Features
Firearm access by at-risk people

A Canadian perspective

The overall contribution of people with serious mental illness to violent crimes is only about three to four per cent, and most individuals diagnosed with a serious mental health disorder are no more likely to commit an act of violence (with or without a firearm) than the general population.¹ However, individuals with the most severe psychiatric diseases are at a heightened risk for violent behaviour when untreated for their symptoms. There is a crucial need for members of law enforcement to understand this relationship in order to prevent creating a more powerful stigma. Discussing mental illness openly works to reduce the unfair stigma by bringing the subject into the light.

When a government official states that “the shooter has a history of mental illness”, the public is left to assume that the shooter is either schizophrenic or delusional, when in fact it could mean that they have a mood disorder or have an antisocial personality disorder. As we discuss firearm safety and keeping guns away from persons deemed to be ‘at risk’, we should focus on externalizing behaviour and symptomology that is observable, as they are the most detectable for law enforcement. Adult Externalizing Disorders (AED) include Antisocial Personality Disorder, Substance Use Disorders, Psychopathy, and Impulse Control Disorders such as Intermittent Explosive Disorder. They are often preceded by childhood history of Conduct Disorder and Oppositional Defiant Disorder. The symptoms of these disorders are typically observable and often denote a lack of behavioural control.

Dr. John Monahan and colleagues note that directly targeting mental illness as the major driver of gun violence is misguided. Prior violence, substance use, and early trauma are more likely to contribute to subsequent violence than mental illness.²

The relationship between mental disorder and violence is complicated. As Elbogen & Johnson note, “mental illness is clearly relevant to violence risk, but its causal roles are complex, indirect, and embedded in a web of other important individual and situational cofactors to consider.⁴

What does it mean to be ‘at-risk’ for violence?

Risk assessment methodology and its practical application provide useful tools for the safety screening of licence applicants and licence holders. In particular, risk assessment methodology can raise new questions that address the risks of an individual committing an act of violence which, in turn, can inform the safety screening process.

Risk factors are traits associated with an increased likelihood that an individual or community will be affected by or become a perpetrator of violence. Risk factors can occur at the individual, family, school, and community levels. While not everyone who is identified as being ‘at risk’ becomes involved in violence, research shows that those individuals with more than one risk factor and a lack of protective factors are more vulnerable to being affected by, or involved in violence. As an individual is exposed to more risk factors, the probability that they will engage in violent behaviour increases.

Although there have been tremendous advances in our understanding of risk factors, recent trends in violence risk-assessment research emphasize the need for an explanatory theory around the choice to act in a particular moment and the evolution of dynamic risk over time. These elements are difficult, if not impossible, to measure at the time that violence is occurring. Observing externalizing factors and variables as diverse as previous violence, substance abuse, personality disorder, and exposure to environmental stressors may allow us to develop a picture of what happens immediately before an act of violence. Being aware of context and the effect of particular environments on an individual can help illuminate a pathway to violence and assist the police or firearms officers in creating obstacles on those paths.

‘At risk’ can mean perpetrating Intimate Partner Violence (IPV)

In the Annual Report to the Chief Coroner of Ontario, the Domestic Violence Death Review Committee detailed the following risk factors that they deemed to be a common thread in their findings: history of violence outside of the family by perpetrator; prior history of domestic violence; pending or actual separation or estrangement; obsessive behaviour displayed by perpetrator; perpetrator depressed in the opinions of professionals and/or non-professionals; escalation of violence; prior threats of suicide or attempted suicide; prior threats to kill victim; prior attempts to isolate victim; victim had intuitive sense of fear; history of violence outside the family; perpetrator was unemployed; and possession of or access to firearms.

Intimate partner violence (IPV) is the most common form of violence against women in Canada. In 2015, there were 84 intimate partner homicides in Canada and 72 in 2016.⁵ A Canadian report on family murder-suicides from 2001 to 2011 found that firearms were the most common cause of death in spousal murder-suicides and in murder-suicides involving child and youth victims.⁶

In the application for renewal of a firearms licence for an individual in Canada, an applicant is required to have the signature of a current spouse, common-law partner, or other conjugal partner which would make them aware of the application. This portion, as well as personal history questions relating to divorce, separation, or breakdown of relationship are integral to this application given the above statistics on intimate partner violence and firearms.

Being aware of context and the effect of particular environments on an individual can help illuminate a pathway to violence and assist the police or firearms officers in creating obstacles on those paths.

‘At risk’ can mean mental disorder and substance use disorder

Understanding the link between violent acts and mental disorder requires consideration of its association with other variables such as substance abuse, environmental stressors, and history of violence. Certain studies do not distinguish between mental illnesses, substance abuse or co-occurring mental illnesses and addictions. Violent behaviours are significantly elevated when a mental illness co-occurs with substance use. Monahan’s study found that 31 per cent of people who had both a substance abuse disorder and a psychiatric disorder (a ‘dual diagnosis’), committed at least one act of violence in a year, compared with 18 per cent of people with a psychiatric disorder alone.³

This and other research confirm that substance abuse is a key contributor to violent behaviour and that the comorbidity of a mental disorder with a substance use disorder will often reveal a heightened risk for violence. It can also be detectable prior to any firearm violence in many cases. This comorbidity is not sufficiently emphasized when training individuals on the front line to observe people who exhibit behaviour indicative of future violence.

