laws, and increasing investment in screening/crisis intervention services. President Obama has proposed new investment in mental health programs for youth, strengthening the gun background check system, and a review of the categories of gun-prohibited persons. But what is the evidence that these reforms will reduce gun violence? What unintended adverse consequences might result from such policies? We articulate a public health model of gun violence that situates mental illness as a risk factor within larger socio-economic and environmental determinants of the problem. We apply the framework to several legal approaches to gun violence in relation to mental health issues; assess the state of evidence for the effectiveness of these approaches; and present a public health law research agenda to fill important gaps in the evidence base. Better data sources, study designs, and analytic methods should be deployed to build knowledge of the problem of gun violence and its complex link to mental illness, in order to inform the development of policies and laws that are rational, cost-effective, and fair. The demands of public policy sometimes outpace evidence; crisis-driven law can be overreaching and difficult to undo.