Why It is Imperative We Redefine Mental Illness and How We Treat It

How many mass shootings could have been avoided?

The article that prompted this one was published recently in Medscape and the title alone deserves submission to the Oxford Dictionary under the term oxymoron. “Serious Mental Illness Not a Factor in Most Mass School Shootings” deals with research that shows only a fraction of mass shootings are perpetrated by someone that can be currently classified as suffering from “serious mental illness.”

I’d be remiss not to point out that Medscape, in this context, is merely reporting medical news. Their article centers around a new analysis, drawn from the Columbia Mass Murder Database (CMMD), which suggests that mental illness is incidental in mass shootings.

“People with serious mental illness constitute only a small portion of the perpetrators of gun violence in this country,” Paul Appelbaum, MD, professor of psychiatry, medicine, and law at Columbia University in New York City. told Medscape.

The analysis covered 82 incidents of mass murder in academic settings including schools, colleges, and universities. The average number of victims of these incidents was eight. All 82 incidents were initiated by men (mean age 28), and 67% were Caucasian. About two thirds (63%) involved guns.

More than three-quarters (77%) of all perpetrators of mass murders in academic settings had no recorded history of psychotic symptoms. (emphasis added by author)

Swiss Cheese

To extrapolate data and draw conclusions from an existing data set, the cohort needs to be at least mildly historically similar. All this analysis suggests is that 77% of the shooters were not yet diagnosed as suffering from a mental illness or had insufficient coping mechanisms to deal with the stresses they faced. The authors conclusions, that only 23% of the shooters suffered from mental illness is an overreach of monumental proportions.

Most modern research suffers from these biased slants, which either lose sight of their controls or interpret data in wildly irresponsible fashion. All the more sad, as the true value of the data is lost behind an overriding narrative the authors wish to justify. What is clear from this analysis data, is that our systems for managing and identifying mental illness and related conditions are flawed. As is the care we offer to those diagnosed.

A significant majority of these shootings may have been prevented had individuals with a myriad of life challenges or psychological struggles been flagged. This begs the argument, why did the 23% slip through the cracks if they had been diagnosed and were, one would assume, under treatment?

These incidents, targeting young children by individuals who are themselves still just teenagers or newly minted adults, are a new phenomenon. Discovering the “why” matters almost as much as restricting access to weapons.

What can the 82 teach us?

Numerical data in this instance, used as it was, for the analysis above, is of little import and can be manipulated to suit any agenda. What researchers should instead be pursuing are the 82 lives that led to these horrific events.

Who were these young people, social backgrounds, family, schooling, infractions with law and authority, medical histories, friendships, potential triggers, medication, anything and everything that can be found that relates to their lives. Examine this and patterns will emerge. Patterns that may very well point the finger of blame to society, broken families, flawed mental health policies and the social stigma of reaching out for help – even in-patient care.

Identifying these patterns and potential triggers matters. Our human capabilities no longer limit us and AI can be incorporated to search social media for matches, allowing for early intervention. Teenagers or young adults do not just pick up a weapon and commit mass murder. They progress, in increments, to this course of action.

There are always signs.

Often we simply fail to see the signs and sadly, when we do pick up on them, we tend to ignore them – we cannot image that they will lead to something so horrible.

But, there is another challenge – access to mental health help. Ask anyone who needs to find a therapist how daunting the task is. It can take months, sometimes more than a year, to secure an appointment with someone with experience to address serious mental health challenges.

Again, this is unsustainable in a society where stable parenting is becoming an archaic concept, whether by design or necessity. Stable homes are in rapid decline.

The real indictment of this analysis are the diagnosed 23%. They represent the ever-increasing cost of our inability to help children who are crying out for guidance, care and a sense of belonging and purpose. How many lives could have been spared? How many lives will still be forfeit? We can, and must, do better.

Reaching for the closest solution

Mental health issues may be the motivating factor to committing mass murder. The preferred tool of choice for these murders is the assault weapon or other firearm. While we can debate the motivation for each individual heinous act, this choice of tool is far simpler to comprehend. Ease of access.

In countries where access to firearms is limited or non-existent, school shootings DO NOT HAPPEN. In America, gun ownership, legal or otherwise has reached pandemic proportions. It is even questionable at this point if tightening ownership laws and policy changes will have any impact whatsoever on teens being able to find and use weapons designed to maim and kill, so prolific is their distribution in American society.

While we struggle to find ways to prevent these tragedies from a mental health perspective, an arduous and difficult task, surely removing the preferred tool from the equation makes far more sense. No access to guns equates to no school shootings. A globally proven fact.


Medika Life has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by Medika Life

Robert Turner, Founding Editor
Robert Turner, Founding Editorhttps://medkoin.health
Robert is a Founder of Medika Life. He is a published author and owner of MedKoin Healthcare Solutions. He lives between the Philippines and the UK. and is an outspoken advocate for human rights. Access to basic healthcare and eradicating racial and gender bias in medicine are key motivators behind the Medika website and reflect Robert's passion for accessible medical care globally.
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