Are mass shooters mentally ill?

Whether your gut reaction to this question was an instinctive “yes” or “no,” the message found in an August report from the National Council for Behavioral Health is: “Not so fast.”

An expert panel of 26 people, including three special agents from the FBI, synthesized some 122 research articles to arrive at over 70 recommendations for not only general audiences, but for health care organizations, schools, communities, judicial, correctional and law enforcement institutions, legislators and government, research and mass media. This report, “Mass Violence in America: Causes, Impacts and Solutions,” brings startling information to this public health emergency.

The facts in the report paint an illuminating picture. For example, even though the overall homicide rate in the U.S. has shown a decline since a high point in the early 1980s, mass shootings (incidents where there are four or more casualties) are increasing in frequency, deaths and injury. Prior to 2011, the average frequency between these events was about 200 days, but the last 15 or so years had a frequency of 64 days. Still, these killings are only “less than two tenths of 1 percent” of all murders in America between 2000 and 2016. Understandably, these events capture vast media attention and public reaction, and most often the debate then centers on either mental illness or firearms. Sometimes, a focus on one deflects attention from the other.

The report states clearly that there is a very small risk of violence from individuals who suffer from a small subset of mental illness, but this “modest link” fuels the public’s fear, rejection, discrimination and tenacious stigma against an entire class of people with a treatable health problem. One reputable study on the likelihood of violence from people with a mental illness found there is only about a 4 percent risk. What this means is that if, by some magic, we could cure people from schizophrenia, bipolar disorder or major depression tomorrow, 96 percent of violent acts would still be going on in our nation. This is so because practically all violence springs from other reasons, especially social-environmental influences, and not illnesses of the brain.

While the overwhelming majority of people who suffer from a mental health condition have never been nor will ever be violent, there are a few studies that conclude that there is a small fraction of perpetrators of mass violence who do have a mental illness. The FBI examined 63 instances of this nature and concluded that 25 percent had a mental illness; a similar study looked at 226 events and found 22 percent. Unfortunately, many studies have an imprecise definition of what constitutes “mental illness,” so comparisons are difficult.

The report cautions that having a mental health problem is not necessarily the root cause of mass shootings. “Perpetrators of mass violence,” the report states among its nine conclusions, “may be motivated by mental distress from life events and circumstances or by the symptoms of mental illness. These are not the same and thus require different modes of detection and prevention.”

Making the issue of mass shootings into solely a mental health problem is inaccurate, distracting and unfair. It stereotypes people with mental health challenges in a damaging way.

The attention that acts of mass violence receive often brings a discussion about risk-based, firearms-removal laws. Fourteen states have adopted such legislation, including New York and all the New England states except for Maine and New Hampshire. In Concord, a proposed law regarding extreme risk protection orders (House Bill 687) was retained this session by the Criminal Justice and Public Safety Committee. This bill shares the common features of ones in states that have enacted such measures: a civil court order is involved; the focus is on an individual with a high risk of harming themselves or others; law enforcement conducts searches and removal; and there is a time limit on the removal, among other things.

The report offers illustrative statistics from 762 situations of the gun-removal law in Connecticut from 1999 to 2013. Most (92 percent) were owned by men who posed a risk of suicide (61 percent). About half were identified by family members or acquaintances and a 46 percent had a mental-health or substance-abuse treatment experience. On average, seven guns were removed per case. It’s important to note that restricting the means a person has to suicide is a proven method of prevention.

The public health emergency of mass violence will not be addressed by any one particular change in our society. Why these tragedies are more prevalent in America than in other countries has many theories and the root cause is most likely not found in one arena of concern. What we can say with confidence is that, in our country’s struggle with this problem, we need to have an openness to all the facts and avoid temptation to grasp a simplistic and inaccurate perspective. That is why a report like the latest one from the National Council for Behavioral Health is so important in helping us see all sides of this critical issue.

Phil Wyzik, MA, is CEO of Keene-based

Monadnock Family Services, a nonprofit community mental health center serving

the Monadnock Region.