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Should Mental Health Checks Be Required Before Buying a Gun?

Man walking through a field with a shot gun over his shoulder

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Key Takeaways

  • Gun violence continues to take the lives of Americans at an increasing rate.
  • People with serious brain illness, such as schizophrenia, who are not medicated, may be at risk for gun violence.
  • Nearly half of Americans believe mandating a mental health assessment might keep the public safer.


2020 was the deadliest year in two decades for gun violence, taking the lives of nearly 20,000 Americans, according to data from the Gun Violence Archive. As of this August, 2021 is already deadlier with almost 29,000 deaths taken by gun violence.

If death by suicide is added in, the numbers are greater. For instance, the Centers for Disease Control and Prevention (CDC) reports that nearly 24,000 people died by firearm suicide in 2019.

Gun Violence and Mental Illness

While most people who are violent do not suffer from mental illnesses, and people with a mental illness are much more likely to be the victims rather than the perpetrators of violence, a 2021 study published in the Journal of Clinical Psychopharmacology found that many mass shooters in the United States were living with an untreated mental illness at the time they committed their crime.

“The paper showed that people with schizophrenia are less violent than the rest of the population except if they’re unmedicated. The mass shooters turn out to be people with psychiatric illness who are unmedicated,” Ira D. Glick, MD, lead researcher and professor emeritus of psychiatry and behavioral sciences at Stanford University School of Medicine, tells Verywell. 

After analyzing 35 mass shootings in the United States between 1982 and 2019, in which the shooters survived and went to trial, Glick found that 28 shooters had mental illness diagnoses, including:

“These should be referred to as brain illnesses rather than mental illnesses because mental illness covers so much ground,” says Glick.

He adds that his research shows the need to “find a way for people who are selling guns to make sure they don’t get in the hands of people who have brain illness and don’t want to take medicine.”

Can Health Assessments Help with Gun Violence?

OnlineTherapy.com surveyed 1,250 American adults and found that 49% believe mental health assessments should be required by law for gun ownership.

“An encouraging outcome of this recent research is observing an increasing connection being made by Americans that mental health matters when it comes to gun ownership and is an important consideration to prevent gun violence,” Danny Taylor, RCC, clinical counselor and addiction prevention specialist at OnlineTherapy.com, tells Verywell.

Danny Taylor, RCC

An encouraging outcome of this recent research is observing an increasing connection being made by Americans that mental health matters when it comes to gun ownership and is an important consideration to prevent gun violence

— Danny Taylor, RCC

The survey also discovered: 

  • 4 in 10 Republicans support mental health tests before any gun purchase.
  • 1 in 2 gun owners support annual mental health assessments for gun ownership.
  • 54% of those in support of mental health assessments for gun ownership believe they should be done yearly.
  • Mass shooters having a history of mental illness is the #1 reason why Americans say mental health assessments are necessary for gun ownership.

“Ideally an assessment will help prevent guns from ending up in the hands of people whose mental health challenges might trigger great harm. The adage is that guns don’t kill people; people kill people. If this is true, then mental health assessments will help us not only prevent gun violence, but also help people who are struggling find support,” says Taylor.

While the assessments would work by denying gun ownership to a person dealing with a serious mental health issue, he hopes the process would simultaneously refer them to mental health support.

“With referrals being practiced and better support in place, we might see individuals in a much healthier and more responsible frame of mind to assume gun ownership in the future,” Taylor says.

But Is It a Violation of Rights?

The survey found that 45% of people who object to mental health assessments believe it would violate the Second Amendment.

“Gun ownership is more than a political issue; it is a public health and safety issue. Mandated mental health assessments prior to gun ownership ensures collective accountability to support individuals and ensure safe communities,” says Taylor.

Glick agrees, noting that health assessments could save lives.

“Something has to be done. Many people think, ‘who cares who is buying guns’ until someone in their own family gets killed; then they care,” he says.

Ira D. Glick, MD

Something has to be done. Many people think, ‘who cares who is buying guns’ until someone in their own family gets killed; then they care.

— Ira D. Glick, MD

In terms of how a health assessment might look, Taylor envisions an interdisciplinary, diverse representation of Americans to develop and review the assessment criteria and methodology. He adds that the assessment should be regularly reviewed and edited to allow ongoing objective accountability.

“Assessment tools could look like common self-reports utilized in the medical community. Self-reports might also occur in consultation with mental health professionals for a brief interview. On the subject of accountability, I believe having an assessment done onsite at a gun seller is less ideal and can be compromised by profit motive,” says Taylor.

Involving mental health professional services can provide objective expertise and support to potential gun owners, as well as gun sellers, he adds.

A Focus on Safety Not Stigma

While assumptions of mental illness and violence can lead to intolerance and stigma, Taylor says understanding the facts can help develop more understanding attitudes towards mental health.

“It is worth noting that violence from gun ownership also includes self-infliction, such as suicidality... Having ongoing mental health assessments for those wanting to own a lethal weapon can be a valuable step to ensure mental well-being and responsible ownership,” says Taylor.

The more action society takes to support people with mental health challenges, the better it can build community health and safety.

“Gun ownership is an important responsibility and prioritizing mental health support is a valuable step in the direction of cultivating an accountable and supportive community,” says Taylor. 

As for the argument that preventing non-violent individuals with mental illness from owning a gun is not fair, he says, “for the collective good in the face of continued mass shootings and gun violence in America, mental health assessments are a worthwhile intervention.”

Glick agrees, stating that the obvious solution is to keep guns away from people who are severely mentally ill.

However, in addition to mandates, he says teaching family and friends of those with serious brain illnesses how to find help for their loved ones may also make a difference.

“A lot of times the families haven’t forced their kids or spouses to get the help they need. They’re acting paranoid, and they don’t know what to do to help them,” says Glick.

What This Means For You

As gun violence in the United States continues to increase, law makers and the mental health community look for ways to protect the public. Many Americans believe requiring a mental health assessment might make a difference.

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  1. Glick ID, Cerfolio NE, Kamis D, Laurence M. Domestic mass shooters: the association with unmedicated and untreated psychiatric illnessJ Clin Psychopharmacol. 2021;41(4):366-369. doi:10.1097/JCP.0000000000001417

  2. OnlineTherapy.com. Half of America wants mental health test required for gun ownership. Published August 9, 2021.