There’s an unfortunate confusion that exists when talking about mass shootings in America. This confusion is reinforced by politicians and the media, each pushing their own agendas and biases.
Some have erroneously claimed it’s a mental illness issue. I’m not being pedantic when I say we should not confuse mental illness with other, related concerns, such as psychological distress. The two are very different things. A person can be under psychological distress and still not have a mental illness.
Here’s why the distinction is important and why sloppy reporting by both journalists and law enforcement paint a false connection between mental illness and mass shootings.
Mental illness is something that approximately 1 in 5 Americans suffer. So you can understand the concern when politicians, law enforcement, and other well-meaning pundits suggest we need to be more careful in allowing people with mental illness to purchase guns (infringing on their Second Amendment Constitutional rights).
What some don’t understand is that the data are not at all clear or consistent when it comes to a mass shooting perpetrator’s mental illness status. Some point to data like Mother Jones’ mass shootings database, that purportedly shows that in the mass shooting incidents they examined, the perpetrator had “mental health issues” 61 percent of the time.
Well, we’ve all had mental health “issues” from time to time. That’s not at all the same as having a diagnosed mental illness.
Sloppy Reporting on Mental Illness
This is sloppy — and potentially dangerous — reporting on mental illness and violence. To conflate “mental health issues” with mental illness is just poor journalism, since the two are not the same. It would be the same as suggesting that someone who’s served on their town’s governing council has the same abilities as someone who is the prime minister or president. Or that having symptoms that mimic a cold is the same as having pancreatic cancer. No, they are very different things, and while one may be a component of the other, they are the not the same.
The clearest reporting on this issue has come from a surprising source — the U.S. Secret Service’s National Threat Assessment Center’s report, Mass Attacks in Public Spaces – 2018.
In that report, while the authors suggest that many attackers had a mental health issue, they also clearly acknowledge that only 44 percent had actually been diagnosed with a mental illness. For those statistically-challenged, that confirms that most attackers do not have mental illness at the time of the attack.
Saying someone had a mental health issue could mean a family member said they did, with no confirmation from an actual medical record or mental health professional. No offense to family, but mental illness diagnosis — just like a diabetes or cancer diagnosis — is not legitimately done by saying, “I think my family member is crazy.”
Scientifically, we have to set aside such third-party claims, because they have no basis in objective assessment.
Another mention in the report is of “suicidal thoughts.” This again is not an actual mental illness or diagnosis, yet this report lists it as a “mental health symptom.” Many people have suicidal thoughts off and on again throughout their life. That doesn’t automatically qualify them for a mental illness diagnosis.
Only one third of the attackers in the 27 incidents reviewed in this report had “psychotic symptoms” — two-thirds did not. Clearly, while mental illness may be a small factor in mass shootings, it is far less a factor than other characteristics of the shooter.
What are Better Predictors?
Far better predictors of public mass shootings are not related to a person’s mental illness diagnosis. Instead, we turn to other problems in a person’s life — problems that are so commonplace, it’s going to be hard to do much about them from a risk assessment perspective.
The largest risk factor of a mass shooting perpetrator is being male, since nearly all mass shootings are carried out by men.
The number one motive is a grievance, whether perceived or real. Most perpetrators — 52 percent — had a grievance they were seeking to address through the mass shooting.
Furthermore in 2017, 21 percent of attackers cited ideological reasons for their attack. That’s right — people’s political belief system was a strong predictor of violence. “Nearly one-third of the attackers (n = 8, 30%) appeared to have subscribed to a belief system that has previously been associated with violence.”
And yes, we have to acknowledge the report says that 19 percent of motive can be attributed to mental health symptoms. But as I previously noted, symptoms or “issues” is very different than an actual diagnosis.
Fixations, Stressors & Threats
Outside the realm of mental illness, the report found that 41 percent of attackers had unhealthy fixations on someone in their life, all too often an ex-girlfriend or wife. These people often engaged in stalking or harassing others, leaving a criminal reporting paper trail that law enforcement could easily follow — and perhaps even predict — if they had sufficient data analysis resources.
