Mental illnesses include a whole range of different conditions that vary in degree of severity from mild to severe. Within this are two broad categories that can be used to describe these conditions:
Any Mental Illness (AMI) and Serious Mental Illness (SMI)
AMI encompasses all recognized mental illnesses.
SMI is a smaller and more severe subset of AMI.
So, for clarity, AMI is defined as “a mental disorder, behavioral disorder or emotional disorder. Those within the AMI category may have disorders that impact their lives mildly, moderately, and even severely. Those that fall within SMI are defined as having a mental, behavioral or emotional disorder resulting in serious functional impairments, which substantially interferes with or limits one or more major life activities.” 1 NIMH
Is someone who commits murder, or mass murder, mentally ill? If they do not have a history of mental health issues or behavioral issues that fall into a mental health category, are they mentally ill? Do we look at all the people who have murdered anyone and just say, “Oh, well, they must have been mentally ill?” It makes me simultaneously angry and frightened that our legislatures chalk up tragedies like our most recent in Uvalde, Texas, to a “mental health issue.” It angers me because the idea that all mass murderers must be mentally ill is simply false.
“It is true that severe mental illnesses are found more often among mass murderers. About one in five are likely psychotic or delusional, according to Dr. Michael Stone, a forensic psychiatrist at Columbia University who maintains a database of 350 mass killers going back more than a century. The figure for the general public is closer to 1 percent. But the rest of these murderers do not have any severe, diagnosable disorder.” 2Are Mass Murderers Insane
In an article by Michael Friedman LMSW, in MedPage Today, “People with mental illness rarely commit homicide, and few homicides are committed by people with mental illness. About 5% of homicides are committed by people with psychotic conditions.” 3 Mental Illness Doesn’t Mean Mass Murder People with mental illness are far more likely to be the victims of a crime and far more likely to take their own life, than the reverse.
Looking closer to home, and as someone with mental illness, I find the statements of Governor Abbott [Texas], to be particularly distressing, misleading, and perpetuating the myth that the mentally ill are violent. It is upsetting to me that the only time the conditions of our mental health system are brought up is to bolster his agenda that stricter gun laws won’t save lives and that his concern for mental health issues is solely a diversionary tactic. No, it’s not only upsetting to me, it’s horrifying. Horrifying because there are many, many reasons to fix the mental health system, many more reasons than the violence of a mass shooting and not just in Texas. For example:
- Its failure to serve 60% of Americans with diagnosable mental disorders
- Its failure to provide even “minimally adequate care” more than one-third of the time
- Shorter life expectancy of people with serious mental illness
- Continuing homelessness
- Disproportionate incarceration of people with serious mental illness in jails and prisons
- The fragmentation of physical health, mental health, and substance abuse services
- Workforce shortages
Has Governor Abbott done anything to help the mental health system of Texas? No. “Texas ranked last out of all 50 states and the District of Columbia for overall access to mental health care, according to the 2021 State of Mental Health in America report.” Oh, and by the way, “in April he slashed $211 million from the department that oversees mental health programs.” But, according to Governor Abbott, “We as a state, we as a society, need to do a better job with mental health.” We do. But slashing $211 million is not the way. 5 Abbott Calls Texas School Shooting Mental Health Issue
It is also my opinion that chalking up an individual’s twisted thought process which leads them to kill 19 innocent children and two teachers to being mentally ill, diminishes his culpability in this heinous crime while at the same time stigmatizing the mentally ill. Why? Because claiming mental illness implies the person is insane. They didn’t know what they were doing. It is not right and it is not fair. Not only to those who suffer mental illness (which already bears the weight of stigma attached) but to those grieving parents attempting to make sense of what happened and all those other families who still grieve the loss of a family member taken too soon.
“Extensive case history shows that mass shooters don’t just suddenly break — they decide. They develop violent ideas that stem from entrenched grievances, rage, and despair. In many cases, they feel justified in their actions and regard killing as the sole solution to a problem. They arm themselves and prepare to attack, choosing where and when to strike. Often this is a highly organized and methodical process.” 6 Mass Shooters Don’t Snap. They Decide To Kill
Our minds can’t help but try to unravel and understand what can bring another human to this point. We look at it and think there is no way this person could be thinking with a clear and rational mind, and yet…if not suffering mental illness, what? I believe we have to look between what is normal and what is mentally ill. That space between, because a person that goes out and kills indiscriminately can’t be “mentally healthy.”
There are warning signs that can be looked for in some, such as: “threatening comments, personal deterioration, patterns of stalking and other aggression, as well as fixating on guns, graphic violence, and previous mass shooters.” 7 Mass Shooters Don’t Snap. They Decide To Kill
I believe wholeheartedly with Follman that to make progress it’s, “going to take everything we’ve got: strengthening our nation’s gun laws, quashing a surge in violent political extremism, raising cultural awareness of shooter-warning signs — and, yes, investing in a lacking mental health care system to give troubled people the help they may need before it’s too late.” 8 Mass Shooters Don’t Snap. They Decide To Kill
We can’t just talk anymore. We can’t just offer condolences and prayers. We can’t shake our fists at one another blaming. We can’t hide behind the Second Amendment when innocent people are dying. When our children are dying. Change never came easy. Sometimes it requires sacrifice. Sometimes it hurts. But those families are hurting. And that hurt will never go away.
1National Institute of Mental Health (NIMH). 2022. Mental Illness. [online] Available at: <https://www.nimh.nih.gov/health/statistics/mental-illness> [Accessed 26 May 2022].
2Carey, B., 2017. Are Mass Murderers Insane? Usually Not, Researchers Say (Published 2017). [online] Nytimes.com. Available at: <https://www.nytimes.com/2017/11/08/health/mass-murderers-mental-illness.html> [Accessed 26 May 2022].
3,4Friedman, LMSW, M., 2018. Mental Illness Doesn’t Mean Mass Murder. [online] Medpagetoday.com. Available at: <https://www.medpagetoday.com/psychiatry/generalpsychiatry/76884> [Accessed 26 May 2022].
5Hixenbaugh, M. and Siemaszko, C., 2022. Abbott calls Texas school shooting a mental health issue but cut state spending for it. [online] NBC News. Available at: <https://www.nbcnews.com/news/us-news/abbott-calls-texas-school-shooting-mental-health-issue-cut-state-spend-rcna30557> [Accessed 26 May 2022].
6,7,8Follman, M., 2022. Op-Ed: Mass shooters aren’t mentally ill people who suddenly snap. They decide to kill. [online] Los Angeles Times. Available at: <https://www.latimes.com/opinion/story/2022-05-21/blaming-mental-health-mass-shootings-buffalo> [Accessed 26 May 2022].
How You can help families in Uvalde, Texas.