mentalhealth

Mental Health Laws Won’t Save Us From Mass Shooters

Because here’s a terrifying fact: They’re not any crazier than the rest of us

When President Donald Trump delivered his statements in the aftermath of two mass shootings over the weekend, he made sure to home in on mental-health treatment as a panacea for vicious gun violence in public settings. “We must reform our mental-health laws to better identify mentally disturbed individuals who may commit acts of violence, and make sure those people not only get treatment but — when necessary — involuntary confinement,” Trump said Monday in a White House address. “Mental illness and hate pulls the trigger, not the gun.”

This is the most common prescription from other Republican politicians and the National Rifle Association in the aftermath of public shootings, but in hearing it again from Trump, I couldn’t help but think of people who live on the streets of L.A. I’ve spent more than five years reporting on Southern California’s homeless crisis, and seen how the high rates of serious mental illness in homeless individuals plays out in communities like Skid Row, a 50-block community that’s ground zero for the crisis and also has extremely high rates of violent crime.

If there’s any place that could show links between varying levels of mental illness and physical aggression, it’s this corner of L.A., where tent cities sit next to mental-health clinics, emergency shelters and the busiest LAPD division in the city. But five years of interviewing members of this community, police leaders and advocates confirm for me something that the data already shows: People with mental illness are victimized at 10 times the rate of someone who isn’t mentally ill. (A 2013 review found that only around 3 to 5 percent of violent crimes in the U.S. are perpetrated by people with mental illness.) 

Mass shootings innately seem like acts of psychosis, because most of us can’t imagine plotting to murder indiscriminately. Yet again and again, researchers have found that the profile of the modern mass shooter is a young man with mental symptoms seen in all kinds of young men, not just killers. Things like depression, anxiety and low self-esteem — what the FBI refers to as common mental health stressors in its 2018 report on mass murderers. “There may be complex interactions with other stressors that give rise to what may ultimately be transient manifestations of behaviors and moods that would not be sufficient to warrant a formal diagnosis of mental illness,” the report concluded. 

Joseph Pierre, a professor of psychiatry at UCLA, notes in an essay that the American public desperately wishes for some mechanism that can spot the “evil” in mass murderers. In reality, the web of symptoms that mass shooters tend to share are also found in other Americans who will never commit a violent crime. And so, screening for loners who feel socially isolated, enjoy violent media and have anger toward others would create a huge swath of “false positives,” Pierre argues.

“Proposed solutions, usually couched in terms of enhancing mental health services, often involve plans to further marginalize those struggling with emotional issues, screening them based on risk factors and warning signs so that they can be locked away in psychiatric hospitals or prisons, which themselves have become the largest mental institutions in the U.S.,” he writes. “Such proposals reflect the instinct to cull such individuals out of the pack so that they can be banished from society.” 

This is an allusion to tactics like the involuntary commitment that Trump referenced, but even that is borderline impossible to secure unless a person explicitly states they plan to harm themselves or others, and has a history of mental-health diagnoses. This is the bar set by most jurisdictions across the country, and it’s hard to conceive how the shooters in El Paso, Dayton and Gilroy, among many others, could have qualified. This is why mental-health experts continue to be cynical about whether “red flags” and screenings can ever prevent this kind of mass violence. If a man with paranoid schizophrenia who defecates on a Downtown Los Angeles crosswalk can’t be kept in serious care, how would a brooding young man stand out in an examination? 

Mass killers aren’t usually inspired in a fit of passion either; rather, they plan deliberately, sometimes even dropping hints to certain loved ones or classmates. But even if someone was confident that a friend or family member was a mass killer in the making, it’s unclear what would motivate that person from cooperating at all. “With their tendency to externalize blame and consider themselves as victims of mistreatment, mass murderers see the problem to reside in others, not themselves,” criminologists Monica DeLateur and James Fox wrote in their groundbreaking 2014 study of mass shootings. “If urged or even coerced to seek counseling, the would-be mass murderer would likely resist angrily to the suggestion that something is wrong with him or her. He or she desires fair treatment, not psychological treatment.”

So screening mass murderers would be incredibly complex with a lot of false positives, and the archetypal mass shooter would be inclined to refuse care anyway. Emergency intervention protocols like involuntary commitment don’t appear to legally apply to most shooters. Not to mention, state-level resources for mental-health care generally are lagging behind demand. Plus, there’s little evidence that the psychiatric field can predict violent outcomes. And then there’s the inconvenient fact that Trump himself rolled back Obama-era restrictions on firearm ownership by people with mental-health diagnoses. 

No wonder that many have reacted to Trump’s statements by claiming that “mental health” is basically a big smokescreen for another effort: banning the sale of “assault weapons” outright. Military-style rifles like AR-15s, AKs and variants like the WASD-10 used in Gilroy and El Paso have long horrified those who see them as more vicious than a hunting rifle or handgun. But even here, the evidence bears little proof for the gut feeling. Many people decried the end of the federal assault weapons ban, which expired in 2004 after 10 years. Yet research into the impact of that ban suggests it had “virtually no effect,” as mass shootings frequently feature handguns and other firearms that wouldn’t be affected by the extension of the federal ban. 

The expansion of “extreme risk order” state laws, in which a civil court can confiscate weapons from a person deemed by law enforcement and the person’s family as potentially dangerous, is a small positive step. But given that several shooters simply steal, borrow or buy their weapons from friends, how much optimism can we glean?

Given that reality, perhaps the answer is reducing the total number of guns in the U.S., period. The biggest predictor of gun violence continues to be the prevalence of gun ownership in an area, and the majority of gun deaths are a result of interpersonal violence and suicide, not mass killings. And a minority of Americans control the vast majority of the gun stock, making the U.S. the most armed developed nation in the world

This feels like an impossible and distant answer, given the furious pushback from the NRA and the gun industry whenever such broad moves are discussed. But Pierre, the UCLA psychologist, argues that the last two decades of mass shootings are very likely a result of glorifying gun violence in all forms of media and culture. “Obsessed with revenge, those aspiring to mass murder draw from the archetypal U.S. hero who relies on gun violence to right wrongs and overturn oppressive institutions,” he writes.

We can see it in the specificity of the El Paso shooter’s decisions. He allegedly lamented the fact that his WASD-10 rifle didn’t pack as much of a punch as he needed. So he compromised by buying the bullets that would damage a human body the most: the 8M3, a hollow-point bullet designed to expand, fragment and spray through human muscle, causing the most bodily damage possible per hit. 

It’s a bullet widely available to civilians and treasured by self-defense fetishists. This wasn’t about merely killing people, it was about killing them in the most savage, stylish way he could imagine. It doesn’t seem like the thinking of a man who would simply respond to clinical intervention. 

Worse yet, given everything above, it seems like the archetypal shooter will likely continue to slip under the radar, even if that radar grows — and that’s the most frustrating lesson of all.