Are Mass Murderers "Mentally Ill"?

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What is the relationship between mental illness and violence? 3%. Yes....3%. Media reports of mass shootings often exaggerate or assume that individuals who commit these heinous and horrific crimes are presumed to have a mental condition that led them to be successful at devastating lives.

Reports from the World Psychiatric Association (WPA) conclude that "mental health disorders are neither necessary nor sufficient causes of violence. Common determinants of violence continue to be socio-economic and demographic factors. Substance abuse (problems with drugs and especially alcohol) is a major determinant of violence, and this is true whether it occurs in the context of a concurrent mental disorder or not." Other more accurate predictors of violence/aggressive behaviors are 1) being male 2) young adult age 3) troubled childhood (physical abuse, head trauma.)

Epidemiological studies have also shown that MOST individuals with "severe" mental illnesses ("severe" often referencing mental illnesses that are chronic, difficult to manage or involve individuals' non-adherence, which is multi-factorial in its sense,) are NOT violent toward others. Also important to note here: "psychotic" does not mean "violent."

It is possible that the most recent mass shooter is apart of the 3%? It is possible. Is it likely that he had a mental illness and none of his family members or friends were aware? Not likely, based on the information shared via media outlets. The formation of a mental illness often involves the onset of SEVERAL symptoms and rarely does it involve any ONE change.

So, what constitutes a "mental illness?" The legal definition of "innocent by reason of insanity requires that a person not be aware of what they were doing, or the consequences of it, at the time of the crime." Likewise, the exemptions of incompetence or borderline intellectual functioning require an extreme level of debilitation. Majority of those with a mental illness are far more functional than that. Moreover, ALL of us are somewhere on the spectrum of traits included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). An individual who is classified as "mentally ill" is at a more extreme point along that spectrum.

The term "mental illness" has no agreed societal meaning and is rather used loosely. Many are not aware that personality disorders are not classified under "mental illness" by the American Psychiatric Association (APA).

Mass murderers are much more likely to have antisocial personality disorders such as sociopathy or psychopathy. Contrary to the myth, Mass murders are not successful because of a high IQ. Instead, it is the OBSESSION, METICULOUS PLANNING and an ANTISOCIAL/PSYCHOPATHIC PERSONALITY that enable mass murderers to operate over an extended course, undetected.

People living with mental illness are more often victims than perpetrators of violence. The rates of violent acts against people with mental illness are much higher compared to the general population; those living with complex mental disorders and psychotic disorders are at a greater risk. Individuals with certain mental illnesses are more at risk of becoming victims of homicide, attempting suicide, and self-harm.

The term "mental illness" is defined by APA. Education is required for those who attempt to redefine it. This is important if societal representations of mental illness aren’t accurate. The misconceptions and misuse of the term "mental illness" often lead to an insidious stigma that shapes society's perceptions of individuals with psychological disorders, including the false belief that severe mental illness leads to violence. Another myth that has been "debunked."

Dawn Brown, M.D.Comment