-by Helen KleinFinally, talk about taking action in response to the horrendous mass shootings in our country is taking center stage. This is thanks to the wonderful and courageous students from Stoneman Douglas High School in Florida, who have experienced tragedy first-hand and have given new impetus to a nationwide movement. Kudos to them, and kudos to the many thousands of other students and their parents around the country who have taken up their call to action!Congress is supposed to work for the American people, not the NRA. This is a clash of enormous proportions: the safety of American citizens, including our children, vs. the right to own guns, any guns, including military-style weapons and ammunition.How many Americans know that Congress has had a 22 year ban on gun violence research? Why is this? Obviously, because the statistics would be absolutely staggering and devastating to the gun lobby, which pays them well, quite well. Emily Atkin discussed this issue in last week’s article in the New Republic:
This (research) is the easiest, least controversial step Congress can take in the wake of Wednesday’s mass shooting at Marjory Stoneman Douglas High School in Parkland, Florida, which left 17 people dead. Gun control legislation certainly isn’t going anywhere—House Speaker Paul Ryan suggested as much on Thursday morning, when he said Congress needs more information on what would be an effective policy: “I think, as public policymakers, we don’t just knee-jerk before we even have all the facts and the data.”But as things stand now, Congress will never have the facts or the data Ryan claims to need because, as the Washington Post reported in October, “Gun-control research in the United States essentially came to a standstill in 1996.”“In the area of what works to prevent shootings, we know almost nothing,” Mark Rosenberg, who led the CDC’s gun-violence research in the 1990s, told the Post.
Not surprisingly, the NRA has led the charge behind these efforts. How the NRA Suppressed Gun Violence Research is described by the Union of Concerned Scientists:
The National Rifle Association used its influence over a Congressman to codify language that prevents the Centers for Disease Control and Prevention (CDC) from funding research into gun violence, which kills and injures tens of thousands of people in the US each year.Research on gun violence is not inherently political. However, its results can inform policy changes to protect public health, potentially including restrictions on gun access. And this has made gun violence research a target for the National Rifle Association (NRA), which is primarily funded by contributions, grants, royalty income, and advertising from the firearms industry.During the 1990s, the NRA used its influence over NRA member and Arkansas Rep. Jay Dickey to insert an amendment into the federal spending bill that has effectively prevented the Centers for Disease Control and Prevention (CDC) from funding any research on gun violence.In 1996, the Republican-majority Congress threatened to strip funding from the Centers for Disease Control and Prevention unless it stopped funding research into firearm injuries and deaths. The National Rifle Association accused the CDC of promoting gun control. As a result, the CDC stopped funding gun-control research-- which had a chilling effect far beyond the agency, drying up money for almost all public health studies of the issue nationwide.The NRA has taken credit for blocking government gun violence research. In 2011, the organization said, “These junk science studies and others like them are designed to provide ammunition for the gun control lobby by advancing the false notion that legal gun ownership is a danger to the public health instead of an inalienable right.”
Common sense would suggest that the ONLY way to drastically limit such egregious mass shooting incidents is to totally ban assault weapons based on an informed definition of what constitutes an “assault weapon.” For a ban to be effective grandfathering cannot be part of it-- there are already way too many AR 15s and similar so-called “black guns” out there. Such a ban must necessarily include making all civilian variants of military weapons and their high-capacity magazines illegal and requiring anyone owning such a weapon to turn it in and receive reimbursement from the government. Would Americans be safer by using our tax money to pay for a “building a wall” or reimbursing people for turning in their automatic or high-capacity semi-automatic weapons? Hmmm.Will this ever happen here? Until this past week, the answer was resounding NO. Now there is a slight glimmer of hope. Let’s put some confidence in America’s teenagers and their parents: may they rise up and defeat the NRA.The NRA has refused to do virtually anything to restrict the purchase of guns. Whether it is mental illness, potential terrorists on a watch list, required age for purchase or restricting automatic weapons that are used only by the military in most countries, the NRA has its heels dug in. Common sense is nowhere to be found.Even after the recent mass school shooting in Florida, a front page article in Sunday’s Washington Post shows that the NRA has not changed its tune: “NRA spokeswoman pushes back on Trump idea of raising age for buying semiautomatic rifles.”
Mental Illness, Guns And Mass ShootingsA major focus of current and past discussions has been to prevent mentally ill people from buying guns. While this view certainly has some value, in reality it is mostly a good sound bite that appeals to the masses, who have little understanding of mental illness, identification of it or the ability to predict individuals’ behavior. Unfortunately, expecting such prevention to have notable impact has mostly only face validity going for it. That is, it sounds good on the surface and has some worth, but there is little underneath to substantiate that it would make much of a difference in curbing mass shootings. For the right wing and NRA supporters, most of whom are resistant to limiting gun sales to anyone let alone those who are mentally ill, this is simply offering a crumb, an appeasement tactic to serve as a huge distraction. It would at best serve as a drop in the bucket to prevent mass shootings.
