This week I have been outraged over the "mental illness causes mass shootings" thing. I am a student of psychology, and everything I've been taught screams in opposition. Let me bring up a few important facts about mental illness you might not have known, that might help you decide for yourself instead of taking a Big Gulp full of misinformation in fear, looking for any answer that makes sense more than my final statement does. We do need mental health reform, but NOT because we need to "help" these mass shooters before they do what they do.
The Frequency of Mental Illness
About 1 in 5 adults will experience a serious, debilitating mental disorder per year in America (NIMH, citation 1). Nearly half of adults will experience some diagnosed mental health condition throughout their lifetime (Rubina Kapil, 2019). A mental disorder is (grossly simplified) when a few or more areas of a person's life (take job and social life, for example) are inhibited by a group of symptoms. We categorize these symptoms to better treat their ill effects. Take depression, for example- major depressive disorder. This "disorder" may include the symptoms of blue mood, lack of energy or drive, over or under eating, sleep disturbances, feeling less pleasure from previously loved activities, feelings of worthlessness or helplessness. We will all experience some of these throughout our lives, but a mental disorder is marked when functioning is impaired over a period of time. Is it this simple to categorize mental disorders? No. Here's a real life diagnosis: Adjustment disorder, with mixed anxiety and depressed mood. We take symptoms and their severity, and we categorize as best we can, given self-reports and observable symptoms.
Are More People Mentally Ill Nowadays?
Mental disorders have always been around, we just didn't have a name for them- because mental disorders are just what we call a cluster of symptoms. They are how we predict treatment and problems that may come up, by common symptoms and common salves. Allergies have also existed since the dawn of time, but people died from them more often and we didn't have names for them. Because mental illnesses are behaviorally observable, but not overtly physical, people were once cast aside as "crazy" and locked away for not conforming to normal behavioral standards of each time period. This is also to blame for why we think that mental illness is more rampant today. Those diagnosed have always been our neighbors, family and friends, but people were once hidden away for lack of an understanding of what to do to help them or stabilize them.
In early institutions, people were abused and mistreated- they still are in countries that have old-school mental health institutions. People were treated as subhuman. We had no medications to help people, we didn't have the advanced therapeutic approaches we have today. Maybe I could understand my nervous cousin who avoids people, but Suzy next door who talks to the walls and is put in a mental asylum. Now this doesn't mean if a person is a danger to themselves or others that there are no options to keep them and others safe. Most treatment is voluntary, but you can seek to get help for those who are not in a good state of mind, if there is evidence of such. This is more easily done in children, and I see it in my line of work. Short hospital stays to stabilize, then release back into the public is ideal. This approach lets people build a life instead of taking months or years unnecessarily away from them.
Who is Diagnosed More Often?
Isn't it true that young men, especially, would be the most reluctant to get help, therefore more vulnerable to suffering alone and turning into a mass murderer? No, but I'm glad that you brought that up. It is true that men IN GENERAL can feel a stigma when it comes to mental illness, because a mental disorder is not seen as a real illness, to many men and women. For men, a mental disorder's symptoms go against every, "Suck it up, be a man" quip they've internalized over a lifetime, from boyhood to adulthood. This is a problem, because someone who is struggling might be deterred from getting help (societal pressure does that sometimes- think rape victims).
Let's look at the groups that are worse off than white young men. African Americans and Hispanics use mental health services at about ONE HALF the rate, and Asian Americans at about ONE THIRD the rate, as white Americans use them (SAMHSA). Someone who is racist might say that this explains why "colored folk" commit crimes at a higher rate than the general population. This is another societal misconception- and look how most of the mass shooters have been white men.
A Consideration of Perpetrators vs Victims
Are people more likely to be perpetrators of crime when they have a mental illness? This misconception comes from the idea that you must have a "screw loose" to do something outside of, or break, societal rules or norms.
People diagnosed with mental illness are actually more likely to be VICTIMS of violent crime (Canadian Mental Health Association, Durham).
The majority of violent crimes are actually committed by someone with NO MENTAL HEALTH HISTORY.
Could some of them have a mental disorder? Sure, just as often as the rest of the population (1 in 5, perhaps) but if we assume that people must be "crazy" to commit a crime, we forget that crimes take planning, skill, concentration, intelligence, sometimes wit and charm. Think of the Mafia. Think about serial killers and rapists who didn't get caught for years and years.
A More Careful Look at Suicide
Furthermore, people with a mental illness are more likely to hurt themselves than others. 90% of people who die by suicide have shown observable mental health symptoms (Isometsa, E.T., 2001).
"But hey, didn't some of the shooters recently die by suicide?" A suicide because of mental illness is FAR DIFFERENT than a suicide to be a martyr or make a statement. Think suicide bombers in the Middle East. You want to tell me they're all mentally ill? Do we suddenly have sympathy for them?
The majority of mass shooters are described by friends and family after the incident. A "he didn't look right the past few months. Seemed distant. Snapped at me." A killer can be in a bad mood. A killer can struggle with what he or she is about to do. But let's not post-death diagnose like we're doing a mental health autopsy, and lets NEVER use mental illness as an excuse or explanation of violent crime, when it is simply sometimes a co-occurrence.
In Conclusion
What have we learned? Mental illness is COMMON. It is nothing to be afraid of- most people with mental illness are victims rather than perpetrators of violence or crime. It affects people of both sexes and all races, and minorities are less likely than the general population to get help for it.
So please, stop making excuses for monsters- we don't want to believe a sane person could get sucked into a violent spell and do something so vile, so awful. It's scary to believe that people can CHOOSE to take out aggression and do bad things, and they're still sane. Don't explain it away with mental illness as a straw man. It only further stigmatizes people with mental health struggles, and keeps people from coming forward, to family and friends, doctors and mental health professionals.
Note: Citations for numbers and figures below.
1. National Institute of Mental Health. (2019). Mental Illness. Retrieved from https://www.nimh.nih.gov/health/statistics/mental-illness.shtml#part_154785
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