BMJ  2007;335:837 (27 October), doi:10.1136/bmj.39365.683877.BE

Editorials

Violence and gun crime

Protecting children and reducing social exclusion are the priorities

The headlines about gun crime and violent crime in the United Kingdom are tragic and alarming—seven deaths of young people by October 2007 from gun crime and an apparent increase in violent crime generally. When combined with other news of gun related incidents, such as the shooting of Jean Charles De Menezes by a police officer in a London underground station, anxiety about the danger of guns is understandably high.

The statistics behind the headlines help to put the problem into context. Firearms offences in this country constitute 0.4% of all recorded crime; only 0.2% if airguns are excluded. The overall frequency of gun crime in the UK has been decreasing, and in 2005-6 the number of homicides involving firearms was 50: the lowest for 10 years.¹

Looking at homicide figures from an international perspective also helps reduce the collective sense of anxiety. In 2001, the average homicide rate internationally was 1.6/100 000 people,² which interestingly is the same as in England and Wales. The rate in Scotland, which has a total ban on guns, was 2.2. The rate in the United States is 5.6, but even this rate is much lower than that found in Estonia and Latvia (10.6) and Russia (22.1), and it pales into insignificance when compared with South Africa (51) and Colombia (62).

But 50 deaths is still 50 too many. Young people (16-29 years) are the second most likely group of people to be victims of homicide.³ Children under 16 are the group most likely to die as a result of homicide. They are usually killed by their parents or someone known to them, but in 21% of cases no suspect is identified.¹ Firearms seem mainly to be used as a threat, to coerce compliance. Of course, the same could be said of knives, which are potentially just as lethal. The attraction of the gun is that it can be used from a safe distance, so the shooter is disconnected from the victim's suffering.

In 2006, a Home Office report reviewed the use of illegal firearms in 80 young men convicted of acts of violence.⁴ It found that gun crime by young men seems to be facilitated by criminal opportunities (usually drug related) and reinforced by visibly "successful" criminals. Gang membership provides opportunities for conflict, which often starts in nightclubs or other social spaces. The report does not, however, comment on the fact that most high profile shootings (like Dunblane and Hungerford) are not carried out by young people, and have nothing to do with gangs, drugs, or a vision of successful criminality.

What the Home Office statistics and the report suggest is a picture of socially isolated young men, looking for an identity. Of the 80 men studied, 59 came from disrupted family backgrounds—35 from single parent families, presumably with no positive male role models. Just over half had been excluded from school and so were disconnected from the positive influence of peers and teachers. Such disconnected young men may be highly fearful, or highly fearless—both states of mind that are a defence against negative affects like shame, humiliation, anger, and distress. Such affects make violence more likely, especially if the young person lacks the capacity to mentalise (the process of thinking about our feelings and examining what we feel about our thoughts) and regulate these feelings.⁵ A young man who cannot mentalise negative feelings is much more likely to act them out. Failure to mentalise is unlikely to be the only explanation for gun violence, but improving mentalising skills may help people to think more about why they want a gun.

How can gun crime rates be changed? The debate about access to guns remains highly political, and commentators tend to have polarised views. International evidence shows a close correlation between gun ownership and rates of suicide and homicide.⁶ Reducing access to guns should reduce both these forms of violence; however, a US study showed that legislation relating to handgun sales had little effect on homicide and suicide rates, except for suicides in people over 55.⁷ In the UK, ownership of handguns has been restricted since 1997, yet fatal gun crimes still occur. One possible inference might be that guns themselves are not risky, but the intention to use them is.

Improving the welfare of young people at risk of acting violently might be more fruitful. School programmes include Peaceful Schools in the US⁸ and Safer Schools Partnerships in the UK.⁹ An excellent document published by the Youth Justice Board¹⁰ emphasises both risk and protective factors, and it describes possible interventions. Many of the risk factors for later violence are linked to being raised in a disrupted and abusive family, because this experience prevents children forming attachment relationships and negatively affects the capacity to think and mentalise.¹¹ Yet, most of the interventions relate to school and community groups—hardly any interventions target abusive parents or families. No services exist for parents who pose a danger to their children, in sharp contrast to the development of services for men who are dangerous to children in general.¹²

Overall, reducing social exclusion and deprivation and increasing the protection of children may be more effective than focusing on gun control alone. Certain initiatives can improve young people's mental health, which in turn will improve their capacity to mentalise and reach out to others when they are in distress. These require investment and attention to a small group of children who are at risk of acting violently, rather than the much bigger group of children who will never pose such a risk. Early identification of children who are most at risk would help to reduce the development of a paranoid and dangerous mindset that makes a gun one of the easier answers to a conflict. As the National Rifle Association reminds us, "Guns don't kill, it's the finger on the trigger."

¹ Broadmoor Hospital, Crowthorne, Berkshire RG45 7EG, ² Psychoanalysis Unit, University College London, London WC1E 6OT, ³ Berkshire

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Competing interests: None declared.

Provenance and peer review: Commissioned; not externally peer reviewed.

References

1. Coleman K, Jansson K, Kaiza P, Reed E. Homicides, firearm offences and intimate violence 2005/2006. Home Office statistical bulletin.2007. www.homeoffice.gov.uk/rds/pdfs07/hosb0207.pdf
2. Barclay G, Tavares C. International comparisons of criminal justice statistics 2001. Home Office Research Bulletin. 2003. www.csdp.org/research/hosb1203.pdf
3. Wilson D, Sharp C, Patterson A. Young people and offending: findings from the 2005 offending, crime and justice survey. Home Office statistical bulletin. 2006. www.homeoffice.gov.uk/rds/pdfs06/hosb1706.pdf
4. Hales G, Lewis C, Silverstone D. Gun crime: the market in and use of illegal firearms. Home Office research study 298. 2006. www.homeoffice.gov.uk/rds/pdfs06/hors298.pdf
5. Gilligan J. Violence: reflections on our national epidemic. London, Jessica Kingsley Publishers, 1999
6. Killias M. International correlations between gun ownership and rates of homicide and suicide. CMAJ 1993;148:1721-5.[Abstract]
7. Ludwig J, Cook PJ. Homicide and suicide rates associated with implementation of the Brady handgun violence prevention act . JAMA 2000;284:585-91.[Abstract/Free Full Text]
8. Twemlow S, Sacco F, Gies M, Evans R, Ewbank R, Fonagy P. Creating a peaceful school: a controlled study of an elementary school intervention to reduce violence. Am J Psychiatry 2001;158: 808-10.
9. Safer Schools Partnerships. Every child matters. 2007. www.everychildmatters.gov.uk/ete/ssp
10. Youth Justice Board. Risk and protective factors associated with youth crime and effective interventions to stop it. London: YJB, 2005.
11. Meins E, Fernyhough C, Wainwright R, Das Gupta M, Fradley E, Tuckey M. Maternal mind-mindedness and attachment security as predictors of theory of mind understanding. Child Dev 2002;73:1715-26.[CrossRef][ISI][Medline]
12. Adshead G. Dangerous and severe personality disorder: personality disorder, parenting and new legal proposals. Child Abuse Rev 2003;12:227-37.[CrossRef]

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