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There were two mass shootings over the weekend. President Trump blames gun violence on mental ... [+]
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During an address to the nation on Monday, President Trump had an explanation for the pair or mass shootings that occurred in Dayton, Ohio, and El Paso, Texas, over the weekend. "Mental illness and hatred pull the trigger, not the gun," he claimed.

The idea that it is the individual's mental illness that leads to gun violence is not new or uncommon. Back in 2015, when Trump was a presidential candidate, he responded to John Russell Houser's deadly shooting in a movie theater in Louisiana by saying, "These are sick people. This has nothing to do with guns. This has to do with the mentality of these people."

Four years and countless mass shootings later, Trump still adheres to this belief. Other GOP politicians and pundits also often invoke mental illness as a cause for gun violence. The Washington Post reports that there have been four or more people killed in a mass shooting every 47 days, on average, since June 15, 2015. That was the date of the rampage at the historically black church in Charleston, South Carolina.

Despite politicians' beliefs, studies show that people with diagnosed mental illnesses perpetrate less than 5% of violent crimes. They are much more likely to be victims of gun violence than to be instigators of it.

Dr. Seth Trueger, an assistant professor of emergency medicine at Northwestern University, that although rates of mental health conditions have risen in the U.S., other countries have seen similar trends in mental illnesses, but far fewer mass shooters than America had experienced. Dr. Trueger, along with several other medical professionals, argues that it is the access to the guns - not mental health systems - that causes this large-scale firearm violence.

Although none of this is news to many people, blaming mental health for gun violence can lead to grave consequences. According to recent polls over the past few years, roughly half the American public believes that mental health problems is the leading cause of these mass shootings.

Approximately half of the U.S. population experiences a mental illness during their lifetime. That is a disproportionally large population to blame for mass shootings because in actuality they make up a very small percentage of gun violence perpetrators. This thought pattern will only deepen the stigma against mental illnesses and disabilities, further making it harder for those struggling to reach out for help.

A study conducted by the National Epidemiologic Survey on Alcohol and Related Conditions found "that people with mental illnesses are more likely than the general population to have suffered physical or mental abuse, be unemployed, have a parent with an arrest record, or have drug or alcohol dependency. It is these factors, not the mental illness itself, that are more likely to present in people who carry out violent gun crimes."

In reality, people with mental health and cognitive issues are often the victims of violence, most frequently at the hands of law enforcers. A person with a mental illness is 16 times more likely than the general public to be abused or killed by the police.

In June of this year, a 32-year-old man with an intellectual disability was shot and killed by an off-duty officer in a Los Angeles Costco. However, these kinds of incidents rarely make national headlines. Instead, the deaths of mentally ill people by the police remains a hidden epidemic. Meanwhile, the small percentage of violence by those exact people is too often drawn out of proportion. A 2015 study indicated that by the most conservative estimates, at least one in four fatal law enforcement encounters in the country involves an individual with a serious mental illness.

Indeed, the U.S. is facing crises in both gun violence and mental illnesses. However, to correlate those two separate phenomena and to blame mass shootings on the mentally ill is grossly inappropriate.

Instead, the government must focus on restoring the mental health treatment system so that individuals with mental health issues are not left untreated to the point where law enforcement has to get involved. These police involvements too often result in fatalities or unjust imprisonments. Secondly, it also needs to move towards instilling a gun control reform that prohibits average civilians from accessing assault riffles.

The "the mentally-ill cause mass shootings" narrative is not only significantly erroneous, but it also prevents the nation from progressing and ensuring safety for all inhabitants.

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The Dangers Of The Mental Health Narrative When It Comes To Gun Violence

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During an address to the nation on Monday, President Trump had an explanation for the pair or mass shootings that occurred in Dayton, Ohio, and El Paso, Texas, over the weekend. "Mental illness and hatred pull the trigger, not the gun," he claimed.

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There is a complicated, fraught connection between gun violence and mental health: ‘We have to be very careful how we talk about the link between the two’

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America has a mental-health crisis and it also has a gun problem. But are the two related?

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In Stephen King's The Shining, the character Jack Torrance epitomises the popular horror trope of crazed killer who can no longer distinguish reality from hallucination. As Jack slowly descends into madness, he befriends a number of murderous spirits who eventually convince him to kill his wife and son - or die trying.

The audience may conclude that Jack fell victim to an evil, supernatural force occupying the story's famous hotel. Or they may interpret his downward spiral in a very different way: that Jack was a mentally ill man - likely schizophrenic - in the grips of a violent psychotic episode.

The Shining is clearly a work of fiction. But when it comes to mental illness and violence, the public, media and policy-makers often have difficulty discerning fact from fantasy. Opinion polls consistently reveal that the majority of adults in the US believe that people with mental illnesses are more likely to be violent than those without.
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That assumption is further reinforced each time a new mass shooting takes place, inevitably followed by calls for mental healthcare reform. But what does the evidence say about the relationship between mass shooters and mental illness? Are these acts of violence really a mental health problem?

If social media and sensationalist headlines are a guide, the fear of extreme violence from the mentally ill is common. "The idea of losing the capacity to control one's thoughts or behaviours is scary and alien, which translates into fear of mental illness - particularly in its more severe manifestations," says Paul Appelbaum, a psychiatrist at Columbia University College of Physicians and Surgeons. "We also have a tendency as human beings to pay particular attention to unusual events in our environment, so when acts of violence are committed by people with mental illness, they may be particularly salient in our minds."

Senseless tragedies like mass shootings also provoke and demand answers - preferably ones that are also accompanied by easy fixes, says Jeffrey Swanson, a professor of psychiatry and behavioural sciences at Duke University School of Medicine. "We want life to be safe and predictable and to make sense," he says. "The normal reaction is to want an oversimplified master explanation so you can put it in this box and say, 'Ah, it's mental illness'..'"

That knee-jerk conclusion is problematic, he continues, because it encourages even more stigmatisation of people who have a mental illness, many of whom already have extremely difficult lives and already face discrimination in several areas, namely housing, jobs, and relationships. Individuals suffering from mental illnesses are actually three times more likely than the average person to be victims of violence, as they are more vulnerable.

It is true that some mass shootings and other atrocious acts of violence are committed by people who are seriously mentally ill. In 1998, for example, Wendell Williamson, a law student who was later diagnosed with paranoid schizophrenia, fatally shot two strangers on the street in Chapel Hill in North Carolina. Williamson claimed that he had been operating under the belief that he was saving the world, and a jury eventually found him not guilty by reason of insanity.

But such cases, Swanson says, are in the minority. In fact, few mass killers actually suffer from a diagnosable, serious mental illness such as schizophrenia, bipolar disorder and psychotic spectrum disorders. A 2004 analysis of more than 60 mass murders in North America, for example, found that just 6% were psychotic at the time of the killings.

Moreover, much of the violence that people with serious mental illnesses commit are minor infractions, such as verbal assault or hitting, not homicide (suicide, however, is a significant problem), and such infractions tend to be directed at those the perpetrator lives with, not at strangers and not at a mass scale. Large attacks also require a level of planning and organisation that often defies many with serious mental illness. A 2014 study, for example, found that just 2% percent of 951 patients discharged from a psychiatric hospital committed a violent act involving a gun, and just 6% committed a violent act involving a stranger.

A 2011 meta-analysis of over 700 homicides committed by people with a diagnosed psychosis likewise revealed that just between 3% and 14% of the victims were strangers - the rest were known to the killer.

But even in cases in which people with a serious mental illness do become violent, it's difficult to peg their crimes solely on their diagnosis, Swanson says. Confounding variables such as a history of childhood abuse or use of alcohol or drugs can increase the odds of violence. "If you remove additional risk factors and look at mental illness alone, it's almost unrelated to violence," Swanson says. "There's consensus in the field that the unique contribution of psychopathology to violence in the population is very small."

In the wake of an incomprehensible tragedy, however, the implications of that conclusion can be difficult for many to process. "When one of these horrible mass shootings occurs, people say, 'Anyone who would do such a thing must be mentally ill,'" says Renee Binder, a professor and director of the psychiatry and law program at the University of California San Francisco School of Medicine. "But we need to be careful with our definitions because, while something is clearly wrong with them, it's often not a serious mental illness."

Making this inaccurate link can also shift the focus of policy debates in the US. In debates over limiting access to firearms, some people start talking about fixing the mental healthcare system instead. "Suddenly you hear the gun lobby - which is very powerful in this country and has a vested interest in not having guns be regulated - become an advocate for better mental health care in America," Swanson says. "It's a distraction so we don't talk about guns." (Read more: " What if all guns disappeared? ")

It's difficult to psychologically profile mass shooters because they often commit suicide or are killed during their attack. But what doctors and scientists do know is that the perpetrators of such events are frequently angry young men, who feel they have been mistreated by society and therefore seek to extract revenge.

The problem, however, is that tens of thousands of individuals fit that description - yet the vast majority do not commit a mass shooting. "If we could do something about maleness, we could really reduce violence and crime," Swanson says. "But you can't round up all the males."

Predicting who could turn into a mass killer is virtually impossible, Swanson says. Some mass killers had even visited psychiatrists for behavioural problems prior to their attacks, but had no diagnosis of a specific mental illness. "Most of the people who commit mass shootings don't want treatment and don't meet the criteria for treatment," Binder points out. Nor can individuals be committed to a mental hospital just for being angry.

This means that bolstering treatment for mentally ill people (a welcome development in its own right), would not actually solve the gun violence problem in the US, Swanson argues. The majority of perpetrators would still slip through the system.

So, in debates over how to reduce mass shootings, the evidence suggests that framing these events as caused by mental illness is unlikely to help prevent further attacks - and may only serve to perpetuate an ungrounded fear of the mentally unwell that is rooted more in fiction than fact.

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Is there a link between mass shootings and mental illness?

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In Stephen King's The Shining, the character Jack Torrance epitomises the popular horror trope of crazed killer who can no longer distinguish reality from hallucination. As Jack slowly descends into madness, he befriends a number of murderous spirits who eventually convince him to kill his wife and son - or die trying.

