By Keir Liddle
In the wake of the latest US high school shootings debate has raged across the internet determining what can be done to prevent such tragedies from occurring in the future. Everything from tighter gun control to speculation about the mental health of the shooter has been discussed. But is it fair to assume that mental health plays a part in spree shootings?
I have previously explored this issue in a post here .
Even high profile skeptics like Michael Shermer have denounced those who perpetrate such crimes as psychopaths and nutters laying the blame at the door of the shooter seemingly oblivious to the lack of information available about the shooters mental state at the time of the shooting or indeed of the huge body of research that debunks the idea that mental health and violence are strongly linked.
A 2003 review article explored the relationship between violence and mental health by asking the following questions: Are the mentally ill violent? Are the mentally ill at increased risk of violence? Are the public at risk? It’s conclusions may surprise those engaging in the lazy and ignorant circular reason that leads them to assume that someone committing such an atrocity must be mentally ill by definition as “sane people just don’t do that”.
The authors concluded that:
Mental disorders are neither necessary nor sufficient causes of violence. Major determinants of violence continue to be socio-demographic and economic factors. Substance abuse is a major determinant of violence and this is true whether it occurs in the context of a concurrent mental illness or not.
In simple terms mental health problems are not enough to make someone violent nor does someone committing an act of violence have to be mentally ill. Worryingly they found that members of the public exaggerate both the strength of the association between mental illness and violence and their own personal risk. Showing that mental health stigma is still a very real and pertinent issue. People still fear and fail to understand the nature and character of mental health problems and still fear those who are mentally ill as “others” who will cause them harm.
In a series of surveys spanning several real-life events in Germany, Angermeyer and Matschinger showed that the public’s desire to maintain social distance from the mentally ill increased markedly after each publicized attack, never returning to initial values. Further, these incidents corresponded with increases in public perceptions of the mentally ill as unpredictable and dangerous.
The reality is very far from the truth with research paper after research paper being published showing that the mentally ill are more often victims than perpetrators of violence. It is also worth noting that public perceptions of the link between mental illness and violence are central to stigma and discrimination as people are more likely to condone forced legal action and coerced treatment when they believe violence is an issue. The presumption that the mentally ill are violent also, counter-productively,c provides a justification for bullying and otherwise victimizing the mentally ill. Given that the most startlingly common factor in American high school shootings is a bullied, tormented and ostracised shooter I’m sure I don’t need to say much more to point out that this stigma and unfair association needs to be addressed.
People accept it as a common sense “fact” that those suffering from paranoid or delusions or psychosis are more prone to outbreaks of violence without feeling the need to substantiate this claim it is taken as a given. However in the study linked the prevalence of violence among those with a major mental disorder who did not abuse substances was indistinguishable from their non-substance abusing neighbourhood controls. Or to put it another way drug and alcohol abuse is a far better predictor of violence than mental health is. The study also concluded that delusions were not associated with violence, even ‘threat-control override’ delusions that cause an individual to think that someone is out to harm them or that someone can control their thoughts.
What does the study have to say about the risk to the public from the mentally ill? The following is enlightening:
In the MacArthur Violence Risk Assessment Study the most likely targets of violence were family members or friends (87%), and the violence typically occurred in the home. Discharged patients were less likely to target complete strangers (10.7%) compared to their community controls (22.2%).
And what if we could eliminate mental health issues in the US just how much violent crime would be prevented? According to research violence in the community could be reduced by less than five percent. That leaves 95% of violence in the community carrying on as it is being carried out by those without mental health issues.
This study concludes that too much past research has focussed on the person with the mental illness, rather than the nature of the social interchange that led up to their violence. Consequently, we know much less than we should about the nature of these relationships and the contextual determinants of violence, and much less than we should about opportunities for primary prevention. Simply put we focus on something that may or may not exist within the offender rather than the social and environmental pressures that set them on the course to their violent act.
But mental health is a broad definition – is there perhaps room for these spree killers to be mentally ill? To have some identifiable mental health problem that we can detect and use to prevent future tragedies?
This article talks to forensic psychiatrist Paul Mullen about spree shootings (which he terms autogenic massacres) and his conclusions may surprise many. After analysing a number of killers, Mullen concludes,
“Most perpetrators of autogenic massacres do not … appear to have active psychotic symptoms at the time and very few even have histories of prior contact with mental health services.”
So why do we want to label spree killers as mental ill? Is it nothing more than wanting an “other” to be responsible for these atrocities? Do we just not want to accept that anyone has the potential for such horror within them preferring to view them as defective or damaged somehow?
I would ask anyone reading this who believes these people MUST be mentally ill to consider if they would section a child who struck back against their bullies and tormentors. Would the severity of the beating they gave their victims determine how “mentally ill” they might be or would it perhaps more reflect the severity of their torments? Is there really any difference between someone lashing out with their fists and intending to do as much harm as possible and between someone who choose to use an extension to their own fist to achieve their revenge?
I would like people to consider the assumptions, fears and stigma that underly their presumption that spree shooters must be mentally ill.
As by saying “a crazy person did it” all you are highlighting is your own ignorance of the specific situation and your unwillingness to accept that “normal” people may be implicated in either perpetrating these acts or creating the environment that causes them to take place.