‘At risk’ can mean mental disorder and untreated psychosis

A meta-analysis of 204 studies of psychosis as a risk factor for violence reported that “compared with individuals with no mental disorders, people with psychosis seem to be at a substantially elevated risk for violence.” Psychosis “was significantly associated with a 49 per cent to 68 per cent increase in the odds of violence”.⁷

Psychosis is an externalizing behaviour which allows others to see that the individual is suffering from the symptoms that can include delusions, hallucinations, and psychomotor behavioural abnormality. There is often an impaired ability to understand and perceive one’s illness (a lack of insight or ‘Anosognosia’), that often can accompany psychosis. It can be an indicator of a safety risk to oneself or to others.

‘At risk’ can mean criminal record and history of violence

Because the age at ‘act of first violence’ is a key risk factor, it is imperative for the criminal history of an individual to capture any violent act prior to becoming an adult. Laws that do not ask for a Juvenile Record may be missing data indicating a future risk for violence. It is also paramount to capture any breach of law from other countries where an applicant may have resided.

Of all solved firearm homicides in Canada committed between 1997 and 2014, 61 per cent were committed by an accused with a previous criminal record, and 41 per cent had prior ‘other violent offences’ on their record. Because of this high rate of previous violence, it is also understood that many perpetrators using firearms do not have any valid firearms licence. However, there are still many who commit firearm homicide who do possess a valid licence.⁸

‘At risk’ can mean suicidal ideation and behaviour

Violent and aggressive acts are not always directed against others, but instead can be committed against oneself. Suicide is the most significant public health concern in terms of guns and mental illness. Indeed, the research on firearm removal laws suggests that removal by police was rarely a result of psychosis; instead, risk of suicide was the leading reason. Certain mental health disorders, such as major depressive disorders, are strongly associated with suicide or attempted suicide.

Although the total number of suicides in Canada has remained relatively constant, firearm suicide as a per cent of all suicides has declined significantly since 1976.⁸ Nevertheless, adolescents are especially vulnerable to the risks of having a lethal method—such as a firearm—accessible in the home, due to impulsivity being an important factor in adolescent suicide.

Concluding remarks

Firearms do not belong in the hands of “at risk” people and firearms should not be in the homes where “at risk” people are residing. Too often officers are attending firearms calls where an “at risk” family member has gained access to the gun owner’s firearm. In Canada, we are working not to control gun ownership, but to ensure guns are owned in safety.

It is not necessary for law enforcement to diagnose the mental state of a person; the focus is more on the observable behaviors and related risk factors. Police must be trained to ‘detect’ behaviour, not to ‘diagnose’ behaviour, and the focus should be on externalizing disorders and the more obvious symptoms associated with mental disorder.

Disclaimer

The views presented in this article are those of the author and not necessarily the official position of the Royal Canadian Mounted Police or the Canadian Government.

References

1. Fazel, S. & Grann, M. (2006). The population impact of severe mental illness on violent crime. Am J Psychiatry 163(8): 1397–1403.
2. Steadman H.J., Monahan J., Pinals D.A., Vesselinov R., Robbins P.C. (2015). Gun violence and victimization of strangers by persons with a mental illness: Data from the MacArthur violence risk assessment study. PsychiatrServ; 66 (11).
3. Monahan, J. (2002). The MacArthur Studies of Violence Risk. Criminal Behaviour and Mental Health. 12 No. 13 (supplement): S67-S72.
4. Elbogen, E.B. and S.C. Johnson (2009). The intricate link between violence and mental disorder. Archives of General Psychiatry. 66 No. 2.
5. Statistics Canada (2016). Statistics Canada, Canadian Centre for Justice Statistics, Homicide Survey.
6. Sinha, M. 2012. “Family violence against children and youth.” Family Violence in Canada: A Statistical Profile, 2010. Statistics Canada Catalogue no. 85-002-X.
7. Douglas, K.S., Guy, L.S., Hart, S.D. (2009). Psychosis as a risk factor for violence to others: a meta-analysis. Psychological Bulletin 135.
8. Firearms Research, FMSS (2017). Criminal Justice and health-related firearms statistics, Canada selected topics. Unpublished document, RCMP Canadian Firearms Program.
9. Fazel, S.et al (2009). Schizophrenia, substance abuse, and violent crime (May 20, 2009). Journal of the American Medical Association: Vol. 301, No. 19.
10. United States Department of Justice, Federal Bureau of Investigation. January 2020. Crime in the United States, 2019.

Dr. Matt Logan began a career in law enforcement in 1980. He was a member of the RCMP for 28 years serving in B.C. As the first Operational Psychologist in Major Crime, S/Sgt (ret.) Logan co-founded the RCMP Behavioural Science Unit in Vancouver and has been involved as a consultant over the past 20 years. He signed back on with the RCMP and is currently the Criminal Investigative Psychologist in the National Headquarters.