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While many have bought into the simplistic idea that availability of firearms is the cause of mass shootings, a number of experts have pointed out a more uncomfortable truth, which is that mass shootings are far more likely the result of how we've been mistreating mental illness, depression and behavioral problems

Gun control legislation has shown that law-abiding Americans who own guns are not the problem, because the more gun control laws that have been passed, the more mass shootings have occurred

97.8 percent of mass shootings occur in "gun-free zones," as the perpetrators know legally armed citizens won't be there to stop them

Depression per se rarely results in violence. Only after antidepressants became commonplace did mass shootings really take off, and many mass shooters have been shown to be on antidepressants

Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), are well-known for their ability to cause suicidal and homicidal ideation and violence

An article written by Molly Carter, initially published on ammo.com at an unknown date and subsequently republished by The Libertarian Institute in May 2019, and psychreg.org in late January 2021, noted:

"According to the Federal Bureau of Investigation (FBI), a mass murder occurs when at least four people are murdered, not including the shooter ... during a single incident ...

Seemingly every time a mass shooting occurs ... the anti-gun media and politicians have a knee-jerk response - they blame the tragedy solely on the tool used, namely firearms, and focus all of their proposed 'solutions' on more laws, ignoring that the murderer already broke numerous laws when they committed their atrocity.

Facts matter when addressing such an emotionally charged topic, and more gun control legislation has shown that law-abiding Americans who own guns are NOT the problem. Consider the following: The more gun control laws that are passed, the more mass murders have occurred.

Whether or not this is correlation or causation is debatable. What is not debatable is that this sick phenomenon of mass murderers targeting 'gun-free zones,' where they know civilian carry isn't available to law-abiding Americans, is happening.
According to the Crime Prevention Research Center, 97.8 percent of public shootings occur in 'gun-free zones' - and 'gun-free zones' are the epitome of the core philosophical tenet of gun control, that laws are all the defense one needs against violence ...
This debate leads them away from the elephant in the room and one of the real issues behind mass shootings - mental health and prescription drugs.

Ignoring what's going on in the heads of these psychopaths not only allows mass shootings to continue, it leads to misguided gun control laws that violate the Second Amendment and negate the rights of law-abiding U.S. citizens.

As Jeff Snyder put it in The Washington Times: 'But to ban guns because criminals use them is to tell the innocent and law-abiding that their rights and liberties depend not on their own conduct, but on the conduct of the guilty and the lawless, and that the law will permit them to have only such rights and liberties as the lawless will allow.'"

The Elephant in the Room: Antidepressants

Thoughts, emotions and a variety of environmental factors play into the manifestation of violence, but mental illness by itself cannot account for the massive rise in mass murder - unless you include antidepressants in the equation. Yet even when mental health does enter the mass shooter discussion, the issue of antidepressants, specifically, is rarely mentioned.

The fact is, depression per se rarely results in violence. Only after antidepressants became commonplace did mass shootings take off, and many mass shooters have been shown to be on antidepressants.

Prozac, released in 1987, was the first selective serotonin reuptake inhibitor (SSRI) to be approved for depression and anxiety. Only two years earlier, direct-to-consumer advertising had been legalized. In the mid-1990s, the Food and Drug Administration loosened regulations, direct-to-consumer ads for SSRIs exploded and, with it, prescriptions for SSRIs.

In 1989, just two years after Prozac came to market, Joseph Wesbecker shot 20 of his coworkers, killing nine. He had been on Prozac for one month, and the survivors of the drug-induced attack sued Eli Lilly, the maker of Prozac. Since then, antidepressant use and mass shootings have both risen, more or less in tandem.

In the two decades between 1988 and 2008, antidepressant use in the U.S. rose by 400 percent, and by 2010, 11 percent of the U.S. population over the age of 12 were on an antidepressant prescription.

In 1982, pre-Prozac, there was one mass shooting in the U.S. In 1984, there were two incidents and in 1986 - the year Prozac was released - there was one. One to three mass shootings per year remained the norm up until 1999, when it jumped to five.

How can we possibly ignore the connection between rampant use of drugs known to directly cause violent behavior and the rise in mass shootings?

Another jump took place in 2012, when there were seven mass shootings. And while the annual count has gone up and down from year to year, there's been a clear trend of an increased number of mass shootings post-2012. Over time, mass shootings have also gotten larger, with more people getting injured or killed per incident.

How can we possibly ignore the connection between rampant use of drugs known to directly cause violent behavior and the rise in mass shootings? Suicidal ideation, violence and homicidal ideation are all known side effects of these drugs. Sometimes, the drugs disrupt brain function so dramatically the perpetrator can't even remember what they did.

For example, in 2001, a 16-year-old high schooler was prescribed Effexor, starting off at 40 milligrams and moving up to 300 mg over the course of three weeks. On the first day of taking a 300-mg dose, the boy woke up with a headache, decided to skip school and went back to bed.

Some time later, he got up, took a rifle to his high school and held 23 classmates hostage at gunpoint. He later claimed he had no recollection of anything that happened after he went back to bed that morning.

The Risks Are Clear

The risks of psychiatric disturbances are so clear, ever since mid-October 2004, all antidepressants in the U.S. must include a black box warning that the drug can cause suicidal thoughts and behaviors, especially in those younger than 25, and that:

"Anxiety, agitation, panic attacks, insomnia, irritability, hostility (aggressiveness), impulsivity, akathisia (psychomotor restlessness), hypomania, and mania have been reported in adult and pediatric patients being treated with antidepressants for major depressive disorder as well as for other indications, both psychiatric and nonpsychiatric."

SSRIs can also cause emotional blunting and detachment, such that patients report "not feeling" or "not caring" about anything or anyone, as well as psychosis and hallucinations. All of these side effects can contribute to someone acting out an unthinkable violent crime.

In one review of 484 drugs in the FDA's database, 31 were found to account for 78.8 percent of all cases of violence against others, and 11 of those drugs were antidepressants.

The researchers concluded that violence against others was a "genuine and serious adverse drug event" and that of the drugs analyzed, SSRI antidepressants and the smoking cessation medication, varenicline (Chantix), had the strongest associations. The top-five most dangerous SSRIs were:

Fluoxetine (Prozac), which increased aggressive behavior 10.9 times

Paroxetine (Paxil), which increased violent behavior 10.3 times

Fluvoxamine (Luvox), which increased violent behavior 8.4 times

Venlafaxine (Effexor), which increased violent behavior 8.3 times

Desvenlafaxine (Pristiq), which increased violent behavior 7.9 times

Depression Is Vastly Overdiagnosed

In her article, Carter also reviewed the clinical determinants for a diagnosis of clinical depression warranting medication. To qualify, you must experience five or more of the following symptoms, most of the day, every day, for two weeks or more, and the symptoms must be severe enough to interfere with normal everyday functioning:

Sadness

Feeling hopeless

Feeling helpless

Feeling guilty

Fatigue

Loss of interest in hobbies

Restlessness

Abnormal sleep patterns, whether sleeping too much or not enough

Thoughts of death or suicide

Anxiety

Feeling worthless

Feeling 'empty'

Irritable

Lack of energy

Slow talking and moving

Trouble concentrating

Abnormal weight changes, either eating too much or having no appetite

The reality is that a majority of patients who receive a depression diagnosis and subsequent prescription for an antidepressant do not, in fact, qualify. In one study, only 38.4 percent actually met the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, and among older adults, that ratio was even lower. Only 14.3 percent of those aged 65 and older met the diagnostic criteria. According to the authors:

"Participants who did not meet the 12-month MDE criteria reported less distress and impairment in role functioning and used fewer services. A majority of both groups, however, were prescribed and used psychiatric medications.

Conclusion: Depression overdiagnosis and overtreatment is common in community settings in the USA. There is a need for improved targeting of diagnosis and treatments of depression and other mental disorders in these settings."

What Role Might War Games Play?

Aside from antidepressants, another factor that gets ignored is the influence of shooting simulations, i.e., violent video games. How does the military train soldiers for war? Through simulations. With the proliferation of video games involving indiscriminate violence, should we really be surprised when this "training" is then put into practice?

As reported by World Bank Blogs, young men who experience violence "often struggle to reintegrate peacefully into their communities" when hostilities end. While American youth typically have little experience with real-world war, simulated war games do occupy much of their time and may over time color their everyday perceptions of life. As noted by Centrical, some of the top benefits of simulations training include:

1. Allowing you to practice genuine real-life scenarios and responses

2. Repetition of content, which boosts knowledge retention

3. Personalization and diversification, so you can learn from your mistakes and evaluate your performance, thereby achieving a deeper level of learning

In short, violent mass shooter games are the perfect training platform for future mass shooters. Whereas a teenager without such exposure might not be very successful at carrying out a mass shooting due to inexperience with weapons and tactics, one who has spent many hours, years even, training in simulations could have knowledge akin to that of military personnel.

Add antidepressant side effects such as emotional blunting and loss of impulse control, and you have a perfect prescription for a mass casualty event.

On top of that, we, as a nation, also demonstrate the "righteousness" of war by engaging in them without end. When was the last time the U.S. was not at war someplace? It's been ongoing for decades.

Even now, the United States insists on inserting itself into the dispute between Russia and Ukraine, and diplomacy isn't the chosen conflict resolution tool. Sending weapons to Ukraine and calling for more violence against Russians are. Sen. Lindsey Graham has even called for the assassination of Russian President Vladimir Putin. Showing just how serious such a suggestion is, the White House had to publicly disavow it, stating Graham's comment "is not the position of the U.S. government."

Graham, meanwhile, does not appear to understand how his nonchalant call for murder might actually incite murder. In the wake of the Uvalde school shooting, he now wants to mobilize retired service members to enhance security at schools, and while that might be a good idea, how about also vowing never to call for the murder of political opponents? Don't politicians understand that this could translate into some kid thinking it's acceptable to murder THEIR perceived opponents?

As far as I can tell, mass shootings have far more to do with societal norms, dangerous medications, a lack of high-quality mental health services, and the normalization of violence through entertainment and in politics, than it does with gun laws per se.

