Professor Todd Feinberg

 

The Big Question:

“Shooting Rampages -is it really a mental health issue? And what can we do?”

 
 
According to an editorial co-written by Gabrielle Giffords, former Democratic U.S. representative from Arizona, and her husband Mark Kelly, there have been 11 mass shootings in America since she was gunned down by a semiautomatic pistol on January 8, 2011 (USA Today, Time to take on gun violence, NRA; January 8, 2013). This is a truly astounding and shocking number, and if it were not for the gun rights zealots in this country, any other public health threat of this magnitude would have been swiftly dealt with. The tragic shootings of 26 people, including 20 children, at the Sandy Hook Elementary School in Newton Connecticut has finally awoken America to the gravity of the issue of meaningful gun control.

I winced, however, in the aftermath of Shady Hook when “gun rights” advocates tried to blame every possible cause for this crisis – violent video games, the media, and especially  “mental illness”, rather than accepting the obvious problem, the easy public access to semiautomatic weapons of mass destruction.

The facts regarding the clinical profiles of these shooters are actually pretty clear. All are men, they tend to be young, angry, socially isolated, paranoid, suicidal, and all would undoubtedly receive a clinical psychiatric diagnosis were they evaluated prior to their killing sprees. But the idea that somehow, if only our mental health system were “better”, that these killings could have been prevented, is absurd. The fact is, according to Jeffrey Swanson, professor of psychiatry at Duke and an authority on violence, psychiatrists are not much better than chance at predicting which patients will perform a violent act and which will not (New York Times, December 17, 2012). The reality is America is filled with angry, young, isolated men. On the other hand, the final common pathway for all these shootings is the possession of assault rifles and semi-automatic handguns with high capacity magazines.

Once this is understood by the public, and we accept the fact that gun control is our best option for reducing – not eliminating – the impact of these episodes, then we can begin the debate on how best to achieve that end.

There are two points upon which the mental health community can help. First, the public must be made aware that this is not a mental health issue per se. We cannot lock up every individual who fits a certain clinical profile. On the other hand, the clinical profile of these shooters should be widely disseminated to the public. There are parents, employers, teachers, and peers out there who can easily recognize who might become a killer, and if these potentially violent individuals have access to guns, or are stock piling weapons or  ammo clips, then that is a red flag for action.
 
 

Dr. Feinberg (biography here) is the author of From Axons to Identity: Neurological  Explorations of the Nature of the Self  (Norton, 2009) Altered Egos: How the Brain Creates the Self (Oxford, 2001), and co-editor of the textbook Behavioral Neurology and Neuropsychology (McGraw-Hill) now in its second edition and The Lost Self: Pathologies of the Brain and Identity (Oxford, 2005), and has written nearly 100 articles, abstracts, or books. You can find out more about Professor Feinberg at toddfeinberg.com