The controversy over this subject is large. Just look at two recent pieces taking opposing points of view:In the February 23 issue of the Los Angeles Times Grant Duwe and Michael Roque wrote, “Actually, there is a clear link between mass shootings and mental illness.”
"Repeat after me: Mass shooters are not disproportionately mentally ill." But this and other efforts to downplay the role of mental illness in mass shootings are simply misleading. There is a clear relationship between mental illness and mass public shootings.According to our research, at least 59% of the 185 public mass shootings that took place in the United States from 1900 through 2017 were carried out by people who had either been diagnosed with a mental disorder or demonstrated signs of serious mental illness prior to the attack.Mother Jones found a similarly high rate of potential mental health problems among perpetrators of mass shootings-- 61%-- when the magazine examined 62 cases in 2012. Both rates are considerably higher than those found in the general population-- more than three times higher than the rate of mental illness found among American adults, and about 15 times higher than the rate of serious mental illness found among American adults.
On the same day, National Public Radio aired a discussion, “Experts say there is little connection between mental health and mass shootings.”
President Trump has raised mental health as a key factor in mass shootings, including a call Thursday to create more mental hospitals. But experts say there's little connection between a person's mental illness and the likelihood of a mass shooting. The president says the way to stop future school shootings is to identify people with severe mental illness and lock them up.
But NPR's Alison Kodjak reports that doctors and mental health advocates say the link between mental health problems and gun crimes is tenuous.
Matthew Miller is a professor of epidemiology at Northeastern University who has published several papers on the risk factors of gun violence. He says the key ingredient in this mass shooting and others is not mental illness. It’s the guns. (Italics mine) The reason for these sort of mass public shootings is not because we have higher rates of mental illness. And it's not because we have higher rates of violent behavior. We don't. The rate of mental health problems in the U.S., he says, is about the same as in Europe. And the same goes for violent crime. He says if politicians want to reduce mass shootings, they have to deal with the guns. If they want to improve mental health care, they can do that, too.
I suspect that many legislators do not grasp critical aspects of this poorly thought out perspective. As usual with many of our current government office holders, knowledge and expertise are sorely lacking. Senators and Congressmen who aim to “do something” should stop selling tickets to the mental illness side show and zero in on an outright assault weapon ban. The Democrats in particular should shift the spotlight off of mental illness and onto guns, particularly assault weapons. Republicans love distractions and this is surely a good one.Let’s look at some aspects of this topic.What is mental illness?-- this is a vague concept, with widespread disagreement even among professionalsWho defines mental illness? The field of mental health is an extremely broad one. Rather than black and white, this is a wide expanse of many shades of gray. Anyone who thinks that it is possible to do so in the general population has a screw loose. Virtually all of us have a friend or family member who has had some type of mental health problem. There is no such thing as a quick, clear cut blood test for mental illness. The inner workings of the mind are unique and by no means easy to define, access or assess. What does “mental illness” really mean? Would someone with an anxiety disorder be considered mentally ill? What types of mental illness would predict mass violence? Since it would be difficult and perhaps impossible for professionals to reach a consensus on this, how could government agencies possibly do so?How can people with mental illness be identified? -- this is an enormously challenging task filled with endless problemsHow could authorities identify such individuals and construct lists? From the get-go, to assume that this is even possible is absurd. We are not a Big Brother society, yet, and we do not keep track of every one of us and our inner lives. While efforts made to compile and share lists of violent offenders are noteworthy, this is just the tip of the iceberg, a tiny sample of possible mass shooters. Unless an individual has come to the attention of an agency or institution that is able to share such data, any such lists would be woefully incomplete. We still have strong privacy laws in our democracy.The variability of mental health issues in the general population is enormous in range and most individuals have no potential for violent acts. The bulk of those with mental health problems never see a mental health professional and fall well under the radar, as they should in a democratic society. Furthermore, people who have seen a mental health professional for treatment and could potentially be very dangerous are protected from having their lives invaded and would never wind up on any list. Professionals are obligated to respect their patients’ privacy and cannot reveal to anyone who they are seeing or what their issues are. They would never contact authorities except under extreme circumstances. Until the mid 1970’s, mental health professionals were prohibited from releasing any information about their patients under any circumstances, just like attorney-client privilege. Even if a patient threatened to proceed with murder or a mass shooting, the professional was bound to silence. This changed in 1976 with the court case, Tarasoff vs. the Regents of the University of California, which mandated that professionals have a duty to warn and are required to take action.