There are likely many other factors as well, but these are clearly observable phenomena known to nurture violent behavior. I'm afraid Americans are in need of a far deeper and more introspective analysis of the problem than many are capable of at the moment. But those who can should try, and make an effort to affect much-needed change locally and in their own home.
Originally published June 16, 2022 on Mercola.com Views expressed in this article are the opinions of the author and do not necessarily reflect the views of The Epoch Times. Epoch Health welcomes professional discussion and friendly debate. To submit an opinion piece, please follow these guidelines and submit through our form here.

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97.8 Percent of Mass Shootings Are Linked to This

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While many have bought into the simplistic idea that availability of firearms is the cause of mass shootings, a number of experts have pointed out a more uncomfortable truth, which is that mass shootings are far more likely the result of how we've been mistreating mental illness, depression and behavioral

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Wednesday's broadcast of "The View" got heated when the topic turned to the Monday evening shooting at the Michigan State University campus - and Republican co-host Alyssa Farah Griffin, in addition to defending the Second Amendment, dared to suggest that mental health played a role in mass shootings.

Griffin conceded that she would support some additional gun control measures, saying that she was in favor of broader background checks and red flag laws, but argued that individual firearm ownership was protected in the Constitution and that should not be changed.

"Legal gun ownership is fundamental in this country," she said.

Co-host Sunny Hostin brought up the AR-15 - despite it appearing that the shooter at MSU likely used a handgun - referring to it as a "weapon of mass destruction" and asking Griffin whether she believed "assault weapons" should be legal. Griffin pointed out the fact that sportsmen and collectors favored the AR-15.

"You can't shoot anything with an AR-15 and get any meat. That's not sportsmanship. I'm just saying," co-host Whoopi Goldberg claimed.

Griffin continued to push back, saying that while she agreed more could be done to keep guns out of the hands of bad people, shootings were clearly a societal problem - and she argued that one thing that was impossible to ignore was the fact that so many mass shooters fit the same general profile: male loners in their teens-to-mid-forties.
WATCH:

Alyssa Farah Griffin notes that "we have a crisis of young men in this country" pointing to how most mass shooters fit a certain profile.
She notes "the left will not touch the mental health side" of the issue and gets pounced on by Sunny, who proves her point. pic.twitter.com/t6kfLBYfkc

- Nicholas Fondacaro (@NickFondacaro) February 15, 2023

Noting that, statistically, young men were less likely to graduate college than young women and more likely to be arrested or die by suicide, she added, "What is going on with young men in our country that is allowing this to happen, because guns are part of the problem absolutely, but this is where I worry the left and the right bear some responsibility."

"The left will not touch the mental health side of this and the right will not touch the gun side," Griffin asserted, prompting objections from co-hosts Joy Behar and Goldberg - but then Hostin jumped in and proved Griffin's point.

"We've said this many many times, let's stop blaming mental health," Hostin said, arguing that people with mental health issues were more likely to be the victims of crimes than the perpetrators.

"People who shoot up Sandy Hook, that's not a person in their right mind," Griffin pushed back.

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'The View' Piles On Republican Host For Daring To Say Mental Health Is Related To Shootings

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Wednesday's broadcast of "The View" got heated when the topic turned to the Monday evening shooting at the Michigan State University campus - and Republican co-host Alyssa Farah Griffin, in addition to defending the Second Amendment, dared to suggest that mental health played a role in mass shootings.

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Based on the increase in the U.S. population, there are now some one million people with serious mental illness living among the general population who, 60 years ago, would have been treated in state mental hospitals. Multiple studies have reported that, at any given time, between 40% and 50% of them are receiving no treatment for their mental illness. With the best of intentions and the worst of planning, America has emptied out its public psychiatric hospitals without ensuring that the released patients would receive the necessary treatment to control their symptoms. What did we think would happen?

Now we have two more mass shootings, committed over a 13-hour period. In El Paso, Texas, 20 people were killed in what authorities have called a hate crime, while in Dayton, Ohio, the death toll is nine. One database claims these were the 21st and 22nd mass killings in the U.S. in 2019. Such databases vary depending on the number of dead required to meet the definition.

Copyright ©2023 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8

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Opinion | Mental Illness and Mass Murder

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Based on the increase in the U.S. population, there are now some one million people with serious mental illness living among the general population who, 60 years ago, would have been treated in state mental hospitals. Multiple studies have reported that, at any given time, between 40% and 50% of them are receiving no treatment for their mental illness.

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Two years ago this month, a young man who killed his mother and took her guns walked into an elementary school in Newtown, Conn., and began firing. When the smoke cleared, Adam Lanza, 20, had shot and killed 26 people, including 20 children, in the five minutes between the time he shot his way into the school and the time police arrived. He then shot himself dead.

After a lengthy investigation, a Connecticut Commission concluded there was "no clear indication" of why young Lanza killed either his mother or the children at Sandy Hook Elementary School. He wasn't on drugs, but he was inevitably described as "a loner" who had observable behavior problems and had professed to admire mass murderers. He studied previous school shootings and planned his shooting rampage and subsequent suicide at some length before that Friday morning.

The young man, like every school, mall and mass shooter before him, both here and in Europe, was "mentally unbalanced," or what most would call "crazy." Teachers and others had been troubled by what they saw in him and his father later said he thought there was reason to believe that he was slipping into schizophrenia. Those who suggested that it was his "mental condition" - like the mental condition of the earlier shooters in Colorado and Virginia - that policymakers should look to for "a clear indication" of why he did what he did were dismissed by others who think such incidents can be prevented by restricting the ownership of guns.

Those who think that, and who ignore the fact that young Lanza took guns from his dead mother, further dismiss the fact that the perpetrators of every one of such incidents over the past two decades were not criminals but young men with severe mental problems.

There was nevertheless hope that the nation's mental health system might be reformed to make it easier to identify and treat the dangerously mentally ill to minimize the danger in future. While Democrats in Congress focused on guns, Republicans undertook a yearlong attempt to draft legislation to address the reality that the nation's mental health care system had been dismantled, and was no longer capable of dealing with the dangerously mentally ill, either as outpatients or in hospitals.

Many are homeless or in jail or prison, where they get little if any treatment. They are estimated to account for a thousand homicides every year and several thousand suicides. It's not that Americans don't spend money, and a lot of it, on mental health, but that most federal and state spending is directed to helping those who may have had a bad hair day, not those who really need real help.

With few exceptions, two years later almost nothing has been done to deal with this problem. Dozens of states last year actually cut funding to mental health care. Congress punted. Michael Bloomberg, the former mayor of New York City, continues to spend from his many millions to restrict ownership of guns, when he could be spending, and advocating, something that would actually do something good and effective: the rebuilding of the nation's mental health system. This could actually save lives. Feel-good gun control fantasies won't.

If politicians and those to whom they listen want to pay real tribute to Adam Lanza's victims on the second anniversary of their deaths, they could tackle the difficult but possible job of creating a mental health care system capable of identifying and getting treatment for people like Adam Lanza before they kill.

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EDITORIAL: Mental health care can reduce mass shootings

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Two years ago this month, a young man who killed his mother and took her guns walked into an elementary school in Newtown, Conn., and began firing. When the smoke cleared, Adam Lanza, 20, had shot and killed 26 people, including 20 children, in the five minutes between the time he shot his way into the school and the time police arrived.

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What Are the Real Warning Signs of a Mass Shooting?

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While some mass shootings are committed by people with diagnosed mental illnesses, a life crisis is a better predictor of violence, researchers say.

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Wreaths memorialize the victims of a mass shooting in Dayton, Ohio. (Jahi Chikwendiu/The Washington Post)

Every time a mass shooting occurs, the country talks about mental health. Many politicians are quick to point to the shooters' disturbed minds. News reporters probe for "loner" tendencies or signs of instability.

"Mental illness and hatred pull the trigger. Not the gun," said President Trump on Monday, after two mass shootings in less than 24 hours.

So is mental illness to blame for America's mass shootings? Not according to research.

Some mass shooters have a history of schizophrenia or psychosis, but many do not. Most studies of mass shooters have found that only a small fraction have mental health issues. And researchers have noted a host of other factors that are stronger predictors of someone becoming a mass shooter: a strong sense of resentment, desire for infamy, copycat study of other shooters, past domestic violence, narcissism and access to firearms.

"It's tempting to try to find one simple solution and point the finger at that," said Jeffrey Swanson, a professor in psychiatry and behavioral sciences at Duke University School of Medicine. "The fact that somebody would go out and massacre a bunch of strangers, that's not the act of a healthy mind, but that doesn't mean they have a mental illness."

As mass shootings have become more common in recent years, their connection to mental health has been increasingly scrutinized by the FBI, police departments, forensic psychiatrists, mental illness experts and epidemiologists.

In a 2018 report on 63 active shooter assailants, the FBI found that 25 percent had been diagnosed with a mental illness. Of those, three had been diagnosed with a psychotic disorder. In a 2015 study that examined 226 men who committed or tried to commit mass killings, 22 percent could be considered mentally ill. A report from the conservative think tank the Heritage Foundation estimated that a majority of mass shooters have mental illness, based in part on looser definitions and retroactive assessments.

Research has long debunked another common explanation among politicians: that violent video games are driving the mass shooting crisis. The idea was floated again by House Minority Leader Kevin McCarthy (R-Calif.) and Trump, who talked of restricting "gruesome and grisly video games."

There is, however, no statistical link between playing violent video games and shooting people, said Jonathan Metzl, director of the Center for Medicine, Health and Society at Vanderbilt University.

A 2004 report conducted by the Secret Service and the Education Department found that 12 percent of perpetrators in more than three dozen school shootings showed an interest in violent video games. Despite a continuing lack of a link, lawmakers and public figures continue to blame the gaming industry.

"When politicians like President Trump perpetuate this narrative, to me, it is the height of irresponsibility, because it's perpetuating a falsehood," Metzl said.

The eagerness to blame mental health and video games means society is searching for answers in the wrong places, experts say.

At the height of the reflex to blame video games - following the Columbine High School shooting in 1999 - a Gallup poll found that 62 percent of adults nationwide believed entertainment was the major catalyst for the tragedy and that 83 percent supported restrictions on the sale of violent media to children. President Bill Clinton even called for an investigation on how the advertising industry sold violent entertainment.

