Dr. Archie Bleyer: The Fallacy of Blaming Gun Violence on Mental Health

Safety in Numbers

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Sarah Burd-Sharps, Senior Director of Research

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An interview with researcher Dr. Archie Bleyer on why focusing on mental illness as the cause of firearm violence diverts attention from the larger problem of gun violence in the United States.

Can you describe your work on the relationship between mental health disorder prevalence and the causes of gun violence?

The United States has the world’s highest citizen firearm injury and mortality rate in the world—even higher than countries currently involved in wars. The death rate in Gaza, for example, is reported by their authorities to be approaching 50,000 since the war began in October 2023.¹Palestinian Ministry of Health. “occupied Palestinian territory Health Cluster.” March 1, 2025. https://shorturl.at/U8TP9, Huynh, Benjamin Q et al., “No evidence of inflated mortality reporting from the Gaza Ministry of Health.” The Lancet, Volume 403, Issue 10421, 23 – 24 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02713-7/fulltext In that same time period, the United States has had 64,000 firearm deaths. Comparing the United States to the 40 other countries²Andorra, Australia, Austria, Belgium, Bermuda, Brunei, Canada, Cyprus, Czechia, Denmark, England, Estonia, Finland, France, Germany, Guam, Iceland, Ireland, Japan, Kuwait, Latvia, Lithuania, Luxembourg, Monaco, Netherlands, New Zealand, Northern Ireland, Norway, Qatar, San Marino, Scotland, Singapore, Slovakia, Slovenia, South Korea, Sweden, Switzerland, Taiwan, United Arab Emirates, and Wales. with comparable economic, educational, fertility and other indices, we find similar incidences of adult mental disorders and mental illness in our population. To blame our firearm problem on our country’s mental disorder prevalence makes no sense. If we have by far the worst firearm death rate but are not different in mental disorder prevalence, then we can’t blame the problem on a cause that doesn’t exist.

What motivated you to challenge these assumptions? 

I was tired of firearm lobbyists, owners, advocates, and defenders laying the blame for our firearm deaths on untreated mental illness. Instead of assuming that the firearms, their owners, or industry had a role in our gun violence crisis, they blamed others, especially those with mental health issues. The National Rifle Association (NRA) even proposed the creation of a national database of persons with mental illness. Also, the NRA’s mantra that, “The only thing that can stop a bad guy with a gun is a good guy with a gun” was increasingly being adopted, as evidenced by the all-time record of firearm purchases just four years ago. To blame others is a cop-out, and indeed cops are dying in the United States because of this opinion.   

Describe the mental health and firearm mortality data you used in your study.

In our August 2024 study, the mental health data come from an exceptional resource: the Institutional for Health Metrics and Evaluation (IHME) Global Health Burden of the University of Washington. The IHME compiles health data sourced from the world’s 204 countries and territories. In the area of mental health disorders, they have data on anxiety, depression, attention deficit/hyperactive, bipolar, conduct, schizophrenia, autism, eating, idiopathic developmental intellectual disability disorders, and other mental disorders. 

Using a system developed over decades, IHME classifies countries according to a sociodemographic index (SDI) that combines measures of income per capita, educational attainment, and fertility. SDI is a measure that has been used in 1,313 reports in medical journals. The United States is in the high SDI category, along with 40 other countries, most of which are located in Europe, North America, Eastern, and Australasia. 

Annual firearm death rate data was obtained from the Centers for Disease Control and Prevention.³Centers for Disease Control and Prevention Web-based Injury Statistics Query, Reporting and WONDER Systems.

What did you find with respect to mental health prevalence and gun violence?

For each of the nine mental health disorders above plus an overall category of mental disorders, we compared the United States with 40 other high SDI countries. The United States is similar in all of these major categories to its 40 comparable countries, including those mental health disorders primarily associated with suicide (such as depression, anxiety, schizophrenia, bipolar, and conduct disorders). Yes, we have mental health challenges in our population, but the United States is not worse than our peer countries.

The most obvious difference is firearm prevalence, for which there is no country in the world like ours. We are the only country with the Second Amendment in its Constitution and we have more than half of all the world’s civilian-owned firearms, while making up only 4 percent of the world’s population.