The Supreme Court of California held that mental health professionals have a duty to protect individuals who are being threatened with bodily harm by a patient. The original 1974 decision mandated warning the threatened individual, but a 1976 rehearing of the case by the California Supreme Court called for a "duty to protect" the intended victim. The professional may discharge the duty in several ways, including notifying police, warning the intended victim, and/or taking other reasonable steps to protect the threatened individual.
While this sounds all well and good and has likely had slight positive impact, in reality this is an extremely difficult assessment for a professional to make. The therapist-patient relationship is built on trust and should not be sacrificed lightly. Implementing a warning would shatter the rapport and end treatment. Who has never said in a fit of anger that they would like to kill someone? Many individuals acknowledge all kinds of emotional turmoil and violent fantasies within the confines of therapy and it is up to the therapists to determine whether a threat is real and serious enough to warrant duty to warn. This is an incredibly difficult and at times impossible task. It is rarely undertaken.Another aspect of this issue, especially relevant to school shootings, is students identified as having problems who may be receiving counseling services in school. To my knowledge, unless a student has actually committed a crime, school staff are not obligated to report information to authorities. Furthermore, once the student leaves the school premises, the school’s responsibilities typically end. All high schools have some students who would fall into this category: children who have demonstrated acting out and violent behavior and who have made threats. Anyone working in a high school is well experienced in these matters and schools have procedures that are implemented to manage them. Internet threats and cyber bullying are pervasive. Some of these students are in special classes and receive counseling. Some have Individual Education Plans (IEPS) and may even be classified as Emotionally Disturbed but this information is confidential and not available for public scrutiny: therefore, these students would not be on any “lists” available to authorities nor should they be. Many students who have been identified with emotional problems have issues other than acting out and would not necessarily be viewed as candidates for school violence. Finally, many teenagers go through phases of anger and have conduct issues – this is often construed as part of their development. Just survey some of the parents you know-- most of these teenagers never proceed with mass violence.What is the connection between known mental illness and becoming a mass shooter?-- extremely lowAlthough there is some correlation between mental illness and mass shooters, within the broad context of mental illness, this is negligible. While some mass shooters were identified as mentally ill prior to the incidents, many were not. Hindsight is always illuminating. Many mass shooters were not on anyone’s radar. Even if they had been, what could or would have been done to monitor them? I doubt warrants would have been approved to invade their residences without any bona fide evidence just because they appeared to have potential. As it is, authorities are tied up with prospective terrorists.The extreme difficulty of identifying potential mass shooters cannot be overemphasized. The universe of potentials is huge and it is impossible to cull it down to a reasonable number.Within the school setting, while some students may be perceived as having the potential to become mass shooters, others would not be on the radar. There are also quiet ones seething inside who have not acted out in school and have not come to the attention of staff.There were some signs of potential violence with Eric Harris and Dylan Klebold, who became the spree killers at Columbine High School. However, their background was not atypical of many teenagers in high schools across the country, and they had not been identified as mentally ill.
At Columbine High, Harris and Klebold were active in school play productions, operated video productions and became computer assistants maintaining the school's computer server.According to early accounts of the shooting, Harris and Klebold were very unpopular students and targets of bullying. While sources do support accounts of bullying directed toward the pair, accounts of them being outcasts have been reported to be false.In March 1998, Jefferson County Sheriff's Office investigator Michael Guerra looked at Harris's website after the parents of Brooks Brown, a fellow student of Harris and Klebold, discovered Harris was making threats aimed at their son after a falling out between them. Harris also wrote on his website that he had been building and detonating pipe bombs. Guerra wrote a draft affidavit for a search warrant, but the affidavit was never filed as authorities believed that they did not have the necessary probable cause to conduct a search of the Harris household. This information was not revealed to the public until September 2001 by 60 Minutes, though it was known by the police the entire time. In December 1998, Harris and Klebold made Hitmen for Hire, a video for a school project in which they swore, yelled at the camera, made violent statements, and acted out shooting and killing students in the hallway of their school as Hitmen for Hire. They both displayed themes of violence in their creative writing projects for school; of a Doom-based story written by Harris on January 17, 1999, Harris's teacher said: "Yours is a unique approach and your writing works in a gruesome way-- good details and mood setting." The two boys got into trouble with the law for breaking into a locked van and stealing computers. In January 1998, they were charged with mischief, breaking and entering, trespassing, and theft. They both left good impressions on the juvenile officers, who offered to expunge their criminal records if they agreed to attend a diversionary program to include community service, received psychiatric treatment, and obeyed the law. Harris was required to attend anger management classes where, again, he made a favorable impression. They were so well-behaved that their probation officer discharged them from the program a few months earlier than the due date. Of Harris, it was remarked that he was "a very bright individual who is likely to succeed in life", while Klebold was said to be intelligent, but "needs to understand that hard work is part of fulfilling a dream."
