I’m at a loss for words after hearing about the most recent mass shooting that took place — this one against four innocents — two therapists and a psychologist (who was pregnant at the time of the shooting).
It begs the question in the ongoing gun control debate in America: If mental health professionals are suddenly the ones who are supposed to be vetting people for their potential future risk of violence, who is going to protect them in their jobs? Because, clearly, we as a society have utterly failed to address this very basic, fundamental question.
The latest mass shooting occurred in a veterans home in Yountville, California on a enormous 600-acre campus filled with buildings that provide services and housing for veterans. On Friday, a decorated Army veteran armed with a high-powered rifle decided to get back at those people who kicked him out of a program for combat stress, killing all three mental health workers.
According to news reports, the victims were identified as The Pathway Home’s executive director, Christine Loeber; staff therapist Jen Golick; and Jennifer Gonzales, a psychologist with the San Francisco Department of Veterans Affairs Healthcare System. Incidents like this, while still rare, would certainly make many mental health professionals think twice about working with anyone who has had a violent past.
Mental Illness = More Prone to Violence?
You hear some people speak over and over again about how most mass shootings are seemingly carried out people with mental illness. However, it’s not mental illness that binds these men together — it’s a propensity for violence and violent behavior. That is a very different thing than the rich multitude of disorders that constitute “mental illness.”
In fact, out of all of the hundreds of disorders in the diagnostic manual of mental illness, there are really only two primary diagnoses that feature violence or the disregard of the safety of others prominently — intermittent explosive disorder, and antisocial personality disorder. That’s a drop in the bucket of mental disorders.
As we’ve repeatedly demonstrated, violence is not significantly correlated to mental illness (except, perhaps, for substance abusers). People with a mental illness diagnosis are far more likely to be the victims of a crime than its perpetrators. (Don’t believe me? Then go read what Jeffrey Lieberman, the president of the American Psychiatric Association has to say on the subject.)
Who Will Protect the Therapists?
We don’t have to talk about mental illness and violence, because there will be fewer and fewer therapists willing to even see a person with violent tendencies if society has no way of ensuring that professional will be protected in carrying out their jobs. What will the next suggestion be, that every therapist be armed and ready for such attackers?
What kind of society is it that we’re living in would even consider the ridiculousness of such a plan, arming the people who are entrusted to try and help heal the emotional wounds of war and of life? If I were a therapist, how could I ever find that therapist/client therapeutic bond that is so important in the healing process if I was afraid for my life every day I came into the office? Will the next client be the one to get angry at me and shoot me if I make the wrong decision in his eyes?
Identifying Those at Risk Early On, Targeting Interventions
Thomas O’Hare, Ph.D., writing in a letter recently to the Wall Street Journal, notes that we should be focusing on at-risk youth early on; those who are most prone to violence based upon their past behavior:
Rather than focusing on the complex and very heterogeneous concept of “mental illness,” mental-health practitioners, law enforcement and the criminal-justice system need to focus on people who have shown evidence of violent behavior.
This attention should begin early on, concentrating on conduct disorders and antisocial behavior in, primarily, young men from their early teens onward. Because of a misguided understanding of psychology and the unwillingness of the mental-health professions to compare notes with law enforcement and the courts due to overweening concerns about patient confidentiality, the violent tendency in these young boys is reinforced until they become violent young men and kill someone.
Yes, perhaps we would target some young adults and teens who would never become mass shooters. But so what? All we’ve done is perhaps offered them more programs aimed at helping them learn to redirect their anger and violent tendencies into more constructive behaviors. Would that be such a bad thing?
We are living in dangerous times. We risk losing the support of those people who work on the front-lines everyday in dealing with the increasing problems of a broken mental health system and the emotionally-scarred, often-poor people it serves. Nobody appears to care for them, and few are willing to speak up on their behalf.
It’s time we started working on thoughtful solutions to these problems, and had real, honest discussions about the multi-pronged approach that is necessary in order to bring them to a halt. Because if we don’t do it soon, all the funding in the world won’t buy you a therapist or psychologist willing to work with this population if they have to risk their very lives in order to serve them.