MARY LOUISE KELLY, HOST:
Along with gun control, the link between mental illness and gun violence has been a major focus in the days since the shooting. NRA spokeswoman Dana Loesch put it this way in a CNN town hall this week.
(SOUNDBITE OF ARCHIVED RECORDING)
DANA LOESCH: I don't believe that this insane monster should have ever been able to obtain a firearm - ever. This individual was nuts.
KELLY: President Trump has repeatedly pointed to mental health as the root of the problem, including yesterday at the White House.
(SOUNDBITE OF ARCHIVED RECORDING)
PRESIDENT DONALD TRUMP: And we're going to be focusing very strongly on mental health because here's a case of mental health.
KELLY: President Trump says part of that focus will be keeping guns out of the hands of people with mental illness. Another proposal from the president - opening more mental health institutions. But NPR's Alison Kodjak reports that doctors and mental health advocates say the link between mental health problems and gun crimes is tenuous.
ALISON KODJAK, BYLINE: The president says the way to stop future school shootings is to identify people with severe mental illness and lock them up.
(SOUNDBITE OF ARCHIVED RECORDING)
TRUMP: So we're going to be talking seriously about opening mental health institutions again.
KODJAK: And he added...
(SOUNDBITE OF ARCHIVED RECORDING)
TRUMP: We used to have mental institutions. And I said this yesterday. We had a mental institution where you take a sicko like this guy - he was a sick guy - so many signs - and you'd bring him to a mental health institution.
KODJAK: That troubles Bethany Lilly, an attorney with the Bazelon Center for Mental Health Law, because the United States has a dark history of locking people away in psychiatric hospitals.
BETHANY LILLY: We did that for most of American history. And then my organization and civil rights lawyers across the United States and journalists and investigators found out how horrible these snake pits were.
KODJAK: The patients received little mental health care. They were often abused and neglected.
LILLY: Mental health institutions not only imprisoned people who would have what we today call a mental health disability or a mental health diagnosis. They also imprisoned people who simply behaved outside of the norm of society.
KODJAK: So in the 1970s and 1980s, many psychiatric hospitals were closed. The number of patients fell by more than 90 percent. The president isn't completely alone in suggesting that that went too far. Health policy experts at the University of Pennsylvania wrote in 2015 that there's a need for more mental asylums, ones that actually provide quality mental health care for people who cannot safely live in the community. But Lilly fears people will once again be locked up not because they pose an actual threat but simply because they carry a diagnosis that others fear.
LILLY: If you talk to any practicing psychiatrist, they will tell you that the risk factors for gun violence are being a young, angry, socially isolated man. Sometimes in the constellation of effects, you will also have people with mental illness.
KODJAK: The Parkland Florida shooter was 19 and by many accounts very isolated. He was referred to police multiple times for violent threats. Matthew Miller is a professor of epidemiology at Northeastern University who has published several papers on the risk factors of gun violence. He says the key ingredient in this mass shooting and others is not mental illness. It's the guns.
MATTHEW MILLER: The reason for these sort of mass public shootings is not because we have higher rates of mental illness. And it's not because we have higher rates of violent behavior. We don't.
KODJAK: The rate of mental health problems in the U.S., he says, is about the same as in Europe. And the same goes for violent crime.
MILLER: But we have much higher rates of violent death because when people try to harm other people, for example, they are much more likely to use guns.
KODJAK: He says if politicians want to reduce mass shootings, they have to deal with the guns. If they want to improve mental health care, they can do that, too.
MILLER: One doesn't need to invoke homicides in order to say we should be doing a better job trying to treat mental illness and trying to give people access to mental health care. That's an argument you can make on its own merits.
KODJAK: Alison Kodjak, NPR News.
(SOUNDBITE OF CUL DE SAC'S "BLUES IN E") Transcript provided by NPR, Copyright NPR.