Last year, a Post-ABC poll on mass shootings found that 57 percent of people believed shootings were a reflection of failures to identify and treat people with mental health problems. Meanwhile, 28 percent thought it reflected inadequate gun-control laws.

"The irony is clearly we do need more robust mental health system," said Arthur C. Evans Jr., a psychologist who heads the American Psychological Association. "But that's separate and apart from these shootings."

Almost 5 percent of the U.S. population suffers from a serious mental illness in a health-care system that most clinicians say severely under-prioritizes mental health. That has often left those in crisis begging insurers and providers for help. More than 60 percent of counties in America don't have a single psychiatrist. Only 43 percent of adults in the United States with a mental health condition received help in the past year.

People with serious mental disorders are 3.6 times as likely to exhibit violent behavior, according to the National Epidemiologic Survey on Alcohol and Related Conditions. But they are far more likely to be the victims of violence - at 23 times the risk, compared with the general population. A study published in the journal Annals of Epidemiology found that "the large majority of people with mental disorders do not engage in violence against others, and that most violent behavior is due to factors other than mental illness."

"We like to think that anyone who kills others is somehow mentally ill," said Phillip Resnick, who served as a forensic psychiatrist in cases including Oklahoma City bomber Timothy McVeigh and Unabomber Ted Kaczynski. In an interview last year, Resnick said, "you have to remember, people kill for all sorts of reasons. They kill for profit or love or greed."

Mental health advocates say comments such as Trump's labeling shooters as "mentally ill monsters" can exacerbate false stereotypes about the mentally ill.

"When you blame people with mental illness for things like mass shootings, it's not just untrue," said Angela Kimball, head of the National Alliance on Mental Illness. "It keeps people from seeking help even when they need it. It spreads unjustified fears about the mentally ill and worsens the stigma around it."

The 2018 FBI study found that shooters typically experienced several stressors in the year before they attack: financial pressures, fights with classmates or co-workers, and substance abuse. And on average, shooters displayed four to five concerning behaviors that those around them could notice - the most frequent being behavior related to mental health, interpersonal conflicts or some sign of violent intent.

Researchers point out that other countries have similar rates of mental illness but a small fraction of America's gun deaths. Similarly, video games are widespread in Europe and Asia, yet their rates of gun deaths are much lower than that in the United States.

Epidemiologists say that what sets the United States apart from the rest of the world is guns.

America has nearly 400 million civilian-owned firearms, or 120.5 guns per 100 residents - meaning that the country has more guns than it has people. The second-closest country, Yemen, had 52.8 guns per 100 residents, according to the Small Arms Survey.

"Mental illness is not the real issue, because mental illness is something that happens across the globe. Mass shootings? Not so much," Kimball said. "The sad truth is that in America, it's easy to get a gun. It's very difficult to get mental health care."
Timothy Bella contributed to this report. Read more Police probe whether shooter's sister was target in rampage Mexico says eight of its citizens were killed in El Paso, plans legal action to protect Mexicans in the U.S. A mother died shielding her infant. The father died shielding them both.

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Are video games or mental illness causing America's mass shootings? No, research shows.

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Every time a mass shooting occurs, the country talks about mental health. Many politicians are quick to point to the shooters' disturbed minds. News reporters probe for "loner" tendencies or signs of instability. "Mental illness and hatred pull the trigger. Not the gun," said President Trump on Monday, after two mass shootings in less than 24 hours.

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Nikolas Cruz, who methodically went up and down the hallways of his former Florida high school on Valentine's Day, killing 17 people, had a history of threatening others. Adam Lanza, who killed almost two dozen children in a Connecticut school in 2012, struggled with developmental disorders and was on psychiatric medication, which he had stopped taking. Jiverly Wong was suspected of suffering from paranoia before he walked into the American Civics Association in New York in 2009 and murdered 13 people.

The most recent mass killing in Florida last month has reignited the debate over the extent to which mental illness plays a role in such violence, and even about what is meant by mental illness. The horror at Marjory Stoneman Douglas High also is shining a light on the contradictory views among prominent criminology and mental health experts about mental illness as a risk factor in mass shootings.

In a study of 185 public mass shootings- defined as an incident in which four or more people are killed at a public location - from 1900 through 2017 criminologist Grant Duwe found that 59 percent were committed by people who had been diagnosed as mentally ill or showed signs of having a serious mental disorder before the attack.

"Typically what we see with those who carry out a mass public shooting is that they do suffer from a mental disorder, in some cases it's diagnosable, or there's some information from friends and family that indicates they suffered from mental illness," said Duwe, who is the research director for the Minnesota Department of Corrections and author of "Mass Murder in the United States: A History."

"Paranoid schizophrenia is what is more common among these individuals," Duwe told Fox News. "They feel like large groups of people are out to get them, and that they are responsible for making their life miserable. We also see that individuals who do this are loners, they're not trusting, so they don't have close friendships of social relationships."

Mother Jones, the left-leaning publication, compiled a database of mass shootings going back to 1982, and found that about half involved some form of "mental health issue." They included people who had been diagnosed with serious conditions, but also those who had domestic violence and work conflict histories.

An analysis by Everytown for Gun Safety released last year showed that in mass killings between January 2009 and December 2016, the shooter displayed at least one red flag, or troubling behavior, in 42 percent of cases.

At the same time, many studies on mass shootings and mental illness show a smaller link.

Many widely cited studies, including some conducted by the National Institutes of Health, on gun violence show that anywhere between 4 and 20 percent of the incidents are caused by people with a serious mental illness.

Jeffrey Swanson, a professor in psychiatry and behavioral sciences at Duke University who specializes in gun violence and mental illness, conducted a study funded in part by the National Institutes of Health that found that 4 percent of gun and other violence is traceable to schizophrenia, bipolar disorder and depression - the three mental health conditions most frequently found in violent incidents.

Swanson says the role of mental illness is overplayed after a shooting that grips at the country.

A mass shooting is so disturbing, so irrational, and horrifying, people want to know why is happened, and mental illness is the perfect master explanation.
- Jeffrey Swanson, professor in psychiatry at Duke University

"A mass shooting is so disturbing, so irrational, and horrifying, people want to know why it happened, and mental illness is the perfect master explanation," said Swanson to Fox News.

What is more common among perpetrators of mass shootings, Swanson said, are potentially red flag behaviors such as festering anger, alienation, and bitterness over being bullied, perhaps, that do not meet the threshold of a mental disorder -- and that may not be perceptible even to those close to the person -- but that can lead to violence. Substance abuse is a common thread in mass shootings, found to be a factor in nearly 40 percent of shooters.

"If we were to cure mental illness, all of it, tomorrow, how much of our violence problem would go down? It would go down about 4 percent," said Swanson, who has studied the issue for the National Institutes of Health. "The mass shooters, with some exception, have been angry, alienated, emotionally troubled young men who act out these incredibly deviant cultural scripts and have access to firearms."

"There are tons of people who are risky, who are angry or suicidal, but who would pass a background check," Swanson said. "They don't have a felony conviction, they've never been involuntarily committed. How do you make sure dangerous people don't get access to firearms?"

Duwe argues that the role of mental illness in mass shootings is underplayed.

"Part of the blowback with connecting mental illness to mass shootings is the fear that mentally ill people will be stigmatized," Duwe said, adding that the concern is a valid one. "That's what we try to be careful with, most of the people with serious mental illness are not violent."

"But we should not ignore the connection between mental illness and mass shootings that is very real," said Duwe, who recently co-authored an op-ed on the issue in The Los Angeles Times. "The issue has become very politicized, like tribal warfare."

A major obstacle to a better system for predicting who might commit a mass shooting, experts say, is that it is relatively rare, and more funding is needed to study it more in-depth.

Many studies differ in their definition of mental illness, with some looking at diagnosable conditions, others only at serious ones such as paranoid schizophrenia, and still others taking a broad approach, including more common things such as attention deficit disorder and anxiety.

"It's an elastic boundary, a rubber ruler," Swanson said. "About 48 million people in the U.S. have some kind of diagnosable mental illness."

We should not ignore the connection between mental illness and mass shootings that is very real. The issue has become very politicized, like tribal warfare.
- Grant Duwe, research director for the Minnesota Department of Corrections

What is more, not all studies or news reports look at the same categories of violence when addressing the role of mental illness, Duwe and Swanson noted.

Some look at all violence, others look at mass killings (which may or may not involve guns), and still others look at mass shootings that don't occur in a public place or that targets strangers - such as when a disgruntled fired employee commits workplace violence or someone kills four or more people in a household or when a criminal kills several people in the course of say a robbery.

"There has not been systematic assessment of mass shooters" that would meet scientific criteria, Swanson said. "We often are operating on the basis of sketchy information" about a perpetrators'odd behavior.

Gun rights advocates say the answer is not curbing Second Amendment rights, but acting more responsibly when behavioral "red flags" are observed, as they were in the case of Cruz in Florida. They argue that the massacre likely would never have happened if law enforcement officials had simply done their job and investigated numerous leads suggesting Cruz had mental illness issues.

One approach gaining momentum is Red Flag Laws, which allow relatives and officials to seek a court order to remove guns from dangerous people. Five states have the laws, and Red Flag measures are pending in roughly 20 others.

In a written statement, the FBI said a person close to Cruz contacted the agency's tip line Jan. 5 to report concerns about "Cruz's gun ownership, desire to kill people, erratic behavior, and disturbing social media posts, as well as the potential of him conducting a school shooting."

Florida does not have a Red Flag Law.

"Under established protocols, the information provided by the caller should have been assessed as a potential threat to life," the FBI said.

In a speech at the Conservative Political Action Conference on Thursday, the leader of the National Rifle Association Wayne LaPierre said that opponents of gun rights want to "sweep under the carpet" the failure of school safety, families "and even the unbelievable failure of the FBI" to prevent the shootings. LaPierre made the case that there is room for the gun lobby and gun control advocates to find common ground.

Efforts by Fox News to get a comment from the NRA were unsuccessful.

