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Will the Discussion from Latest Shooting Steer Away From Mental Health This Time?

Mental Health Weekly February 26, 2018

The kind hearts and articulate voices of the Marjory Stoneman Douglas High School community that lost 17 of its own in a Valentine’s Day shooting are offering hope that a more impactful outcome will rise from the post-tragedy discussions this time.

Mental health advocates such as Debbie Plotnick, vice president for mental health and systems advocacy at Mental Health America, are by nature optimists, so they hang on  to the possibility that this time the discussion can be dominated by talk of access to weapons and violence prevention, not mental illness.

“We have to stop moving there as the first place to go,” Plotnick told MHW. “This is not a debate about mental health.”

An important distinction between this month’s Parkland, Florida, shooting and most of the countless other mass murders in the United States in recent years is that this perpetrator is alive, offering a rare opportunity to gain insight into the psychology of a killer. A Temple University professor who studies violent and risk-taking behavior says that so little hard data exists on these types of perpetrators that any attempt to affix an exact label to Nikolas Cruz in the short term becomes a dangerous proposition.

“This person is ill, no question,” Frank Farley, Ph.D., the Laura H. Carnell Professor of Educational Psychology at Temple, told MHW. “But multiple murderers are in a class all by themselves. It stigmatizes others to be put in the same basket with mass murderers.”

And that is the crux of the problem with discussions that focus on mental health status as the main criterion for gun ownership. Such talk leads the public to conclude, wrongly, that persons with mental health disorders are more prone to violence than the general public, when the data actually show that persons with mental illness are much more likely to become crime victims than perpetrators.

“Despite these facts, it has become commonplace for some to blame these tragedies on mental illness, and call for the country to focus on the ‘mental health crisis’ rather than on guns,” reads a statement from the Judge David L. Bazelon Center for Mental Health Law. “Among those are many politicians who have repeatedly proposed gutting Medicaid and the Affordable Care Act, both of which provide significant support to people with mental health disabilities.”

The statement continues, “Others have demanded that individuals be reported to the federal gun database just because they have a mental health disability — a step that no evidence suggests will meaningfully lessen gun violence.”

Converging discussions

But mental health inevitably enters the conversation in the aftermath of events such as the killings at Douglas High. Sometimes this is for legitimate reasons: Educators in Florida in recent days have lamented the overall lack of school counseling staff to assist troubled students (Cruz had been enrolled in several schools and had a history of combative behavior with teachers and staff, and had struggled further after the recent death of his mother).

“Yes, we need more resources for schools,” Plotnick said. “We need more resources for mental health. We need more screening for mental health. However, that’s a separate conversation.”

Instead, the discussion should focus on what Plotnick sees as some clear facts: Individuals with a history of violence or who have expressed threats of violence should not have access to weapons. “This is true whether someone has had or hasn’t had a mental health condition,” she said.

“Common sense will tell us that background checks are appropriate,” Plotnick said.

Farley points to several obvious warning signs about Cruz that have been reported in the media: numerous visits to his home by police, as well as a fascination with weapons and even a boast about wanting to become a “professional school shooter. Farley discusses in regard to such individuals the potency of what is called the “weapons effect,” where the mere presence of weapons of destruction may potentiate aggression.

Plotnick said that in the aftermath of the Parkland shooting, “I am heartened to see young people taking advocacy stances. They are saying things that reflect what I’ve said.”

What knowledge can we gain?

Since most mass murderers either are killed by police or kill themselves in the act, “These perpetrators are very rarely studied in a serious and valid way,” Farley said. Because of that, a “Monday morning quarterbacking” kind of exercise takes place, with highly speculative diagnoses being attached to the person, he said.

Comments about the perpetrator are thus prone to biases such as hindsight bias (manifesting as statements such as “I knew this person was going  to  do  something  really bad”) or confirmation bias (people buying into a persuasive individual’s explanation of the perpetrator’s psyche). “It ends up being something that looks like a Rorschach test,” says Farley, with everyone projecting their own thoughts onto the subject.

Farley, who last year chaired an American Psychological Association national summit on violence, said that even with the opportunity to study a living perpetrator such as Cruz, there are limits to what the science can uncover. “The human mind— no one has ever touched it, seen it, photographed it,” he said.

He doesn’t think any human behavior is caused by just one factor, so in the case of studying mass murderers, there is a search for any common ingredients in a recipe for extreme violence. He suggests that those who have an opportunity to evaluate Cruz should conduct as many valid psychological tests as possible, covering dimensions from cognitive to intellectual to emotional to attitudinal. Neuroscience workups also will be important. Farley says he is not certain how helpful open-ended interviews with the perpetrator will be.

Many will try to land on a factor in a mass criminal’s youth as the explanation for the later behavior, but Farley urges people to be careful with this. “You’ve got to be real cautious at this stage of the science,” he said. “The long-run strategy is to find early factors that predict this behavior, but we are a long way from that, in my judgment.”

Besides, Farley added, “Many other people will show similar patterns, and will never kill anyone.”