The mass shootings that have become an epidemic in America are eerily similar yet vexingly random, each one set apart by circumstances that make an effective response elusive.
In one of the deadliest years ever for multiple shootings in America — 81 dead, 88 wounded — the Newtown massacre seems to have galvanized the nation into action. The killings have become so common, and progressively awful, that doing nothing is no longer seen as an option. Outraged Americans have called for solutions ranging from stricter gun control laws to broader access to mental health care services. But just what should be done is complicated by the nature of the crimes themselves. Each one is different, and what may work as a remedy for one would have no impact on another.
At first blush, the Newtown shooter, 20-year-old Adam Lanza, fits the stereotype of the young, disaffected white male who is often highly intelligent and hails from a well-to-do family. Yet a Dayton Daily News examination of the major mass shootings over the last decade and interviews with mental health experts show that it’s virtually impossible to predict who will strike next.
“This guy could have met 15 criteria for becoming a mass murder, but so would 1,000 other kids who never end up doing that,’’ said Dr. Douglas Songer, a medical director for psychiatry at Miami Valley Hospital. “Violence predictions are incredible difficult.’’
Upon closer examination, the 13 mass shootings in the United States this year have at least as many differences as similarities. Only four of the shooters were under 30. Military-style assault weapons were used in only four of them — Newtown; Aurora, Colo.; Happy Valley, Ore.; and College Station, Texas — while the nine other killers used handguns.
In all but a handful of the crimes, the weapons were purchased legally. T.J. Lane was an exception. Lane, 17, allegedly stole a handgun from an uncle last February and walked into the cafeteria of Chardon High School near Cleveland, firing 10 shots at four students sitting at a table.
At a hearing in Chardon Wednesday, Lane’s mother said she was so shocked at hearing her son was a suspect that day, “Honestly, I thought he was being wrongly accused.” Lane didn’t even attend the school where the shooting took place.
Apparent motivations — to the extent that they are known at all — varied widely in this year’s mass shootings. Wade Michael Page, the white-supremacist gunman in the shooting at a Sikh Temple in Oak Creek, Wis., appears to have been motivated by racial hatred. Andrew Engeldinger was dismissed from his job at a sign-making company before fired on his former co-workers in Minneapolis. Five died in Seattle after Ian Lee Stawicki was asked to leave a coffee shop. Radcliffe Franklin Haughton, a former Marine, killed his wife and two others at a suburban Milwaukee spa three days after she filed a restraining order against him.
Some perpetrators gave vague hints of the trouble to come, while others, like Lanza, revealed no public warning signs. Aurora shooter James Holmes mailed a troubling letter to his former professor, but it wasn’t opened until after the massacre. Jacob Tyler Roberts’ roommate said he “acted weird” and talked of giving away his possessions before his shooting spree in an Oregon mall only three days before the Newtown slaughter.
Nine of the killers committed suicide, leaving many questions unanswered forever. Lanza was one of them. He left so few footprints before his violent rampage that little is known about him beyond a grainy, haunted image of his wide-eyed face.
Despite these differences, the shooters can share common traits, according to James Burke, a police training officer at the Ohio Peace Officer Training Academy: “You’re usually looking at kids with a troubled home life, living on the social fringe — kind of reclusive loners who don’t have a ton of friends.”
That’s exactly how friends and relatives described Lanza to police. Until Dec. 14, he lived quietly with his mother — and first victim — Nancy Lanza. If he was troubled, it was a secret that his mother guarded carefully. “She tried to keep everything so private, but it’s impossible to do that,” observed Michelle Maloy-Kidder, executive director of the National Alliance on Mental Illness (NAMI) of Montgomery County. “You have to reach out to your community. You have to reach out to your family.”
Nancy Lanza was reportedly a gun enthusiast who taught her son to shoot. That’s shocking to Maloy-Kidder, whose husband and son have been successfully treated for bi-polar disorder. “They are both doing well on their medications, but I would never have a gun in the house, even though I would like to do target shooting,” she said. “Even before my son was diagnosed, I took all the shotguns and gave them to my in-laws. Even though my husband was stable, I was not foolish enough to have a gun in my home when I have family members with mental illness. I feel very bad for the mother and the surviving family members, but it was very careless of her to have guns in the home.”
Local psychiatrists applaud the call for more effective and widespread mental health services, but they hasten to point out that’s only a small part of the solution. Just 4 percent of violent crimes are committed by people with some form of mental illness, according to the National Institute of Mental Health.
“What is the most powerful predictor of violence?” asked Jerald Kay, professor and chair of psychiatry at the Wright State University Boonshoft School of Medicine. “It’s substance abuse, with or without mental illness.”
In some mass shootings, psychological intervention could have made a difference. The deadliest mass shooting in American history occurred at Virginia Tech Univesity on April 16, 2007, when Seung-Hui Cho shot and killed 32 people and wounded 17 others before committing suicide.
Kay, who testified before the Virginia Tech Review Panel, said prior to the rampage, faculty and peers “voiced concern over Cho’s mental stability. He had sought treatment but the institution provided no follow-up to the university.”