Bonnie Zampino, a behavioral health professional who trains educators, among others, on how to manage people with mental illness and behavioral issues, said it's important that school officials, counselors, families and law enforcement work together and establish communication lines when a young person begins exhibiting so-called red flag that might lead to violence.

Often, she said, efforts to address such behaviors are disjointed or have no follow-up.

"This young man was exhibiting behaviors that would indicate that he had been exposed to trauma in life, he received medical care, he was evaluated, they didn't find the need for further care," said Zampino of Cruz, based on published information.

"It's our job to be the professional who can look at the behavior, meet the need, stop the aggression," said Zampino, who has an autistic child. "But [too often] we're not paying enough attention, we're not talking to one another."

"Here we help teachers understand when they see a child coming into their classroom that clearly shows an issue and they're being aggressive, how to get ahead of that behavior and deal with the trauma and how not to trigger the aggression," she said. "We teach teachers proactive approaches."
The Associated Press contributed to this report.

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How prevalent is mental illness in mass shootings?

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Nikolas Cruz, who methodically went up and down the hallways of his former Florida high school on Valentine's Day, killing 17 people, had a history of threatening others. Adam Lanza, who killed almost two dozen children in a Connecticut school in 2012, struggled with developmental disorders and was on psychiatric medication, which he had stopped taking.

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It seems like there's one thing everyone agrees on after a mass shooting: The shooter must have been mentally ill. President Barack Obama said as much in his reaction to the Umpqua Community College shooting on Thursday: "We don't yet know why this individual did what he did, and it's fair to say that anybody who does this has a sickness in their minds, regardless of what they think their motivations may be."

But what if the assumption is wrong, or at least misses the nuance of the issue?

Jonathan Metzl, a professor of psychiatry, sociology, and medicine, health, and society at Vanderbilt University, argues that mental illness is often a scapegoat that lets policymakers and the public ignore bigger, more complicated contributors to gun violence. Metzl, who reviewed the research on mass shootings and mental illness in a paper for the American Journal of Public Health, points to studies that show people with mental illness are more likely to be victims - not perpetrators - of violence, and that very few violent acts - about 3 to 5 percent - are carried out by the mentally ill. And while mental illness can be a contributor to some violent behaviors, other factors - such as substance abuse, poverty, history of violence, and access to guns - are much stronger predictors of violence and shootings.

For example, some studies have found that people with schizophrenia are more likely to commit violent acts. But other research has found that this propensity toward violence is almost entirely due to substance abuse, a common problem among people with schizophrenia who are self-medicating. And substance abuse - particularly when it involves alcohol - can make someone much more likely to commit violent crime.

But the focus on mental illness after mass shootings lives on. In a 2013 Gallup poll, 48 percent of Americans said failure of the mental health system was "a great deal to blame" for mass shootings, compared with 40 percent who cited easy access to guns, 37 percent who cited drug use, and 29 percent who cited the spread of extremist viewpoints on the internet. This may reflect, Metzl suggested, the inability of many Americans to understand why somebody sane would attack and kill strangers.

To dive deeper into the issue, I spoke with Metzl about the research and his thoughts on mass shootings. This interview has been edited for length and clarity.

People with mental illnesses are more likely to be victims of violence, not perpetrators

German Lopez: What do we know about a connection between mass shootings and mental health?

Jonathan Metzl: In the work that I do, I construct arguments that call on the growing body of gun research in fields such as medicine and public health.

One is that there's no real way of predicting a mass shooting. Mass shootings are very often statistical anomalies. The trouble people get into a lot of times is that they think, "Oh, he must have been crazy or something, and a psychiatrist should have been able to see him before and predict it." That's a complete miss, unfortunately.

As an aggregate group, people with mental illness are less likely than the general population to shoot other people, and they are far more likely [to be] victims of violence rather than perpetrators of violence. So I think this intense psychological profile of mass shooters as a way of preventing other mass shootings is really the wrong path to go down, even though it's understandable.
"People with mental illness ... are far more likely [to be] victims of violence rather than perpetrators of violence"
Point number two is that there is research that shows a certain proportion [ up to 60 percent] of mass shooters do have some kind of psychiatric or psychological symptoms. As an aggregate group, mass shooters are very often young, white, paranoid men who've had histories of depression and possibly sometimes psychosis. So at least there are profiles that can allow you to aggregate some of these mass shooters into particular groups.

But there are a lot of other factors that aren't linked to mental illness that are equally predictive if not more predictive: access to firearms, substance use or abuse, and past history of violence or arrests. These are all far more predictive than a diagnosis of mental illness - and they're more preventive in the long run.

So while I do think there's a particular profile that many mass shooters fit into, the problem we get into when we diagnose the individual mass shooter and say mental illness is the cause is twofold. One, mental illness is really not causal for shootings; there's no mental illness that causes people to shoot other people. Two, focusing on mental health takes the shooting out of context. If you look at recent mass shooters, whiteness, for example, is a theme that runs through many, many mass shooters, but we would never say whiteness is a cause of this. It shows we collapse and oversimplify the roles of mental illness in shootings, and mass shootings in particular.

German Lopez: The way I look at it is that there are some serious mental illnesses like psychosis or schizophrenia that might contribute to mass shootings, but the vast majority of people with these conditions are not going to participate in an event like this. Is that correct?

One of the major symptoms of schizophrenia is what are called negative symptoms: people with schizophrenia, they tend to stay home because they lack energy. So even though people tend to jump on schizophrenia as the cause of the cause of many mass shootings, if you look at people diagnosed with schizophrenia as an aggregate group, people with schizophrenia aren't more likely to shoot other people than are sane people. In other words, we might do better by looking at predictive factors from people we deem sane. I can't say that more clearly.

I understand why people jump to this narrative. It's because mental illness is some sort of contributor. And killing strangers seems so far outside the bounds of civilized society and sanity that looking to insanity is understandable. But at the same time, there's no causal link between the diagnosis of something like schizophrenia and shooting somebody else.

Substance abuse is a big contributor to violence

German Lopez: Are there any particular mental health diagnoses that you think can predict violence?

Jonathan Metzl: I don't think there's any one psychiatric diagnosis - except for substance abuse. A lot of studies have shown that the presence of alcohol in the context of an argument when guns are present increases the chance that there's going to be a shooting by five to seven times. That's probably the most important psychiatric diagnosis to look at.

Antisocial personality disorder has also in the past been associated with other kinds of killings. But again, we're talking about 32,000 gun deaths in a year - so it's really hard to pin down a specific diagnosis.

German Lopez: What do you think of mental illness background checks for guns?

Jonathan Metzl: I think background checks are important tools to help stem gun crimes, and they're often very effective. That's not just because of the diagnosis of the mental illness, but because there are predictive factors in gun violence, like history of gun violence and history of substance abuse, that these checks can pick up.

Attempts to stop gun violence should focus on comprehensive factors, not just mental illness

German Lopez: It seems like you want to focus on a comprehensive set of factors. What kind of other factors are you thinking of?

Jonathan Metzl: Well, we know that most gun deaths occur within social networks [such as family, relatives, friends, enemies, and neighborhoods], so we can look at particularly vulnerable social networks. Do people live in an area where there's a lot of tension or a lot of violence? If that's the case, we can intervene on a sociological level - not try to diagnose everybody with some mental illness.

Access to firearms is huge, particularly in terms of gun suicides. [The research shows places with more guns have more homicides, and many experts believe the correlation is at least partially causal.]

Has somebody attempted suicide in the past? That's another factor to consider.

Another is whether somebody has a history of violence. It's much more predictive of someone's future propensity to commit violence than is a diagnosis of mental illness. So I'd ask someone if they have a history of assault or a history of arrest.

Of course, there's substance abuse. That's another very important factor to consider.

We need to acknowledge that it's complex. I think the question is whether we want to prevent the next mass shooting, which is very hard to do, or do we want to do things to prevent gun deaths across the country, in which case everyday violence is what we want to target.

German Lopez: Is your hope that targeting gun violence broadly, including homicides and suicides, could help prevent mass shootings from occurring?

Jonathan Metzl: Yes. I think that's absolutely right.

German Lopez: What would you say to people and lawmakers talking about mental illness as the big contributor to mass shootings?

Jonathan Metzl: Let me be clear. I think mental illness is a factor, clearly, in many mass shootings. But I think there is no one diagnosis that's linked to mass shootings, so there's no psychiatric test that can prevent a mass shooting.

Mass shootings, as traumatic and horrible as they are, are statistically very rare, so they're very hard to predict. So I think we're far better off as a society trying to prevent everyday shootings - and when you look at everyday shootings, there really is no strong correlation between mental illness and shootings.

So mental illness is important, but it becomes a scapegoat. It becomes the one thing we can all agree on - "Oh, yeah, it must be crazy people!" - but I feel compelled to resist that narrative because it gets us off the hook from looking at society, culture, laws, and other things that hit closer to home for people.

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Everyone blames mental illness for mass shootings. But what if that's wrong?

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It seems like there's one thing everyone agrees on after a mass shooting: The shooter must have been mentally ill. President Barack Obama said as much in his reaction to the Umpqua Community College shooting on Thursday: "We don't yet know why this individual did what he did, and it's fair to say that anybody who does this has a sickness in their minds, regardless of what they think their motivations may be."

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RALEIGH, N.C. (WGHP) - On October 12, 2022, a 15-year-old boy allegedly killed 5 people and wounded three others in a mass shooting that spanned several miles through a Raleigh neighborhood.

Very little information has been released specifically about the suspect, who was shot during the event and has remained in the hospital since. The Raleigh Police Department released information about the path the shooter took and the order in which the victims were confronted, the massacre allegedly starting with the death of his 16-year-old brother, James Taylor.

Days later, two were killed and several more injured in a shooting at a St. Louis school. In a note left by the alleged shooter, he referred to himself as a "perfect storm for a mass shooter," saying that "he had no friends, no family, no girlfriend and a life of isolation." His family discussed his mental health issues and that he had been hospitalized in the past.

While discussions of mental health and how stigmas around mental health could play a part in the prevention of future tragedies become amplified after shootings, experts say mass shooters are often either not mentally ill at all or that mental illness was just one of many factors at play.

