James L. Knoll & Ronald W. PiesPsychiatric Times
Originally posted August 19, 2019
Here is an excerpt:
Another way of posing the question is to ask—Does immoral, callous, cruel, and supremely selfish behaviors constitute a mental illness? These socially deviant traits appear in those with and without mental illness, and are widespread in the general population. Are there some perpetrators suffering from a genuine psychotic disorder who remain mentally organized enough to carry out these attacks? Of course, but they are a minority. To further complicate matters, psychotic individuals can also commit violent acts that were motivated by base emotions (resentment, selfishness, etc.), while their psychotic symptoms may be peripheral or merely coincidental.
It bears repeating that reliable, clinically-based data or complete psychological autopsies on perpetrators of mass public shootings are very difficult to obtain. That said, some of the best available research on mass public shooters indicates that they often display “rigidness, hostility, or extreme self-centeredness.” A recent FBI study found that only 25% of mass shooters had ever had a mental illness diagnosis, and only 3 of these individuals had a diagnosis of a psychotic disorder. The FBI’s cautionary statement in this report is incisive: “. . . formally diagnosed mental illness is not a very specific predictor of violence of any type, let alone targeted violence…. declarations that all active shooters must simply be mentally ill are misleading and unhelpful."
Psychiatric and mental health treatment has its limits, and is not traditionally designed to detect and uncover budding violent extremists. It is designed to work together with individuals who are invested in their own mental health and seek to increase their own degrees of freedom in life in a pro-social manner. This is why calls for more mental health laws or alterations in civil commitment laws are likely to be low-yield at best, with respect to preventing mass killing—and stagnating to mental health progress at worst.
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