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Media and politicians often emphasize that mental illness is a precursor and cause of violence, including gun violence. This paper reviews which serious mental health problems predict violence, and whether serious mental health problems account for what proportion of violence. The paper also reports on the state of the art on screening individuals for mental health problems that put them at risk to commit violence. Empirical knowledge in these areas are compared with experts’ opinion about the causes of violence and the desirability and use of optimal screening methods. The implications of the results are discussed for policy makers and legislators, and for future research.