PsychiatryToday writes that mass shooters are often terrorists, with many being radicalized or motivated by specific ideologies, not usually people suffering from serious mental illness. They wrote, in the wake of the Uvalde shooting, that estimates put about 20% of mass shooters as having "serious mental illness" which means 80% either have less serious mental health issues or no known mental illness at all.

"Further, the contribution of serious mental illness to violent crimes involving a gun may be as low as 3%. In fact, individuals with mental illness are more likely to be the victims -not the perpetrators-of violent crimes," the article explains. "What we are saying is that serious mental illness is not the issue in the majority of these cases."

'Serious mental illness'

There are a broad spectrum of mental illnesses. Mental illness is defined as disorders that impact your mood, thinking and behavior.

Most people will experience mental health issues in their lifetime. That is distinct from mental illness, which is defined as "ongoing signs and symptoms [that] cause frequent stress and affect your ability to function."

Serious mental illness is defined as "a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities."

Many mass shooters are reported to have had mental health struggles, which is different from "serious mental illness." Sudden personal crises like divorce, home instability or the loss of a job are more common inciting factors for acts of mass violence, the New York Times reported.

In a 2020 study, the National Institute of Mental Health estimated there were 14.2 million people suffering from serious mental illness in the United States, versus 52.9 million suffering from "any mental illness." Young adults had a higher prevalence of serious mental illness than older adults.

Mentally ill vs. 'insane'

Many people might refer to a suspect accused of committing acts of mass violence as "crazy" or "insane." However, doing things that are morally or legally wrong is not a symptom of mental illness, and to be mentally ill or have mental health struggles is not the same as being insane.

Criminal insanity is defined by Cornell Law as a "mental illness or disease that makes it impossible for a defendant to know they were committing a crime or to understand that their actions are wrong."

The Legal Dictionary at law.com describes it as "mental illness of such a severe nature that a person cannot distinguish fantasy from reality, cannot conduct her/his affairs due to psychosis, or is subject to uncontrollable impulsive behavior."

The suspect in the shooting at a supermarket in Buffalo is accused of having planned the attack online for months. Witnesses during the trial of Nikolas Cruz, who was sentenced to life in prison last month for the shooting at Marjory Douglas Stoneman High School, said that he "faked brain damage during testing and that he was capable of controlling his actions, but chose not to."

Between the elaborate planning required for acts of mass violence and the presence of manifestos, many mass shootings are neither "impulsive" nor a result of a detachment from reality, with their written statements used as evidence of their mental state at the time of the crime.

James Holmes, the man who opened fire on an Aurora, Colorado movie theater during a screening of "The Dark Knight Rises" in 2012, used an insanity defense. Ethan Crumbley, who killed four students and wounded several others at his Michigan high school in 2021 was also reportedly going to pursue that defense.

Holmes was found guilty, and a psychiatrist who worked with him accused him of lying to her about his desire to kill people prior to the shooting, which indicates an element of premeditation that is in conflict with the legal definition of insanity.

Crumbley pleaded guilty in October to all charges, saying "yes" when asked if he "knowingly, willfully and deliberately" chose to shoot his classmates.

Crumbley's parents are also charged with involuntary manslaughter due to the allegations that the school had made them aware that Crumbley needed mental health care and they ignored it, instead buying the teenager a gun as a "Christmas present" and telling him to not "get caught" looking up ammunition on his phone at school.

"Put simply, they created an environment in which their son's violent tendencies flourished. They were aware their son was troubled, and then they bought him a gun," prosecutors said in a court filing.

Crumbley will be sentenced in February, and his mental health is among several mitigating factors that will determine his sentence.

As PsychiatryToday writes, many mass shooters are motivated by ideology and several different types of ideology have been cited as a motivation for mass violence across the nation and the world in recent years.

Bigotry

Among ideological motivations for mass shootings, many of them fall under the heading of "bigotry." These range from racism to homophobia to antisemitism.

On May 14, a young white man allegedly shot and killed 10 Black people at a supermarket in Buffalo, New York. He had allegedly researched where he would commit his crime, picking a neighborhood that was demographically less than one percent white.

A manifesto was found, and, in it, the suspect discussed the "Great Replacement" theory, which is a racist conspiracy that alleges that white Christians are being "replaced" by ethnic or religious minorities. It is a topic that Tucker Carlson has discussed on his show, for which he faced criticism in the wake of the shooting.

The suspect has been charged with domestic terrorism.

The "Great Replacement" narrative was also a factor in the mass shooting at a Wal-Mart in El Paso that killed 22 and wound dozens more. The suspect posted a " racist screed railing against an influx of Hispanics into the U.S. " prior to the shooting, according to the investigators.

It was also the motivation for the attack on two mosques in Christchurch, New Zealand, in 2019 that killed 50 and wounded 40 more, carried out by an Australian man who was a self-described white supremacist who wrote an anti-immigrant, anti-Muslim manifesto before the attacks.

The massacre of churchgoers at a Black church in Charleston was also motivated by white supremacy. Dylann Roof did not allow jurors to hear evidence about his mental health and he was found competent to face the death penalty.

Antisemitism is another ideological motivation that drives mass violence. A gunman opened fire on the Tree of Life synagogue in Pittsburgh in 2018, killing 11 people in what was called "America's deadliest antisemitic act."

In 2016, a gay nightclub in Orlando was targeted and 49 people were killed, many of them LGBTQ. The suspect was described by an ex-wife as abusive. Studies have shown that as many as 2/3rds of mass shooters have a history of domestic violence.

"Incels"

Another ideology that has led to mass violence in recent years is that of "incels." Incels, which is a portmanteau of "involuntary celibate," are a group that promotes violence and hatred, primarily against women but also minorities and LGBTQ people.

Much of their ideology is based on their own sense of isolation because they do not have romantic or sexual partners or connections, blaming women and minorities for their lack of social success.

This group came to the forefront in 2014 when Elliot Rodger, the son of a Hollywood producer, killed six people by shooting or stabbing. In a manifesto, Rodger said he had "no choice but to exact revenge on the society" that he believed "denied" him sex and love.

"I am the true victim in all of this. I am the good guy," he said.

Rodger inspired others within the incel movement, including Alek Minassian who used a van to kill 10 people in 2018 in Toronto and a Canadian teenager who allegedly killed a woman with a machete at a massage parlor.

Several men who have identified with the incel movement have attempted or plotted mass violence but have been caught before they were able to enact their plan. Incels have also been responsible for other non-lethal attacks, mostly on women.

Dissatisfaction with relationships also factored into October's school shooting in St. Louis, but the alleged shooter's note did not specifically reference incels. Sex also played a factor in the killing of several massage parlor workers in Atlanta, a case in which it was speculated the suspect had a "sex addiction."

Non-ideological violence

Any act of mass violence where the suspect might personally know the victims, rather than a location being chosen for a demographic purpose, would hold a more personal, vendetta-based motivation. These don't have a specific ideological tie but can be motivated by sudden individual crises.

These can be workplace related, such as the mass shooting at a railyard in San Jose, or related to issues of bullying, unhappiness or hatred of school, like in the Columbine shooting.

" Focusing on mental illness, particularly psychotic illness, when talking about mass school shootings risks is missing other factors that contribute to the vast majority of cases, as well as exacerbating the already widespread stigma surrounding severe mental illness," said Paul Appelbaum, professor of psychiatry, medicine and law at Columbia University.

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Mass shootings are not a mental health problem. Here's why experts say they happen

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RALEIGH, N.C. (WGHP) - On October 12, 2022, a 15-year-old boy allegedly killed 5 people and wounded three others in a mass shooting that spanned several miles through a Raleigh neighborhood. Very little information has been released specifically about the suspect, who was shot during the event and has remained in the hospital since.

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Kevin Neal's family knew he was mentally ill, but they never thought he would kill five people and attack an elementary school in rural northern California. But Neal committed both those acts on Tuesday, and it has left his family asking some very difficult questions.

"We got, 'I can't take it anymore' a thousand times - like when do you know if it's real?" asked Sheridan Orr, Neal's sister.

Orr said her brother had made such statements for nearly 20 years, and the family came to consider it to be an empty threat. Though they continued to pressure him to receive help for his mental health, he seemed unwilling to pursue treatment.

Experts say it is difficult to know what to do in those situations, but Dr. James Alan Fox, a criminologist with Northeastern University and and author of "Extreme Killing: Understanding Serial and Mass Murder," said it's dangerous to assume that the mentally ill tend to commit these shootings.

"There's not really a correlation," said Fox, who maintains a database on mass shootings. "We like to think that these people are different from the rest of us. We want a simple explanation and if we just say they're mentally ill, case closed. Because of how fearful dangerous and deadly their actions are, we really want to distance ourselves from it and relegate it to illness."

Despite this, Orr's question is one that is now dogging Washington, as politicians discuss how to resolve a seemingly unending number of mass shootings. And now Republicans have framed the issue as a mental health crisis, rather than a gun control problem.

President Donald Trump pushed that perspective after the shooting in Sutherland Springs, Texas, stating "mental health is your problem here" and calling the shooter "a very deranged individual."

Related: Texas Shooting Exposes Gaps in Gun Background Checks

This week Sens. Jon Cornyn, R-Texas, and Chris Murphy, D-Conn., revealed that they are working to pass bipartisan legislation that would improve background-checks for gun sales by incentivizing states to upload and verify the criminal and mental health records to the National Instant Criminal Background Check system.

Fox is skeptical this will bring about any change.

"Most mass murderers don't have criminal records or mental health treatment," said Fox. "The reason we should have [background checks] occurs every day in America. We have an average of 40 shooting homicides a day. That's the reason, not the occasional mass shooting."

Experts say that the public has to be careful with how it thinks about gun violence and mental illness, otherwise it could stigmatize those who suffer from mental health issues.

And considering that suicide by firearm killed 313,641 people between 1999 and 2015, according to the National Center for Injury Prevention, it appears much more likely that the mentally ill will hurt themselves than others.

