"It must be mental illness. My mind cannot possibly conceive of an alternative. A rational healthy mind cannot be capable of this, Doc."
These were the opening words of one of many discussions that I had with patients in the wake of yet another gut-wrenching tragedy where we saw innocent children and their teachers murdered in school.
This narrative is appealing, regardless of whether or not it is true, because we find some measure of solace in it. We are now at a point in our nation where we are not ashamed to say that we live in a mental health crisis. It is inconceivable to us that a "healthy" brain could plot and premeditate the cold-blooded execution of children.
But just because something feels true does not mean that it actually is.
I personally felt this after a shooter walked into my hospital and shot my coworkers, murdering one and injuring several others. How can this be? It didn't make a whole lot of sense then. I don't know if it makes any more sense now. But he had no mental illness that we knew of.
Do Any Mass Shooters Have Untreated Mental Illness?
There are data to suggest that of 14,785 murders studied in a database to track death by guns, 1315 mass shootings were identified. Of these mass shootings, 11% of the shooters had serious mental illness. Could we have diagnosed those cases earlier? Intervened sooner? Offered more effective treatment? Certainly. Would that have explain away the rest of the cases? Unfortunately, no.
What Is It, Then?
The scary answer is that the people who are capable of doing this are not so far away. They are not the folks that we would image locking up in a "psych ward" and throwing away the key. They are, rather, people who are lonely, neglected, rejected, bullied, and broken down by life. Anger, hatred, racism, and evil may be ailments of the soul, but they are not mental illnesses. The carnage they produce is just as tangible. As a psychiatrist, I must admit to you that I do not have a good medication to treat these manifestations of the human condition.
What Do We Do as a Society?
Gun reform is the first obvious and essential answer, without which little else is truly as impactful. We must advocate for it and fight tirelessly.
But at the time you will read this article, your disgruntled coworker will be able to walk into a local store in a moment of despair, anguish, and hopelessness and purchase a semiautomatic weapon of war.
What if we were to start seeing, as a society, that our lives are interwoven? What if we saw that our health is truly interdependent? The COVID-19 pandemic shattered many things in our lives, but one element in particular is our radical individualism. We saw that the choices you make certainly affect me and vice versa. We saw that public health is just that — a public matter, not a private one. We saw that there are some areas of our lives that force us to come together for our own survival.
Perhaps politicians will not save us here. Perhaps kindness will. Empathy can be as potent as legislation, and compassion as impactful as a Twitter hashtag. We each know a lonely coworker, an isolated neighbor, a bullied student, or someone beaten down by life.
What if some of the prevention is in fact in our hands? Together.
"Darkness cannot drive out darkness. Only light can do that. Hate cannot drive out hate; only love can do that." —Rev Dr Martin Luther King, Jr.
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Cite this: Mena Mirhom. What Can We Do About Mass Shootings? - Medscape - May 26, 2022.