Until Dec. 14, 2012, Adam Lanza seemed like just another 20-year-old kid living with his mom in suburban Connecticut. It’s not known if he was seeing a mental health professional, although he’s said to have suffered from a form of autism. He had no history of violent behavior. Yet last Friday he picked up his mother’s gun, shot her dead, drove to a local elementary school, and opened fire on the small children and teachers there. Then he shot himself.
President Obama has sworn to use “whatever power this office holds” to try to prevent massacres like the shooting at Sandy Hook Elementary from ever happening again. The national discussion has focused on two policy prescriptions: tighter restrictions on firearm sales and improving mental-health services. But it’s unclear whether assigning more federal money and attention to mental-health programs would have prevented Lanza’s rampage -- or whether Lanza's actions were in any way connected with his mental health.
Studies show that even people who have been diagnosed with a serious disability — like schizophrenia—are only slightly more prone to violent behavior than the general population. Under the influence of drugs and alcohol, the mentally ill are more likely to turn violent, but then again, so is the average person.
“You could come up with a descriptive profile of all the people who have perpetrated mass shootings like this. And you’d get a description of troubled young men that matches the description of thousands of other troubled young men that never do this,” said Jeffrey Swanson, professor in Psychiatry and Behavioral Sciences at Duke University.
Troubled young people certainly need more help than many get now, and improving the mental-health care system is an important first step. Federal, state, and local officials can always do more to fund mental-health care programs in their communities, promote screening for mental illness in high schools, and encourage parents to be on the alert for violent tendencies in their children.
But even psychiatrists struggle to pinpoint who could turn violent. “We are really terrible at anticipating behavior, or predicting behavior. There’s no theory—in psychology or psychiatry—that gives us a good basis or framework” to predict what will cause a young person to act violently, said Dr. Victor Schwartz, medical director at suicide-prevention group The Jed Foundation.
Policymakers can also strengthen state gun laws to make sure that people who have been hospitalized for serious mental illness or who have a history of drug abuse can’t legally purchase guns. The National Instant Criminal Background Check system is unevenly implemented and poorly enforced, a 2011 report from Mayors Against Illegal Guns found.
Defining who is too mentally ill or disabled to carry a gun is more complicated than it seems, however. The perpetrators of recent mass shootings didn’t have a history of court-ordered medical treatment. But broadening the law to encompass everyone with a mental illness doesn’t make sense, said Ron Honberg, national director for policy and legal affairs at the National Alliance on Mental Illness.
“I think that would not only be pretty blatantly discriminatory, but it would also potentially have a chilling effect on the willingness of people to seek treatment, if they knew that by seeking treatment their name would go into an FBI database,” Honberg said. Nearly half of all Americans will suffer from a mental illness during their lifetime, according to the Centers for Disease Control and Prevention.
And more rigorous screening at the checkout counter wouldn’t have kept weapons out of Lanza’s hands, anyway. All he had to do was grab one of his mother’s rifles.
“Regulations that are focused on point of purchase—which is, let’s not let a dangerous person buy a new gun—they’re pointless if ordinary people have such ready access to highly deadly weapons,” Swanson said. People barred from buying a gun legally can pick one up illegally, he pointed out.
No one policy can prevent mass shootings like the massacre at Sandy Hook, experts say. But a holistic approach might. Providing more mental-health services, fostering a culture that encourages troubled people to seek help, and making sure weapons are kept out of dangerous people’s hands are all pieces of the puzzle.
Expanded access to mental-health care is already on its way. The expansion of Medicaid, under the 2010 health care reform law, should expand access to mental-health services to the previously uninsured. The law will require all health insurers to cover mental-health services on a similar basis to other kinds of health care, and health insurance plans sold in the new state exchanges will be required to include mental-health coverage.
The final piece of the puzzle is gun control. It’s not just the mentally ill who act on an urge to do harm to themselves or others. Homicides and suicides take place in the United States every day. Statistics show that rates of firearm deaths are higher in states where guns are more prevalent.
Focusing on mental-health issues, but staying silent on gun control, in the wake of a shooting spree is something of a political choice, Swanson said.
“The gun-rights advocates are jumping on the mental-health bandwagon and saying, it’s not the guns, let’s have a better mental-health system,” Swanson said. “Well, they weren’t saying that last week.”