Dr. Jonathan Metzl, director of the Center for Medicine, Health and Society at Vanderbilt University, said that these mass shootings highlight Americans' desire to reaffirm a stigmatization of the mentally ill as "ticking time bombs" to avoid more difficult conversations about gun violence.

"Mass shootings are horrific and terrifying," he said. "But if we really want to stop gun violence in this country, everyday gun violence is predictable and could be stopped. Ending everyday gun violence would help end mass shootings as well."

According to Everytown for Gun Safety, 34 percent of the mass shootings that occurred between Jan. 2009 and Dec. 2016 were committed by those considered to be "prohibited possessors" - or people who are unable to purchase guns because of their age, criminal conviction(s), history of addiction, a domestic abuse conviction or a person who has been "adjudicated as a mental defective" or been admitted to a mental institution.

According to a 2016 report published by the American Psychiatric Association (APA), just ensuring weapons don't enter the hands of the mentally ill isn't enough to prevent mass shootings from occurring regularly. Instead, the report suggests that public health and education campaigns are needed to teach people how to report concerning behavior to authorities and how to learn coping skills for anger and conflict resolution.

The report also proposes that policies and laws be focused on dangerous behavior that shows risk for committing gun violence, rather than a blanket category for the mentally ill, and recommends that institutions and communities develop threat assessment teams that can evaluate reports of potential danger.

As Fox asserts, the belief that the mentally ill are more likely to take part in a mass shooting appears to be a misleading. There were 198,760 homicides committed by a firearm in the United States between 1999 and 2015, according to the National Center for Health Statistic. Despite the high number, the APA report from 2016 says that fewer than 1 percent of firearm homicides are committed by a person diagnosed with a mental illness.

Metzl has researched the correlation between mental illness and gun violence, and he said that it's a tenuous connection at best.

"There's no mental illness diagnosis that explains causality," Metzl said. "There's no mental illness whose symptoms are shooting anyone else. Most mental illnesses cause people to withdraw from society."

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Connecting mental illness with mass shootings misses the point: experts

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Kevin Neal's family knew he was mentally ill, but they never thought he would kill five people and attack an elementary school in rural northern California. But Neal committed both those acts on Tuesday, and it has left his family asking some very difficult questions.

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Improved access to treatment might help many Americans, but experts say it would not prevent Las Vegas-style tragedies

Fifty-eight people are dead from the worst mass shooting in recent U.S. history. As happened after Omar Mateen killed 49 people at a nightclub with a gun, or after Dylann Roof killed nine African Americans with a gun, or after Adam Lanza killed 26 children and teachers with a gun, or after James Holmes killed 12 moviegoers with a gun, the call for action from some policy makers has centered on one commonality between these events: All of the killers had brains.

"Mental-health reform is the critical ingredient to making sure that we can try and prevent some of these things that have happened in the past," House Speaker Paul Ryan said Tuesday in response to reporter questions about mass shooters. (President Obama also proposed better mental-health care last year, when recalling the mass shooting at Sandy Hook Elementary School in 2012.)

It's worth noting that investigators and reporters have so far uncovered no psychiatric diagnoses in the background of the Las Vegas suspect, Stephen Paddock. His brother, Eric Paddock, has said to reporters that Stephen had "not a bit" of mental-illness history. But even if he did, better treatment access might not have deterred him.

While improving access to mental-health care might help lots of suffering Americans, researchers who study mass shootings doubt it would do much to curb tragedies like these. According to their work, the sorts of individuals who commit mass murder often are either not mentally ill or do not recognize themselves as such. Because they blame the outside world for their problems, mass murderers would likely resist therapies that ask them to look inside themselves or to change their behavior.

The connection between mental illness and mass shootings is weak, at best, because while mentally ill people can sometimes be a danger to themselves or others, very little violence is actually caused by mentally ill people. When the assailants are mentally ill, the anecdotes tend to overshadow the statistics. Both Jared Loughner, who shot and severely injured Representative Gabrielle Giffords, and the Aurora, Colorado, shooter James Holmes, for example, had histories of mood disorders. But a study of convicted murderers in Indiana found that just 18 percent had a serious mental-illness diagnosis. Killers with severe mental illnesses, in that study, were actually less likely to target strangers or use guns as their weapon, and they were no more likely than the mentally healthy to have killed multiple people.
Linking psychopathic killers with the mental-health system is no easy task.
"If we were able to magically cure schizophrenia, bipolar disorder, and major depression, that would be wonderful," Jeffrey Swanson, a professor of psychiatry and behavioral sciences at the Duke University School of Medicine, told ProPublica. "But overall violence would go down by only about 4 percent."

One review paper published in 2014 found that though "a history of childhood abuse, binge drinking, and male gender" are all linked to serious violence, mental illness was not, unless the person was also a drug addict. According to the National Center for Health Statistics, fewer than 5 percent of the 120,000 gun-related killings in the United States between 2001 and 2010 were perpetrated by people diagnosed with a mental illness. A 2001 study of teen mass murders found that only one out of four was mentally ill.

As Northeastern University criminologist James Alan Fox has written, in a database of indiscriminate mass shootings-defined as those with four or more victims-compiled by the Stanford Geospatial Center, just 15 percent of the assailants had a psychotic disorder, and 11 percent had paranoid schizophrenia. (Other studies have come to a higher estimate, suggesting about 23 percent of mass killers are mentally ill.)

Certainly, getting those 15 or 23 percent into treatment might chip away at their pathological thinking-and thus their potential future acts of violence. But as Fox argues, linking psychopathic killers with the mental-health system is no easy task. After studying mass shooters for decades, he's concluded that the killers have more mundane motivations: revenge, money, power, a sense of loyalty, and a desire to foment terror.

He explained further in a 2013 paper in the journal Homicide Studies:

Revenge motivation is, by far, the most commonplace. Mass murderers often see themselves as victims-victims of injustice. They seek payback for what they perceive to be unfair treatment by targeting those they hold responsible for their misfortunes. Most often, the ones to be punished are family members (e.g., an unfaithful wife and all her children) or coworkers (e.g., an overbearing boss and all his employees).

"The thing about mass killers is that they externalize blame," Fox told me. "All the disappointments, all the failures, the broken relationships, are because other people treated them wrong. They don't see themselves as being inadequate and flawed." Indeed, a recent paper similarly concluded, "very few of persons [sic] in the risky category of having anger traits combined with gun access had ever been hospitalized for a mental-health problem." That could be because they didn't think they needed help.

Other experts have echoed Fox's view. Michael Stone, a forensic psychiatrist at the Columbia College of Physicians and Surgeons and author of The Anatomy of Evil, on the personalities of murderers, recently conducted a study that found that a fifth of mass killers had a serious mental illness. "The rest had personality or antisocial disorders or were disgruntled, jilted, humiliated, or full of intense rage," as The Washington Post's Michael S. Rosenwald wrote last year. "They were unlikely to be identified or helped by the mental-health system."

Fox acknowledges that some mass killers are mentally ill. The problem is, many don't realize it or seek treatment. In his remarks to the press about mental-health care, Ryan appeared to be referring to the 21st-Century Cures Act, which contained provisions aimed at increasing the number of mental-health providers and strengthening insurance reimbursements for mental-health care.
People who wished to own guns could simply avoid attending therapy.
One thing the law does is expand Assisted Outpatient Treatment, or court-ordered mental-health care, which could help rope the mentally ill into treatment. But this route is usually only available to those with a prior history of psychiatric hospitalization or arrest.

Meanwhile, as Fox notes, mass killers tend to share a few characteristics-"depression, resentment, social isolation, the tendency to externalize blame, fascination with graphically violent entertainment, and a keen interest in weaponry"-that are common in the general population. Attempting to flag so many angsty, un-self-aware young males as potential future killers might push them closer toward violence, rather than away from it.

Finally, Fox argues that if there were some sort of law in which therapists could report their threatening patients to gun registries-as exists in California -people who wished to own guns could, in that case, simply avoid attending therapy.

Instead, a better way of predicting whether someone might be predisposed to violence is if they have a history of violence, as Swanson told ProPublica. For example, Spencer Hight, who killed his ex-wife and seven others at a football-watching party in Plano, Texas, earlier this month, had been violent at least twice, reportedly slamming his wife's face against a wall.

Compared to those with no criminal record, handgun purchasers who have at least one misdemeanor conviction are seven times more likely to be charged with a new offense after they buy their gun. Right now, only 23 states restrict people with a history of violent misdemeanors from owning firearms.

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Why Better Mental-Health Care Won't Stop Mass Shootings

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Improved access to treatment might help many Americans, but experts say it would not prevent Las Vegas-style tragedies Fifty-eight people are dead from the worst mass shooting in recent U.S. history.

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Tuesday marked yet another tragic day in America, after a gunman opened fire at an elementary school in rural Texas, leaving 19 children and two teachers dead, and dozens of family members and friends in mourning.

As the nation reels from the tragedy, politicians and pundits have been pointing fingers as to who and what is to blame for these relatively rare but increasingly common public mass casualty events.

At the forefront of the debate is the role of mental health in these incidents, with some legislators asserting that such atrocities are the result of the nation's mental health crisis.

"We have a problem with mental health illness in this community," Texas Gov. Greg Abbott said on Wednesday.

However, physicians, psychiatrists and other leading experts told ABC News that it is inaccurate to assert that "mental health issues" are solely or primarily responsible for the United States' ongoing rash of gun violence.

Instead, while experts say some aspects of mental illness are associated with mass violence, they insist that it is truly a multi-layer and complex crisis, driven by a confluence of other factors as well, such as widespread access to firearms, stalled gun reform and exposure to increased stressors and crises.

"There is no 'the mentally ill.' It's all of us. It's our kids, our families, our uncles, our cousins," Joel Dvoskin, a clinical and forensic psychologist who served on the American Psychological Association's Task Force on Reducing Gun Violence told ABC News.

"These events slap us in the face... This is a public health crisis, and we should think of it as a public health crisis," Dvoskin said in reference to the gun violence and Tuesday's tragedy in Uvalde.

In fact, a 2018 report of the FBI on the characteristics of active shooters found that only 25% of shooters from 2000-2013 had confirmed mental illness.

