“Fake news” might be an early catchphrase of the Trump Era, but false narratives are a modern form of propaganda, which has been around for hundreds of years. The concept of propaganda (and the word itself) has its roots in the missionary activities of the Catholic Church in the 1600s and later in the American and French Revolutions, and in the fight to abolish slavery.

In a historical context, the concept of propaganda is relatively neutral, or at least it is not by definition an intentionally false narrative device. But starting in the mid-20th century, propaganda became increasingly used to promote false narratives to advance political purposes (McCarthyism and the Red Scare come to mind). And in that context, they are troubling enough. But they are even more insidious when both sides embrace the same false narrative, even if for very different reasons.

People with a lived experience of mental illness are far more likely to be victims of violent crime than perpetrators of it.

Such is the case with the false narrative that conflates gun violence with mental illness. While the Substance Abuse and Mental Health Services Administration (SAMHSA) has estimated that nearly 1 in 5 people experience some form of mental illness in any given year, other research has found that fewer than 3 to 5 percent of crimes in the United States involve someone with a diagnosable mental illness. According to the National Center for Health Statistics, fewer than 5 percent of the 120,000 gun-related killings in the United States between 2001 and 2010 were perpetrated by someone diagnosed with a mental illness.  At the same time, another study found that about 1 in 4 people with a serious mental illness had been victims of violent crime in the previous year—a rate more than 11 times higher than for the general population. In short, people with a lived experience of mental illness are far more likely to be victims of violent crime than perpetrators of it.

Yet both sides of the political spectrum have advanced (or at least accepted) the conflation of gun violence and mental illness for their own purposes. Referring to gun violence in an October 2015 interview with George Stephanopoulos, then-candidate Donald Trump said, “This isn’t guns. This is about, really, mental illness.”  On the opposite side of political spectrum, President Obama quietly signed an executive order in the waning days of his administration to implement a Social Security Administration rule restricting gun ownership from certain individuals with a diagnosed mental illness. This action essentially (if unintentionally) lumped them into the same category as convicted felons and potential terrorists.

When President Trump signed a bill on February 28 to reverse the Obama executive action, it was less likely an attempt to address the prejudice exacerbated by the original action than a statement of alignment with the National Rifle Association. After all, the corporate gun lobby wouldn’t want to be seen in support of any legislation that would restrict gun ownership, even from those they most often blame (falsely) for gun violence in the first place.

Allowing this false narrative to continue is damaging in two important ways: It diverts attention away from policies that might actually address gun violence or mental illness, and it reinforces the discrimination that discourages many people from seeking or accepting help when confronted with a mental health challenge (which are very treatable).

Mixed Messages

Unfortunately, even gun violence prevention and mental health advocates have demonstrated a willingness to conflate the issues of mental illness and gun safety for their own purposes. Linking mental illness to a high-profile public safety and public health crisis has allowed progressive supporters of gun safety to find common ground with conservatives on what they see as winnable policy battles; it has also allowed mental health advocates to draw attention and much-needed resources to the prevention and treatment of mental illnesses.

But this strategy has made it all too easy for both groups to fall into a trap. During deliberations over the 21st Century Cures Act in 2016 (which was widely supported by the mental health sector), one of the bill’s supporters, Pennsylvania Republican congressman Tim Murphy, wore a button with the slogan, “Treatment before tragedy.” While the button was likely a reference to the prevention of suicide—a legitimate concern in the context of mental illness—it also reinforced the conflation of mental illness and violence. 

Similarly, consider fashion designer Kenneth Cole’s infamous 2015 tweet, which showed a photo of a billboard he installed in New York City that read: “Over 40 Mil Americans suffer from mental illness. SOME can access care ALL can access guns.”

Well-intended though it might have been, Cole’s tweet essentially threw people with a mental illness under the bus in service to a gun violence prevention message.

Reframing the Issues

What we need now is a proactive, focused, comprehensive, and sustained strategy that decouples the issues of gun violence and mental health, and reframes our national dialogue about both.

Progressive advocates too often assume that they “have the facts on their side” and that the framing of issues is necessary only to “spin” their way out of a hard-to-sell narrative. Yet science tells us that people make decisions about what to believe and what to do based on their values and assumptions about how the world works. Then they consider the facts, accepting those that support their assumptions and rejecting those that contradict them.