Most importantly, 85 percent of attackers examined by this report had a significant stressor within the previous five years (and for 74 percent, it occurred in the previous year). This stressor was: family/romantic relationship issue (death, break-up, etc.), work/school issue (denied promotion, losing a job, etc.), contact with law enforcement with no arrest (domestic violence), and personal issues (homelessness).
We all encounter stressors in life, however. So again, we find that one of the strongest predictors of mass shootings isn’t a characteristic that is all that helpful to single out because it’s so common.
Finally, 93 percent of attackers also engaged in threats or concerning communication. Again, concerning communication is something many people engage in — but it doesn’t mean they’re a future mass shooter waiting to happen.
A Slippery, Sloppy Slope
By using sloppy terminology, people and politicians are conflating actual, diagnosable mental illness with the more squishy category of “mental health issues.” They’re doing this because law enforcement agencies also engage in this conflation in their annual reports, which is then amplified by media reporting on such reports. Nobody has stopped to say, “Hey, wait a minute. A report by a family member of a perpetrator’s supposed mental health issues is not the same as an actual mental illness diagnosis made by a trained mental health professional.”
Because in hindsight, people often see what they want to see. Psychologists refer to this as “confirmation bias.” We tend to interpret and recall information in a way that affirms our own pre-existing beliefs. “Joe was always a little off. I’m not surprised he perpetrated that mass shooting. He obviously had some issues.”
This is the kind of low-quality, biased data that some law enforcement agencies and researchers use to determine a perpetrator’s mental health. Such false information distorts our knowledge and our understanding of these criminals.
The Way Forward
As the National Council notes in their detailed 2019 report, Mass Violence in America:
While there are identified risk factors for violence among those with mental illness, they are sensitive but not specific, and because of the low incidence, there is a problem of false positives. In addition, the risk assessments can identify people at greatest risk but not when their violent actions may occur.
Moreover, only a small portion of those people identified as having increased risk ever perpetrate mass violence.
As noted in this Congressional Research Service report:
…[C]riminologists contend further that while mass murderers are often afflicted with some form of severe emotional duress and mental instability […] they are rarely psychotic and hallucinatory, and are seldom found to be criminally insane or otherwise unfit to stand trial.
In many cases, their mental conditions did not rise to a level such that they would have previously had significant encounters with either the mental health or law enforcement communities.
And elsewhere in the same report:
One observer stated: “If you focus on mental illness, all you get is a huge number of false positives.”
In short, by focusing on mental illness, we’re attempting to filter for people we have absolutely no capability of finding beforehand. We’d be left with a vast number of people with mental illness who’re denied a Constitutional right, all the while mass shootings continue.
Furthermore, we need to question the sloppy op-eds and reporting that suggest that 60 percent of attackers were diagnosed with mental illness or had “signs” of serious mental illness (such as this editorial which cites not peer-reviewed research, but the author’s own book; this is the level of “journalism” that sometimes informs this debate). Mother Jones’ reporting on this topic also leaves much to be desired, since they will put a third-party unverifiable report of mental health symptoms in the same category as someone who carried an actual diagnosis.
This is especially important if lawmakers are going to try and start defining new policies about gun ownership and past mental illness. As clearly demonstrated, mental illness is a really poor indicator of the likelihood of someone committing a future mass shooting. Let’s not implicate an entire group of people — 1 in 5 Americans! — due to bad science and people trying to push their own biased agendas.
There’s only one characteristic that clearly differentiates the United States from other industrialized nations — ready access to firearms. Until that changes, mass shootings — and the tragic deaths and injuries that accompany every sad incident — will continue unabated in America in the years to come. No amount of talking about everything else from “violent video games” to “mental illness” will change that.
For further information
Download the National Council’s full report: Mass Violence in America (PDF, August 2019)