What implications does your research have for policymakers?

Reducing firearm prevalence, which is correlated with the country’s firearm death rate, is a logical solution that has been applied successfully by other countries, including Australia, Canada, New Zealand, Switzerland, and Israel. An analysis of 16 Western European countries documents more restrictive firearm policies being associated with fewer homicides committed with firearms as well as a decreasing effect on the overall homicide rate.⁴Hurka, Steffen, and Christoph Knill. 2020. “Does Regulation Matter? A Cross-National Analysis of the Impact of Gun Policies on Homicide and Suicide Rates.” Regulation & Governance 14 (2): 259–77. https://doi.org/10.1111/rego.12227. Focusing on mental illness as the cause of firearm violence diverts attention from the larger problem of gun violence in the United States, and distracts from the major cause of US firearm deaths: suicide. The strikingly higher suicide rate in the United States has been attributed primarily to suicidal persons access to firearms. According to a comparison of Canada with the United States, one in four US suicide fatalities could be averted if we had the same suicide rates as in Canada and its lower firearm ownership rates.⁵Raifman J, Sampson L, Galea S, Suicide fatalities in the US compared to Canada: Potential suicides averted with lower firearm ownership in the US. PLoS ONE. 2020;15(4):e0232252. Pmid:32353022, 

What’s the best way to communicate these findings to counter misinformation?

First, each time a gun proponent blames our problem on mental illness, they should be corrected. Correction of misinformation should occur at multiple levels: personally on an individual basis, locally (city, county, district), statewide, regionally, and nationally.

Second, the emphasis should be at a national level, which for the current Presidential term of office, will be even more difficult, as evidenced by the recent closure of the White House Office of Firearm Violence Prevention. Nonetheless, the firearm violence prevention effort in the United States is nationally fragmented, with more than 100 organizations across the country trying to help solve the problem. Coordination of these efforts is essential for maximum impact. 

Third, the firearm lobby, gun owners,and industry should be directly included in this focus. They are losing more Americans to physical and mental harm and death as well.

Fourth, funding for, and organization of research on our world’s unique problem should be increased and coordinated nationally. An important current example is the National Institute of Health (NIH), whose funding has been dramatically reduced when it should be expanded on firearm crisis solutions. 

Fifth, we need other countries that have been successful in reducing firearm prevalence  to assist us in this effort. They may be blocked by the current federal executive administration, but those willing to help should undertake prevention efforts urgently.

Safety is in the numbers, in reducing the number of accessible firearms and armamentarium, in increasing the number of national leaders to accomplish this, and in better coordination of efforts.  

About Dr. Archie Bleyer

Dr. Bleyer is a Clinical Research Professor in Radiation Medicine and The Knight Cancer Institute at the Oregon Health and Science University, Professor of Pediatrics at McGovern Medical School of the University of Texas, and Collaborator of the Institute for Health Metrics and Evaluation Global Burden of Disease at the University of Washington. He was previously at the National Cancer Institute, Fred Hutchinson Cancer Center, Seattle Children’s Hospital, and University of Texas M.D. Anderson Cancer Center.

Recent publications, of which he is particularly proud, are: 

• Bleyer A, Siegel S, Thomas CR. Increasing rate of unintentional firearm deaths in youngest Americans: Firearm prevalence and Covid-19 pandemic implication. J Natl Med Association. 2021;113(3):265-77. 
• Bleyer A, Siegel SE, Estrada J, Thomas CR. The fallacy of attributing the US firearm mortality crisis to mental health.  PLoS One  2024;19(8|Aug 5):e0290138. doi.org/10.1371/journal.pone.0290138.
• Bleyer A, Barnes B, Finn K.  United States marijuana legalization and opioid mortality epidemic during 2010-2020 and pandemic implications. J Natl Med Association  2022;114:412-25. 
• Bleyer A, Siegel S, Thomas CR. Increasing firearm deaths in the youngest Americans: Ecologic correlation with firearm prevalence. MedRxiv BMJ, Yale, Cold Spring Harbor Preprint Server for the Health Sciences, doi:https://doi.org/10.1101/1900919.