Conservative advocates—and their funders and think tanks—have long been effective at framing issues around the core values of their constituencies, even when facts aren’t necessarily on their side. The pro-gun lobby has grounded messaging and narratives in values such as freedom, individual rights (“the right to bear arms”), and safety, and has been all too willing to employ fear-based appeals to communicate that guns make people safer, even though the evidence suggests they do not.

Some gun violence prevention advocates have taken initial steps to invoke these same values (freedom, individual rights, and safety) for their own purposes. A team of communications and policy analysts described this strategy in a 2012 publication titled, “Preventing Gun Violence Through Effective Messaging.” Josh Horwitz, executive director of the Coalition to Stop Gun Violence, described the research underpinning that strategy in a recent interview: “The most powerful word for us is ‘freedom,’” he said. “People want to be free from gun violence. They want to be able to sit on their front porches without fear of gun violence.”

Shifting the discourse by invoking the opposition’s core value has proven effective before, as when smoking cessation and prevention advocates embraced the value of individual freedom—championed by the tobacco industry for decades (freedom to smoke if one wishes)—and employed it for their own purposes (freedom from exposure to dangerous second-hand smoke).

The mental health sector has made progress on changing the language around mental illness and the people affected by it, including avoidance of any terminology or labeling that further reinforces the prejudice and discrimination associated with mental illnesses. For example, building on the legacy of former first lady Rosalynn Carter (an early and very public champion of mental health), the Carter Center published a guide for journalists encouraging them to avoid describing someone as “mentally ill,” “crazy,” or “psycho.”

Another publication distributed by the Chicago-based Depression and Bipolar Support Alliance explained that such terminology can “reinforce negative stereotypes that promote discrimination” and make it “harder for people living with these challenges to speak up, seek treatment, and find support.”

Yet, harmful terminology persists, as with the widespread use of the phrase “mental defective” throughout federal policy to refer to people with a lived experience of mental illness.

In recent years, some in the mental health sector (led by Mental Health America and it’s B4Stage4 initiative) have sought to advance a more strength-based message about mental health. And this messaging may have helped generate the support needed to pass the 2016 21st Century Cures Act that President Obama signed last December. It also may have helped shift some media coverage in a more factual direction, even while the vast majority continues to associate mental illness with violence. “We do think it’s taking root,” Paul Gionfriddo, president and CEO of Mental Health America, told me in an interview in February. “We have a long way to go, but it has made a big difference.”

But can that support and a modest realignment of media coverage change such well-entrenched views politically and culturally, especially in the face of a better organized—and much better funded—corporate gun lobby and a US president with twitchy Twitter finger?

Ultimately, success will hinge on the extent to which an often-dispersed (and sometimes fractured) constellation of issue advocates and champions can come to agreement on (and consistently employ) a new way of framing the issues. This will require an approach grounded in research about the underlying core values and supporting facts that motivate sustainable changes in attitudes, behaviors, policies and systems. While gun violence prevention advocates say they are more than willing to collaborate on such a reframe, they are clearly looking to mental health advocates to take the lead. That could be a challenge for the mental health sector, which has found it hard over the years to speak with one voice.

“We really need to have a collective message we can all use that connects with American values,” said Mighty Fine, deputy director of the Center for Professional Development and Public Health Systems and Partnerships for the American Public Health Association when I spoke with him late last year. “Some of this exploration has been happening locally and some nationally, but it has been happening in silos. The timing seems right more than ever for people and groups who are looking for solutions to come together and frame the subject and figure out what messages to deliver.”

Going Forward

Building sustainable public will for mental health prevention and treatment—and for reasonable gun safety policy—won’t happen overnight. It will require a sustained investment not just in influencing policymakers or legacy media coverage, but in engaging community-based organizations and champions that can authentically carry the message while simultaneously providing people in communities with something actionable to do, whether it’s rallying in the town square for passage of a specific policy, or reaching out for mental health services or support if they need it.

This sort of strategy has worked for progressive social purpose advocates in the past. Witness the great success of the marriage equality movement in recent years. Whether it can change the narrative about mental health and gun violence, too, remains to be seen. But one thing is certain: There’s no choice but to try. The false narrative conflating gun violence and mental illness won’t go away by itself. False narratives never do.