Since I wrote my last column, there have been two mass shootings in the United States. 

The media has a difficult time reporting on people who commit these atrocities. They bounce around from not even reporting the shooters’ names for fear of encouraging publicity-hungry copycats, to digging for every detail about these incomprehensible monsters and their mental health.

When the latter happens, mental health advocates sit up straight. Those of us who rally for understanding the full diversity of people with mental illness instinctively pick apart the illogical but common inference that because one must be mentally ill to open fire on innocent people, all 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 victims of violence. They accurately point out that, in general, people with mental illness are much less violent than people without mental illness.

Those of us who rally for understanding the full diversity of people with mental illness instinctively pick apart the illogical but common inference that because one must be mentally ill to open fire on innocent people, all people with mental illness are violent. 

But like those in the media who conflate all mental illness with violence, mental health professionals who endlessly insist that those with mental illness are not violent also obscure the truth. Specifically, those who go untreated.

The data changes drastically when you consider people with untreated or undiagnosed severe mental illness, especially psychosis. In fact, two things become clear: Those who suffer from severe mental illness and don’t get help suffer disproportionate violence, but they also commit acts of violence at rates much higher than the general population.

In fact, according to the U.S. Secret Service report Mass Attacks in Public Spaces, as many as two-thirds of mass shooters experience severe mental health issues sometime during the year of their crimes. Compare that to the general population, of which only 20% suffer from either minor, moderate, 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 only 3.5% over a lifetime.

People with moderate depression, anxiety, or mood swings do not want to be stigmatized as violent. So, they, the professionals who treat them, and the massive lobbying groups who represent both push the narrative that mental illness does not equal violence. And for their particular place in the spectrum of mental health challenges, it probably doesn’t. But they suck the air from the room as they protest any portrayal of violent offenders as affected by mental illness. 

The predictable if unintended result is that fewer resources are available for those with severe mental illness and psychosis, and less attention is paid to their needs. Few efforts are made to understand them, and so fewer get treatment.

All too often, the inevitable outcome is violence. Predictable violence.

It’s time to admit both the truth that mental illness plays a role in mass shootings and the truth that most people with mental illness have never acted out in violence. Maintaining that there is no link between mental illness and violence, when it is so painfully obvious to almost everyone, simply makes all of us take the issue less seriously.

It’s incredibly difficult for someone who feels a compulsion to commit violence to reach out and get help, and it’s also very difficult for their families to intervene, despite the warning signs. Sweeping the issue, and the facts, under the rug to protect the image of people with successfully treated mental illness may help us combat stigma, but it also isolates those with more severe mental illness and a tendency toward violence.

Maintaining that there is no link between mental illness and violence, when it is so painfully obvious to almost everyone, simply makes all of us take the issue less seriously.

After these shootings, the media often looks back at the shooter’s history and we all wonder why friends and family didn’t see or hear the warning signs. Maybe it’s because we aren’t listening until it’s too late. If we make people with mental health issues and who act out violently feel isolated, when, in fact, it’s not uncommon and the disease is treatable, we get more of the behavior we try to hide.

In the name of overcoming the stigma of mental illness, we must not ignore, or worse yet, deny, a very real problem. Let’s invite people with dangerous compulsions hearing dangerous voices into treatment, instead of denying that they exist.

George Hofmann is the author of Resilience: Handling Anxiety in a Time of Crisis. He writes on religious liberty and American politics at The Psalms Meditations Project. George lives in Philadelphia with his wife, their daughter, and two poorly behaved dogs.

3 thoughts on “George Hofmann: Mental illness and mass shootings”

  1. Not sure anyone is saying there’s no link between mass shootings and mental health though. Thing is 1. Mass shootings only account for a tiny percentage of gun violence 2. Every developed country has roughly the same amount of people struggling with mental health yet WAY less gun violence. How does the author account for that if not the fact that other developed countries either a) have fewer guns or b) lots of guns but sensible laws regulating them (Israel and Switzerland)

    Personally I’m in favor of the latter in the US but of course the US also has the biggest gun manufacturer lobby in the world which intentionally sabatoges any rational debate about this issue to protect their bottom line.

    We also have politicians who manipulate people by making up stories about big bad Democrats sending agents door to door to confiscate guns and literally comparing calls for background checks to what Nazis did to Jews.

    1. Thanks for your comment Will. You’ve either missed the point of the post or chosen to ignore it. The post is about information about mass attackers and mental illness as reported in a Secret Service research paper. I express concern that the mainstream mental health community’s denial of the fact that often untreated mental illness does lead to violence may prevent people with severe mental illness and violent psychosis from entering treatment. In your zeal to make your point you overlook that nowhere in the article do I mention guns or gun policy.

      1. You did talk about mass shootings, specifically, and so the comment wasn’t far off base, as it was on the topic of guns/shootings and mental illness. People are understandably zealous and are not always going to respond narrowly to an original point.
        From my own perspective, I strongly disagree that “one must be mentally ill to open fire on innocent people.” With the power of social media, the hopelessness felt by many people nowadays (esp the young), the proven effect of watching violent media, and basic psychologic peer pressure — it’s a perfectly “normal,” though tragic — response to grab something easily available, and act out in rage and/or despair. It only helps the NRA and the politicians it supports, to portray mass shootings to be a result of mental illness. I do appreciate your advocating for more attention/treatment on the overlap of mental illness and violence, esp since, as you say, most mentally ill people are not at all violent.

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