The deadliest mass shooting in this country was by Stephen Paddock in Las Vegas in October 2017. He had absolutely no history of violence, no history of mental health issues and was unknown to authorities. His only interactions with the law were traffic citations. No one associated with him, even his girlfriend who lived with him, had any idea of his plans.
His motivation remains unknown.
Unfortunately, the bottom line is that it is virtually impossible to identify mass shooters in advance. Overall, efforts that depend on pre-identification do not appear viable.Can violent behavior be predicted?-- not well if at allOverall, mental health professionals have a poor track record in predicting behavior. Here is the opinion of one expert, a psychiatrist with experience working in a forensic unit of a psychiatric hospital. In a February 2012 issue of Psychology Today, Dr. Frederic Neuman, M.D., explored, “Is it Possible To Predict Violent Behavior?” One of his responsibilities was to determine how dangerous someone charged with a crime might be in the future. Here are some of his discoveries.
• The people who engaged in violent behavior sometimes, but not always, had a history of violent behavior.• Some of the people who attempted murder were psychotic; but the greater number were not.• Of course, most psychotic patients, even those who are paranoid, do not commit violent crimes, or, for that matter, any crimes.• Those who committed murder, or almost committed murder, were acting under a confluence of events that might not have happened under ordinary circumstances, and could not have been anticipated. These included, first of all, the availability of a weapon, usually a gun.• Some people who have committed murder never do so again, even though they have the opportunity. That suggests that there are very few people who can be said to be “murderous” by inclination.
Dr. Neuman concludes:
It is understandable that confronting the horror of the mass murder reported a few days ago that we look to some kind of hope for preventing such attacks in the future; but the fact is we do not know how to predict them; and I do not think we will ever know. We have to turn our attention to the availability of guns.
As far as school shootings, some responsibility clearly lies with parents. Do parents know what their teenagers are up to? Disagreements between parents and teenagers about privacy issues are common. It is hard to find middle ground; striving for a balance that is acceptable to both sides is difficult at best. Some parents lean way toward accepting privacy, others toward intrusion. Parents tend to assume they know their children’s inner workings and what their major concerns are but this is often not the case.Regarding Columbine, neither the Klebolds nor the Harrises had any idea what their sons were up to. In an essay that appeared in the October 2009 issue of O: The Oprah Magazine, Susan Klebold, Dylan’s mother, stated that she had no clue of her son’s intentions. Furthermore, both sets of parents were oblivious to their sons’ efforts to gather assault weapons and build bombs, which happened right under their noses.
The weekend before the shootings, Harris and Klebold had purchased propane tanks and other supplies from a hardware store for a few hundred dollars. Several residents of the area claimed to have heard glass breaking and buzzing sounds from the Harris family's garage, which later was concluded to indicate they were constructing pipe bombs. Harris purchased more propane tanks on the morning of the attack.
Would preventing purchase of weapons based on being on a list prevent access to guns?-- not really, it is actually way too easyThis is surely a “what have you been smoking” moment. Everyone knows that practically anyone can buy a gun these days, including an AR 15-- style semi-automatic rifle. Just cross a state line, go into a bad neighborhood with enough cash, check out your parents’ gun rack, ask a friend, mail order bullets, etc. It is way too easy. To think a mentally ill person with murderous intentions who is on a list could not obtain an assault rifle is absurd.Guns can be obtained through so many means, legal as well as illegal. While there are some restrictions on legal purchases, which vary widely from state to state, a friend can easily purchase one for you. Illegally, it is obvious that virtually anyone with motivation could purchase a gun.
Because Harris and Klebold were both underage at the time, Robyn Anderson (with whom Klebold attended the prom three days before the shooting), an 18-year-old Columbine student and old friend of Klebold's, made a straw purchase of two shotguns and a Hi-Point carbine for the pair.The shooters also possessed a TEC-DC9 semi-automatic handgun, which had a long history. In violation of federal law, (firearms dealer) Russell failed to keep records of the sale, yet he determined that the purchaser of the gun was twenty-one years of age or older. He was unable to identify the pictures of Klebold, Anderson, or Harris shown to him by police after the shooting. Two men, Mark Manes and Philip Duran, were convicted of supplying weapons to the two.
Check out this video of a 13-year-old buying a gun. Whereas he was unable to purchase beer, cigarettes or a scratch off lottery ticket, he had no trouble buying a rifle at a gun show.So, to wrap this all up, forget mental illness: the only effective way to prevent mass shootings is to get rid of the guns used in them.Don't Shoot by Nancy Ohanian
