Since I wrote my last newsletter there have been two mass shootings in the United States. This is heart wrenching, and our attention and prayers must be directed to the victims and their families. What is near impossible, but demanded by almost every religion we practice, is that we also must feel compassion for the shooters.
These shootings are unique in that in each one the shooter was taken alive. We may find out much about them. The media has a difficult time reporting on the people who commit these atrocities. All at once they bounce from not even reporting the shooters name, for fear of encouraging publicity hungry copycats, to digging for every detail about the incomprehensible monster. Inevitably, this focus turns to the shooter’s mental health.
This is when mental health advocates sit up straight. Those of us who rally for understanding of the fullness and diversity of people with mental illness, and rail against stigma and stereotypes that plague mental health and keep some people from seeking care, pick apart the inference that people must be mentally ill to open fire on the innocent, and the small jump of logic required to conclude that people with mental illness are violent.
Mental health advocates race to the front of the dialogue armed with data that shows that, instead of committing violence, people with mental illness are actually much more likely to be the victims of violence. They point out, with accuracy, that, as a group, people with mental illness act violently at a rate far lower than people without mental illness do.
However, this data changes drastically when you consider people with untreated or undiagnosed severe mental illness, especially psychosis. In fact, two things become clear. Yes, people with untreated severe mental illness suffer disproportionate violence, but they also commit acts of violence at rates much higher than the general population.
In fact, according to the US Secret Service report Mass Attacks in Public Spaces (read it here), as many as two thirds of mass shooters experience severe mental health issues in the year of the shooting. Compare that to the general population, where 20% suffer from minor, moderate or more serious mental illness. Perhaps more telling, over 30% of mass shooters experience psychotic symptoms such as paranoia or hearing voices in the year leading up to the shooting. The rate for the general population is 3.5% over a lifetime.
Endlessly insisting that those with mental illness are not violent obscures the truth and limits the attention paid to the terrible problems, including being victims and perpetrators of violence, suffered by those with severe mental illness. People with moderate depression, anxiety or mood swings do not want to be stigmatized as violent, so they and the professionals who treat them and massive lobbying groups who represent them push the narrative that mental illness does not equal violence. For their end of the spectrum of mental health challenges it doesn’t. But they suck all the air from the room as they protest the media’s portrayal of violent offenders as motivated by mental illness. The unintended though predictable result is that less resources are available for the unprofitable group of those with severe mental illness and psychosis, and less attention is paid to their needs. Few efforts are made to even attempt to understand them.
The outcome, all too often, is violence. Predictable violence.
Let’s fess up and admit the role mental illness plays in mass attacks. Most people with mental illness have never acted out in violence. But extrapolating that to those with psychotic mental illness for fear that more people may be thought of as risks makes no sense. Maintaining that something isn’t true, like the link between mental illness and violence, when to everyone it is so painfully obvious, simply makes everyone take the issue less seriously.
What we need to admit is that in most of these mass shootings the shooter does suffer from severe mental illness. In most of those cases the mental illness is untreated. It’s incredibly difficult for someone who feels a compulsion to violence to reach out and get help, and it’s very difficult for their families to intervene, despite telling warning signs. Sweeping the issue, and the facts, under the rug to protect the image of people with successfully treated moderate mental illness may help us combat stigma, but it also isolates the person with severe mental illness and a tendency towards violence and makes it less likely that they will seek help.
After each of these shootings we look back at the shooter’s history and wonder why their behavior didn’t lead to a cry for help. Maybe it’s because we aren’t listening. Maybe, in making something that in hindsight seems so incredibly obvious and treatable feel like something that only happens to this one troubled person, we make it less likely that the troubled person will seek help. If we make people feel like isolated aggressors who face an uncommon problem, when in fact the problem is not uncommon at all and the disease is treatable, we get the behavior we try to hide.
In the name of overcoming stigma we must not ignore, or worse yet, deny, a very real problem. The hope in this is that it is overwhelmingly people with untreated severe mental illness that commit acts of mass violence. Those with treated severe mental illness rarely do. Let’s invite people with dangerous compulsions hearing dangerous voices into treatment, instead of denying that they exist.
Getting Older With Bipolar
Every Thursday night at 7:00p EST people over 40 meet on Zoom to share their experience with mental illness. We share what works, what doesn’t seem to, and we discuss the unique challenges of aging with a mood disorder. Please join us. You can find the link here.
Meditation
In the popularity of mindfulness, most practitioners and even most teachers overlook the importance of community. We promote meditation as an individual pursuit to address individual suffering and forget that for all but the last few decades most meditators practiced in groups, buoyed by support from and benefit for a close knit community. Covid has cheated us of most opportunities to come together with others and share emotions and silence, but we can still do so virtually. Yesterday, from my back patio, I practiced with people in the UK on the World Community for Christian Meditation site. I’ve recently practiced with people at remote Zen centers as well. The Angel City Zen Center, Upaya and Zen Mountain Monastery all have ongoing on-line groups. Covid has been isolating, but through Zoom opportunities to practice with people we may have never met have opened up to us. Solidify feelings of community with a web search and participation with an on-line group of meditators. It’s not ideal, but it is community – something we’re all sorely lacking right now.
Dear George, Thanks for this thoughtful and insightful article. I think the distinction you make between people with mental illness and people with UNTREATED mental illness is so important, and to your point, all too easily obscured.