Cho is an example of what Burke calls the “fantasy phase,” when some killers foreshadow their actions. Cho turned in an assigment for his creative writing class that almost mirrored his actions before the shooting, Burke said. Similarly, before the Columbine killings Dylan Klebold turned in a school writing assignment that described a man in a black trench coat who is disliked and killed “preps.”
“In this fantasy phase, these kids are very open about it, because it’s still a fantasy in their head,” Burke said. “That’s when we have to start getting some attention to these kids.”
Burke said it’s hard to lump shooters into one group, despite these common traits. He noted that the Columbine killers had a relatively stable home life. “Eric Harris and Dylan Klebold came from wealthy parents, had nice houses and had a group of friends,” he said. “But these kids still manufactured dozens of propane explosives, and built shotguns in their rooms.”
President Barack Obama acknowledged Wednesday that the solution must be as multi-faceted as the problem, but added, “The fact this problem is complex doesn’t mean we can do nothing.” He advocated for an America in which “access to mental health care is at least as easy as access to a gun.”
Mental health experts caution against further stigmatizing the mentally ill, noting that reports about Lanza’s mental state have been fueled by pure speculation. “We don’t know anything about this young man and whether he had a mental illness or not,” said Dr. William Klykolo, director of the division of child and adolescent psychiatry at the Wright State University Boonshoft School of Medicine.
There have been unconfirmed reports that Lanza had Asperger’s Syndrome, a form of autism that affects language and behavioral development “This condition has absolutely nothing to do with violence,” Klykolo said. “Fortunately autism advocacy groups have spoken out very strongly about this.”
Lanza reportedly damaged the hard drive on his computer, possibly destroying clues to his state of mind. Klykolo said a mass killer’s motivation or psychological state may never be revealed: “In many cases they are killed in the process, so all we have is a flood of speculation. If they survive, there’s a big embargo on information because of the criminal justice system.”
Most of the mass shooters aren’t psychotic in the clinical sense of the term, Kay said: “They feel alienated and full of rage, and they may have a significant personality disorder without being acutely psychotic. They often have a sense that life isn’t fair, and they feel bruised. Their self-esteem has been depleted and that can lead to resentment, righteous indignation and rage.”
An individual with a history of violence or drug or alcohol abuse is far more likely to commit a violent act than someone who is mentally ill. Only schizophrenia and bi-polar disorder have been associated with higher risk for violence, with a 16-percent lifetime risk of violent behavior compared with 7 percent for the general population, according to the National Institute of Mental Health.
Songer said that most mass murderers don’t commit violent acts until their killing sprees begin, although they often express feelings of outrage and anger over their perceived victimization by society. “Generally, when you look at the two best predictors we have, neither of them would have been helpful in identifying a lot of the folks who have ended up doing bad things in the past,’’ Songer said.
Many experts agree that mental illness has been given short shrift as a public health issue. Over the past two years, states have cut nearly $2 billion from their combined mental health systems, including about $200 million in Ohio in the past fiscal year, according to a recent report by the National Alliance for Mental Illness, an advocacy group that tracks mental health spending in all 50 states.
But throwing more resources at treatment and counseling is no panacea either and is not likely to have prevented the massacre at Sandy Hook Elementary School, experts say. After all, there is no indication that Lanza was ever treated or diagnosed with a mental illness.
Dr. Mark Hurst, medical director for the Ohio Department of Mental Health, said early intervention and sustained treatment by mental health professionals and others may not prevent all mass murders, but it drives down the likelihood of such crimes occurring.
“Of the individuals in my career who have had severe mental illness that I treated and did well with; if they wouldn’t have been treated, how many of them would have had something bad happen in their life or to other individuals?” Hurst said. “I don’t have any idea. But I’m very certain that at least some of them would have had something bad happen.”
The need for mental health services is growing, Hurst said, noting the number of people diagnosed with various mental illnesses has begun to rise in recent years. “We have had a significant increase in the number of admissions to our state hospitals over the past several years; in the order of 30 percent,” he said.
Nationwide, one in five adults, or 45.6 million people, had a mental illness in the past year, but only about 38 percent of all adults with mental illness received mental health services during that time, according to a survey from the U.S. Substance Abuse and Mental Health Services Administration.
Hurst said more mental health resources are needed, and he’s hopeful that some of the measures required in the Patient Protection and Affordable Care Act will make mental health services more accessible and affordable.
Beginning in 2014, mental health and substance abuse services will become part of the essential benefits package for all insurance policies offered through health care exchanges or paid for by Medicaid.
Klykolo said the Affordable Care Act could help increase access to mental health care, but people shouldn’t expect a miracle overnight.
“It’s going to be a rough transition,” he said. “It’s like turning one of those barges around in the Ohio River.”
Maloy-Kidder of NAMI hopes the Newtown tragedy and the rash of mass shootings doesn’t reinforce negative stereotypes about mental illness.
A better response, she said, would be focusing on those who aren’t getting the help they need.
“The waiting list is so long that you can wait three or four months to see a psychiatrist,” she said. “So many people with mental illness have tried to seek help and have been turned away.”
Information from the (Cleveland) Plain Dealer was used in this story.
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