Mass shootings are hard to prevent with mental health resources alone, experts say

Following another mass shooting, some Texas politicians have called for increased mental health services to help prevent the next tragedy.

But experts working on the ground warn there is no fully effective solution to stopping these shootings before they happen, with some saying blaming mental health is a deviation from the fact that gun control is a necessary part of prevention.

“We can do whatever we can to help the students, but at the end of the day if a student has the idea of ​​going to shoot a school and has access to the guns to do it, I’m not sure that there are actions that may or may not have taken place would necessarily prevent it,” said Jill Cook, executive director of the American School Counselor Association.

“If someone comes to a door with a semi-automatic weapon,” Cook said, “that’s it then.”

On Tuesday, 19 children and two teachers were shot and killed at Robb Elementary School in Uvalde, Texas, by an 18-year-old gunman. State authorities said days after his 18th birthday earlier this month, the shooter purchased two semi-automatic rifles from a local gun store. He also purchased 375 rounds of ammunition.

Although Texas Governor Greg Abbott said Wednesday that a “mental health issue” played a role in the massacre, the shooter had no known criminal history or mental health issues.

And Abbott wasn’t the only one pointing the finger at sanity. In the days following the shooting, Uvalde Mayor Don McLaughlin told News 4 San Antonio that the tragedy might have been averted if more mental health resources had been dedicated to his area.

“Maybe we could have caught it,” he said. “Maybe if we had the advisers, maybe if we had the mental health specialists, we could do it.”

Barriers to Accurately Predicting Violence and Ensuring Treatment

New York-based forensic psychiatrist and clinician Dr. Ziv Cohen said strengthening mental health services in communities and making them more affordable could help reduce gun deaths, particularly suicides, but there is no fully effective mental health solution to stop mass shootings. .

This is largely because they can be difficult to predict. Mass shooters rarely show obvious signs of serious mental illness, such as hallucinating or being completely out of touch with reality, Cohen said. Instead, of those who show signs of mental illness, the vast majority share commonalities with many people who don’t become shooters.

These characteristics include depression, isolation from family and classmates, narcissism, paranoia and suspicion, Cohen said. Many may easily feel threatened or insulted by others or feel on a mission to prove a point.

“If you look at a bunch of people with these mental health issues, it’s almost impossible to pick which one is actually going to commit a mass shooting,” Cohen said. “That’s why we haven’t really found a solution.”

A 2015 article in the American Journal of Public Health notes that “psychiatric diagnosis is largely an observational tool.”

“Largely for this reason, research dating back to the 1970s suggests that psychiatrists using clinical judgment are not much better than lay people at predicting which individual patients will commit violent crimes and which will not,” the authors wrote. authors.

Cook said no single test, assessment or metric could identify a mass shooter early enough to seek mental health treatment.

She said schools should ensure that every adult in the system — teachers, bus drivers, coaches, janitors and cafeteria workers — understands the warning signs of someone at risk of harming themselves or others and has systems in place to report potential threats.

But even then, she says, there are obstacles. Mental health care providers are limited when someone suspected of being at risk refuses help or lies during a mental health assessment.

Earlier this month, authorities said a white teenager in upstate New York underwent a mental health evaluation after a teacher reported a chilling comment he made in class. about a murder-suicide. But he was cleared and ultimately shot 10 black people in a racist rampage at a Buffalo supermarket, officials said.

And last year, before a shooting at Oxford High School in Michigan that left four dead, a teacher alerted school officials to drawings found on the 15-year-old suspect’s desk depicting scenes of violence. A counselor showed the suspect’s parents the drawing, who were told they had to bring their son for consultation within 48 hours.

The parents, who bought the gun used in the shooting and who have since been charged with manslaughter, refused to take their son home and he was brought back to class. The teenager allegedly carried out the massacre later the same day. His parents have pleaded not guilty to the charges.

“Ultimately, if someone has access to a mechanism that could give them the ability to do that, I don’t know the answer,” Cook said.

And the idea that mental health counselors can identify threats and prevent mass shootings isn’t clearly supported by research.

In an article published last year in the Harvard Review of Psychiatry, the authors say that defining a role for mental health providers in preventing mass killings is “inherently difficult”.

“The assumption that mass shootings are motivated solely or even primarily by diagnosable psychopathology pushes the boundaries of mental health expertise,” the article states. “It also creates a false expectation that advancing neuroscience and better therapies to manage psychiatric symptoms will provide ‘the answer’ to solving gun violence.”

He continues: “There is no existing or future unified theory of impaired brain function or cognitive, mood or behavioral dysregulation that could adequately explain mass shootings or homicides by weapon. multiple casualties.”

Avoid the stigma

The subject is complicated, but the public discourse surrounding it “tends to be very simplified,” said Peter Langman, a psychologist who has studied mass shooters and is the author of “Warning Signs: Identifying School Shooters Before They Strike”.

“We have to be careful not to stigmatize mental health issues and associate them with mass violence, because that is wrong,” he said. “On the other hand, happy, well-adjusted people don’t commit mass murder.”

But behavioral health treatment has not been a one-size-fits-all solution to preventing the killings, he added. Langman said that requires a multi-pronged approach, including putting more threat assessment teams in schools and restricting access to guns, especially in homes with minors.

“There have been school shooters who were undergoing mental health treatment and who still carried out attacks because they wanted to, and they did not reveal what was going on in their minds to the professionals of the mental health,” Langman said.

Cook said millions of people in the United States have mental health issues, but the percentage of those who commit mass murder is tiny.

To equate this solely with mental health is a misstep and a diversion,” she said.

Fewer than 10% of shootings nationwide involve a suspect with mental illness, according to the National Alliance on Mental Illness.

Experts said there was little that mental health care providers could do as gun violence and gun purchases rose nationwide.

“Mental health won’t get us that far,” Cohen said. “The mental health community cannot solve the problem of gun violence in America.”

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