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Mental Illness and Violence: Risk Factor? Or One In a Million?

Both.  And maybe neither.

Recent events in Oregon have once more raised the issue of seemingly-random violence in our communities and schools.  And, given the perpetrator’s history, the usual questions are again being asked: Would stringent gun laws prevent such ill young men from having access to deadly weapons?  Would reform of the systems for identifying and treating the seriously mentally ill make a difference?

I have taken up this issue twice [1] before [2], but, on this sad occasion, there appears to be a further complicating factor: religious discrimination.  While not a feature of any mental illness per se, reports suggest that the perpetrator lacked the potential benefits of a Christian worldview for coping with life’s trials and was, in fact, hostile towards such views.

A Risk Factor?

Researchers have suggested that the potential for violence is not any greater among the mentally ill than among the general public, when those with a prior history of psychiatric problems are considered as a group.  In fact, there is ample evidence that those suffering mental illness are more likely, as a group, to be victims [3] of violence.  However, when one considers subgroups of those persons with more serious psychiatric problems such as psychosis, particularly if exacerbated by substance abuse, the probability of violence [4] does increase.  The opinion [5] of one psychiatrist respecting the details of the Oregon shooter’s reported history seems reasonable:

if true, [they] may point to conditions like schizoid personality disorder, Asperberger’s (sic) syndrome or even schizophrenia, any of which can dramatically limit the ability to socialize and empathize with others, contribute to feelings of emptiness and isolation and spawn anything from intense depression to paranoid delusions. 

The take home point here is possibly best encapsulated as follows: society should not be fearful of people with mental illness committing violent acts.  Such fear is unwarranted and further stigmatizes a group of people who has historically received more than its fair share of social rejection.  At the same time, society should prioritize providing comprehensive treatment, not only because it is the right thing to do out of compassion for the many, but also as it may prevent violence by the few.

One In a Million?

Actually less.  Some estimates suggest that more than 13-million Americans have a serious mental illness, such as schizophrenia, bipolar disorder or major depression, and yet the number inclined towards, and capable of, carrying out an atrocity as in Oregon is negligible.  A recent review [6] of the literature on gun violence did not find support for a connection between mental disorder and violence. The authors’ research suggests that a simple link between mental health and mass shootings is unhelpful:

Of course, understanding a person’s mental state is vital to understanding his or her actions.  At the same time, our review suggests that focusing legislative policy and popular discourse so centrally on mental illness is rife with potential problems. 

The conclusion [7] is the same as above: many fail to receive the psychiatric care and services that could help them lead productive lives, which would be a benefit to them and society, regardless of whether such efforts reach the anomalous sufferer who might perpetrate violence.

A Neglected Aspect

So, if we cannot say for certain that addressing mental illness will be a panacea for resolving the problem of violence, and as evidence of the failure of gun control laws to prevent killing in the various jurisdiction where it has been attempted abounds, what are we missing?  Perhaps the 5th Commandment?

The Judeo-Christian worldview admonishes clearly against killing others, yet this most recent atrocity brought to light the perpetrator’s reported hatred of religion.  Some survivors’ families report that he asked the victims whether they were Christians before shooting them.  On a social network profile [8], he described himself as “Not Religious, Not Religious, but Spiritual,” and said he belonged to a group called “Doesn’t Like Organized Religion.”  Given the circumstances and these reports, it seems naive to neglect the reality of evil in the world, and that this most recent atrocity may have been an example of such.  While the perpetrator may indeed have suffered from a significant mental illness, this does not preclude him from also allowing himself to be influenced by negative temptations to hate, “listening” to false voices about his legacy, and being used as an instrument to attack what is good, honorable and even holy: people willing to face the business end of a barrel rather than to renounce their Creator.

So, yes, let’s enforce sensible legislation for public safety and provide improved access to compassionate care for those who suffer interior anguish.  But, let us also pray.  Hard.  Very Hard.