"There are important and complex considerations regarding mental health, both because it is the most prevalent stressor and because of the common but erroneous inclination to assume that anyone who commits an active shooting must de facto be mentally ill," the report said.

"Absent specific evidence, careful consideration should be given to social and contextual factors that might interact with any mental health issue before concluding that an active shooting was 'caused' by mental illness. In short, declarations that all active shooters must simply be mentally ill are misleading and unhelpful."
Millions experiencing mental illness in the US
According to the National Alliance on Mental Illness, approximately 1 in 5 adults in the U.S. experience mental illness, defined as a condition that affects a person's thinking, feeling or mood, each year, approximately 52.9 million Americans. In 2020, 1 in 10 young adults, between the ages of 18 and 25, were found to experience serious mental illness.

With millions of Americans grappling with mental health challenges, doctors and public health experts, interviewed by ABC News, questioned whether it would be feasible to rely on the nation's current mental health infrastructure to stop would-be shooters.

"The notion of blaming this on the mentally ill is an intentionally disingenuous scapegoating of people who have enough problems already -- that they don't need to be insulted by politicians who were looking for a way to avoid a more complicated discussion," Dvoskin said.

Those who live with mental illness are 10 times more likely to be victims of crime than perpetrators, he added.

"Very few of these mass shooters have had a diagnosed mental disorder of any kind. That doesn't mean that they were doing fine. I think the better rhetoric to use [instead of] mentally ill is people who are in crisis. Anybody who's in a crisis of despair or rage... that doesn't mean they're going to shoot anybody but they ought to get help," Dvoskin said.

On Wednesday, the National Alliance on Mental Illness also pushed back on the notion that mental illness is at fault in this shooting or with other similar crises.

"Mental illness is not the problem. It is incorrect and harmful to link mental illness and gun violence, which is often the case following a mass shooting," the organization wrote. "Pointing to mental illness doesn't get us closer as a nation to solving the problem and doing so leads to discrimination and stigma against those with mental illness - who are more likely to be victims of violence than perpetrators. People across the globe live with mental illness, but only in the U.S. do we have an epidemic of senseless and tragic mass shootings," they said.

Globally, estimates suggest around 1-in-7 people have one or more mental or substance use disorders.

However, even with the pandemic impacting people across the globe, the United States is unique in its epidemic of gun violence, with the nation reporting more violent deaths - largely driven by firearms - compared to other high-income countries.

One study found that the U.S. gun homicide rates were 25 times higher than in other high-income countries.

"If mental illness were the simple cause, you'd see mass shootings happen all over the developed world," Senate Majority Leader Chuck Schumer (D-NY) said this week.
Politicians fight over the role of mental illness in mass casualty incidents
Many politicians on the right, who are ardent defenders of gun rights, point to mental health as the principal issue at hand.

Although officials reported that the gunman had "no known mental health history," Texas Gov. Greg Abbott stressed on Wednesday that mental health issues must be addressed in order to evade such tragedies in the future.

"We as a state, we as a society, need to do a better job with mental health. Anybody who shoots somebody else as a mental health challenge, period. We as a government need to find a way to target that mental health challenge and do something about it," Abbott argued during a press conference.

Following other mass shootings in years prior, former President Donald J. Trump, shared a similar sentiment in placing the blame on mental illness.

"Mental illness and hatred pull the trigger. Not the gun," Trump said in the days after two mass shootings in El Paso, Texas, and Dayton, Ohio, in 2019.

However, on the other side of the aisle, many Democrats have rejected such an argument as an excuse to not address gun reform legislation.

"Spare me the bull---- about mental illness," Connecticut Sen. Chris Murphy, a Democrat, who, when he arrived in Washington, D.C., first represented the district home to Sandy Hook Elementary. "We don't have any more mental illness than any other country in the world. You cannot explain this through a prism of mental illness because we're not an outlier on mental illness."
Mass shooting incidents increased during the pandemic, data shows
In the last two years, conversations around mental health and the potential impact on mass casualty incidents have been augmented by the onset of the pandemic.

Since the early days of the pandemic, officials have been warning that COVID-19 could cause spur an uptick in violence across the country.

An internal Department of Homeland Security memo in early 2020, obtained by ABC News last summer, warned that the emotional, mental and financial strain, exacerbated by the new pandemic, combined with social isolation may "increase the vulnerability of some citizens to mobilize to violence."

Thus, the question of what role COVID-19 may have had in exacerbating these already existing issues surrounding mental health, isolation, and radicalization, is one that groups of public health experts have been investigating as the frequency of these mass shooting events has increased.

Dr. Anupam B. Jena, Associate Professor of health care policy at Harvard Medical School, who has been studying the rash of mass shootings across the country, told ABC News that since the onset of the pandemic, there has been a clear increase in the number of mass shootings, defined as shootings in which 4 or more people were killed or injured, not counting the perpetrator, when compared to previous years. Totals for 2021 were even higher than those seen in 2020, according to Jena's research.

"It's very clear that something has changed during the pandemic that has led to an increase in mass shootings and the timing of the increase is timed, really at the start of the pandemic," Jena said. "I feel pretty confident saying the increase in mass shootings that we've observed in the last year and a half two years is a result of changes that have occurred during the pandemic."

CDC data, released earlier this month, found the overall gun homicides increased 35% across the country during the first year of the pandemic to the highest level in 25 years.

According to an analysis, conducted by Jena, there were 343 more mass shootings "above expected," during that period, leading to an additional 217 deaths, and 1,498 people injured, between April 2020 and July 2021.

An FBI report released on Tuesday also revealed a 52.5% increase in active shooter incidents between 2020 and 2021. Such incidents have increased by nearly 100% since 2017.

"The COVID-19 pandemic imposed sudden and additional psychological and financial strains across society through fear of death, social isolation, economic hardship, and general uncertainty," and thus, the tremendous tensions and stresses caused by the pandemic could have led to an uptick in mass shootings," Jena and his co-author wrote in a September study.

Economic and social factors played a significant role in the likelihood of a person committing a mass shooting, Jena argued.

"There's not a person who hasn't been disrupted by the pandemic really, and so the question is does it have a particularly pronounced effect on people who would be prone to committing acts of mass violence, and it seems to be that way," Jena said.

As with COVID-19, there is a "contagious" nature with mass shootings, according to David Hemenway, the director of the Harvard Injury Control Research Center, with incidents at times having a domino effect, one occurring after the other.
The pandemic has had 'enormous' effects on mental health
The pandemic itself has had "enormous" effects on the mental health of people across the country, Hemingway said.

Public health experts say social disruption caused by the lockdown, and by all the changes in the way society operates, has affected everyone, regardless of race, gender or age.

"It's been a time of terrible disruption," Dr. Rebecca W. Brendel, the president of the American Psychiatric Association, told ABC News. "All the institutions and the support and the connectedness that holds us together, was taken away overnight, and it's simply just not back the same way again. How could it not disrupt our lives in ways we're only beginning to understand?"

The vast majority of attackers in mass attack incidents - 87% - had at least one "significant stressor," defined as significant medical issues, turbulent home lives, work and school issues, strained relationships, and personal issues, within five years leading up to the attack, according to a United States Secret Service report on Mass Attacks in Public Spaces.

However, the USSS reported noted that "the vast majority of individuals in the United States who display the symptoms of mental illness discussed.... do not commit acts of crime or violence."

People rely on regularity to protect the predictability, the connectedness of our institutions and our relationships, for a normal healthy development, Brendel said.

"Part of normal development is learning how to interact with other people and learning about one's place in the world, from being around other people and navigating relationships in person," she said, and a number of things have gotten in the way of that normal development.

According to the National Alliance on Mental Illness, 1 in 5 people reported that the pandemic had a significant impact on their mental health, including 45% of people with mental illness.

Young people have been particularly affected, data shows. During the pandemic, more than one-third of high school students in the U.S. reported experiencing poor mental health during the pandemic, while nearly half of students, 44%, reported feeling persistently sad or hopeless in the past year, according to data released by the Centers for Disease Control and Prevention (CDC).

One significant culprit that continues to aggravate these feelings of loneliness is social media, said Brendel. Although it serves as a way to keep in touch, it can also lead to problematic situations.

"We're seeing kids who get their information, or see their friends only through social media posts, and we know that people can portray themselves only as they wish to be seen," Brendel said, adding that this leads to situations where people may feel that their lives were empty or not as good as the perfect lives they saw on social media, leading to increased feelings of isolation, and making it even more difficult to reach out to others.

"We know that when we're in our deepest despair, with being isolated, [social media] makes it worse and it is a big risk factor. We're in for added trouble," Brendel said.
What to do
As officials look for answers, experts say there are no simple solutions to such complicated issues.

Top of mind for many mass shooting health experts is addressing the overarching issues with gun control reform in the U.S.

According to polling from Pew Research, nearly half of adults - 49% - say there would be fewer mass shootings if it was harder for people to obtain guns legally.

"The United States is such a blaming society. Once we blame somebody then we can say, 'oh, our work is done.' And the answer is no, you haven't done, and prevented anything," Hemingway said. "You want a system so it's hard for people to get these lethal weapons. It's hard for people to use these lethal weapons, and it's unlikely for people to be so enraged that they want to use these lethal weapons."

Stigmatization of mental illness is only deterring people from seeking help, experts said.

Thus, ensuring those in need are able to access the care - for mental health, crisis, or stress related issues - without fear of being ostracized or judged, will also be critical.

In getting people the help they need, Dvoskin added that "you would prevent some mass shootings - you would just never know it because you don't know which particular person in crisis is going to do something that's horrific."

"When you blame mass homicides on mentally ill, all you're doing is dramatically increasing stigma. People don't want to join the group of people who are responsible for harm," Dvoskin said. "Those statements not only are wrong but they are directly harmful to citizens who might be struggling with a mental illness, but they haven't asked for help, and why would they when we stigmatize it so drastically."

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Blaming mass shootings on the nation's mental health crisis is 'harmful', advocates say

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According to the National Alliance on Mental Illness, approximately 1 in 5 adults in the U.S. experience mental illness each year.