Mass Shootings Are Not a Mental Health Problem

By Jordan Mayfield, LSCSW, LCAC

Unfortunately, mass shootings are becoming a regular occurrence in our society. It is hard to turn on the news without seeing that another mass shooting has taken place. The knee-jerk analysis of these events is often that the individuals perpetrating them are “mentally ill.” The reason mental illness is an easy scapegoat is because historically as a society we have equated “bad behavior” and immorality with mental illness (Columbia Psychiatry). Additionally, behavior that is difficult to understand can often also be attributed to mental illness as a way to differentiate ourselves from it and offer an explanation for it.

When a client comes into my office and states that they are suicidal, there are several things that are assessed to determine risk level. One of those things is whether the client has the means to enact a plan. The most lethal means is access to a gun. If a client has access to a gun, they are considered the highest risk. NOT because they are “mentally ill,” but because the weapon they have access to is the most lethal. Data show that women attempt suicide at higher rates than men, however men complete suicide more often than women because men are more likely to use a gun, while women are more likely to use medication. If the mental health community knows that a person with access to a gun is at the highest risk for violence then why does society as a whole not understand this truth?

In the largest research study of mass shootings and mass murder between the 1900s and 2019 the data show “the vast majority of mass shootings and mass murder are committed by people without mental illness, and certainly not psychotic illness, and when a person with severe mental illness commits a mass murder, they’re much less likely to use firearms than other methods, such as arson or knives” (Columbia Psychiatry). Additionally, half of all mass shootings in this study show that there was no diagnosed mental illness, substance abuse or past criminal behavior associated with the perpetrators. The most glaring commonality amongst mass shooters is that they are middle-aged men, who recently experienced an acute stressor AND have access to guns. Additionally, “most mass shootings are committed with non-automatic weapons, making them the weapons of choice” which supports the premise that the primary variable in mass shootings is access to guns (Columbia Psychiatry).

Most people with mental illness are not violent and will not become violent. Research shows that persons with mental illness make up only 4% of all violence (NAMI). Furthermore, mentally ill persons are more likely to be violent toward themselves, not others.

Attributing mass shootings to a mental health problem only further stigmatizes the millions of people who are living with mental health disorders. It also alienates those that might have sought treatment in the future from doing so, because they do not want to be clumped together with people who commit mass murder.

If mass shooters do not usually have mental health diagnoses would they at least be considered mentally ill at the time of the crime? The answer to this is also usually no. Research tells us that a large motivator for mass shootings is that the shooter is suicidal and wants to commit suicide in a sensational way and/or commit suicide by cop (Columbia Psychiatry). According to the definition of being not guilty by reason of insanity, thus being too mentally ill at the time of the crime to distinguish between “right” and “wrong” a person committing the crime did not “have the required intention to commit the crime” (Cornell University). In mass shootings the perpetrator shows intent AND if they are attempting suicide by cop, they have the wherewithal to know that what they are doing is against the law and “wrong.” Being suicidal by itself does not mean that a person is mentally ill.

The mental health diagnosis most closely related to violence is Antisocial Personality Disorder. This is when there is “a pervasive pattern of disregard for and violation of the rights of others” (DSM-5). Additionally, it is defined as participating in criminal behavior, lying, impulsivity, aggressiveness, reckless disregard for others, irresponsibility, and lack of remorse. An important note though is that this pattern must be present by the age of 15. A one-time act as a middle-aged man does not constitute a pattern, nor meet this criterion. Psychopathy is what many people assign to mass shooters, however psychopathy is not a recognized mental health diagnosis. So, while the mental health field is grossly underfunded, increasing funding as a response to mass shootings is not addressing the real problem. In addition, people with psychopathic tendencies are going to be the LEAST likely to seek out mental health treatment for themselves.

Continuing to push the narrative that mass shooters are mentally ill, or that the presence of mass shootings indicate a lack of appropriate mental health services is a distraction. It places the blame on the individual without addressing the real social issues that are at play. Access to guns is the highest risk factor for both suicidal and homicidal people. Access to guns, not mental illness, is the problem. The biggest link between mass shootings and mental health is the terror and hypervigilance that people experience by living in a society where you cannot go to school, church, the movies, the grocery store, a parade, a birthday party, or work without fear of being shot.