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Connecting mental illness and mass shooting misses the point, experts say

NBC News logo NBC News 2/20/2018 Phil McCausland

Candle drippings hang off one of 17 crosses at a memorial for the victims of the shooting at Marjory Stoneman Douglas High School in Parkland, Florida, U.S. February 16, 2018. © REUTERS/Jonathan Drake Candle drippings hang off one of 17 crosses at a memorial for the victims of the shooting at Marjory Stoneman Douglas High School in Parkland, Florida, U.S. February 16, 2018.

In the wake of the tragedy in Parkland, Florida, where a gunman killed 17 students and staff, the Trump administration and many Republicans have said that the best way to end the seemingly constant stream of mass shootings is by combating mental illness.

And while some think it a reasonable idea, mental health and mass shooting experts aren't so sure.

Dr. James Alan Fox, a criminologist with Northeastern University 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."

Related: Trump vows mental health care fix after Florida shooting. He also wants to slash coverage.

Despite this, gun violence is an open question that is now dogging Washington, as politicians discuss how to resolve a seemingly unending number of mass shootings. And now Republicans have primarily framed the issue as a mental health crisis.

Broward County Mayor Beam Furr told NPR that Parkland shooter Nikolas Cruz had shown signs of mental illness — as many mass shooters have — and "had been a client at some mental health facilities."

In response to the shooting, President Donald Trump said he would help the nation with "the difficult issue of mental health."

The claim appeared at odds with his administration's 2019 budget proposal that included a 22.5 percent cut to Medicaid, which accounted for a quarter of 2014's mental health spending nationwide, according to the Kaiser Family Foundation.

On Thursday, Attorney General Jeff Sessions said that he intends to have the Department of Justice work with other federal agencies "to study the intersection of mental health and criminality and violence and identify how we can stop people before these heinous crimes occur."

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

House Speaker Paul Ryan Thursday touched on the issue of gun control when he said mentally ill individuals might be "slipping through the cracks and getting guns."

Related analysis: After Florida shooting, Trump offers comfort — to gun owners

But Fox remains skeptical that a greater emphasis on mental health and background checks will bring about 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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