Are people with mental illness more likely to commit mass shootings?

Are mass shooters mentally ill? Are they simply angry with the world? Is mass shooting associated with schizophrenia and psychosis? What leads people to mass shootings? Well...

On May 24, 2022, 18-year-old Salvador Ramos opened fire, killed 19 students and two teachers, and wounded 17 other people at Robb Elementary School, Uvalde, Texas.

Three people died a few weeks later, and 11 were injured in another mass shooting on a regular Saturday night in Philadelphia. There have been other mass shootings in other parts of the US.

And on May 7, 2023, eight people were killed and seven were wounded at a busy outdoor shopping center in Allen, Texas, before police killed the gunman. Is it anything new? Sadly, no.

There was one during a live performance in Las Vegas back in 2017. And, of course, others before that. There have been public assumptions fueled by media commentaries that most mass shooters are mentally ill. But how accurate is this assumption?

In most mass shooting cases, the assailants are either killed on the crime scene or are nowhere to be found, so we can't ask them.

Some mass shooters who died on the scene were found to have been diagnosed with some mental illness before the gruesome incident.

But there are a few cases in which psychiatrists have tried to get into the minds of mass shooters that were caught.

For example, the Aurora theater shooting.

James Holmes killed 12 people and wounded 58 when he opened fire during the showing of "The Dark Knight Rises" in Aurora on July 20, 2012.

William H. Reid, one of the psychiatrists appointed to evaluate Holmes, said that "what led Holmes to open fire in a crowded movie theater was a one-of-a-kind vortex of his mental illness, his personality and his circumstances."

"A big part of it is, it's hidden in Holmes' mind, and he can't see it either," said Reid.

The psychiatrist noted Holmes' mental illness and how his personality shaped his awkward interactions with people as some key factors that led him to homicide.

But this is actually just one out of many mass shooters.

So let's take a dive into some research.

What Studies Show about Mental Illness and Mass Shootings

To find out why mass shooters act as they do, Dr. Ira Glick led some researchers to study 35 mass shooting cases in the US dated between 1982 and 2019.

Of the 35 mass shooters, medical evidence showed that 28 have mental illness diagnoses. Eighteen had schizophrenia, and the rest had other mental disorders, including bipolar and substance abuse disorders.

Interestingly, none of the 28 mass shooters received treatment or medication for their mental illness before their crimes.

The researchers went on to study 20 other mass shooters who died at the crime scene. Out of these, 8 had schizophrenia, 7 had other mental disorders, while 5 had unknown diagnoses. Again, none was receiving treatment leading up to their mass shooting.

Reports suggest that up to 60% of mass shooters in the US since 1970 displayed symptoms of mental illness before committing the crimes.

Again, this are just some cases, and not a full representation of the bigger picture.

In 2021, Ragy Girgis, MD, an expert in severe mental illness, and colleagues from Columbia’s Center of Prevention and Evaluation delivered the first report on mass shootings and mental illness. They used the Columbia Mass Murder Database (CMMD), the largest catalog of mass shootings and mass murder in the world, for their research

The study found that only approximately 5% of mass shootings are related to serious mental illness like schizophrenia and psychosis. Although there was a higher (25%) incidence of mass shooting among non-psychotic psychiatric or neurological illnesses, including depression, the incidence was more coincidental than causal.

Why Consider Mass Shootings and Mental Illness Coincidental?

According to the World Health Organization (WHO), about 1 in 4 people will be affected by mental or neurological disorders at some point in their life. Most mass shooters are middle-aged (although in recent years the median age is younger). Given these statistics, it's hard to imagine that out of 20 mass shooters, there'll be none without any history of mental illness.

Chances are a few would have had some mental disorder at some point. And since mental illness appears a more likely reason why a person would commit mass shooting, it's easy to assume that most mentally ill people are potential mass shooters. And this leads to a stigma.

Mentally Ill People are Not Always Violent

Mentally ill people are not always violent. People with mental illness receiving treatment are no more violent than the general population. And the vast majority of people with serious mental illness are never violent.

But the media highlights a handful of mass shooters with mental illness, and it sends a wave across town, creating a perception that all mentally people are violent and potential mass shooters. It's more like an overgeneralisation.

The effect of such media accounts is therefore counter-intuitive, as people with mental illness become less likely to come out and seek treatment due to the stigma.

Why We Have to Focus on Other Factors Impacting Mass Shootings

Incidence of mass shootings was 7 for every billion people between 1900 and 1970 when there was less gun availability. The incidence has increased four times, now standing at 28 times per billion people. One may argue that it's due to more gun availability. While mass murder using other weapons also grew during this period, it was at a much slower rate. It's like providing an opportunity for people to carry out their dark wishes: desire for notoriety.

Hence, higher gun availability can be considered a primary contributing factor to the growing rate of gun violence.

In short, when a person with severe mental illness commit violence, they're less likely to use firearms.

How Can We Reverse the Stigma?

It may be better for the media to refrain from dispelling personal details of mass shooters. Some of these perpetrators are young people who feel empty and rejected by society, thus desiring to leave their mark in the world. When other young people feeling this way come across such news, it may ignite their desire to become famous through the same horrifying means.

So, before focusing attention on mental illness as a risk factor for gun violence (which leads to stigmatization), we should strive to address other risk factors like gun availability.

Battling Mental Illness?

I want you to know you're not alone. No matter how you feel now, you have worth, and you can get past this phase and live a higher quality of life. Whether it's schizophrenia, depression, or any other mental issue, I want to help you. Come, let's talk!

Author

Satu H. Woodland, PMHCNS-BC, APRN Satu Woodland is owner and clinician of Hope Mental Health, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.  Ms. Woodland with her background in nursing, prefers a holistic and integrative approach to mental health care that addresses the mind and body together. While Ms. Woodland provides medication management services in all her patients, she believes in long-lasting solutions that include a number of psychotherapies, namely cognitive behavioral therapy, exposure and response prevention therapy, attention to lifestyle, evidenced based alternative psychiatric care and spirituality. If you’d like to gain control over your mental health issues, call Hope Mental Health at 208-918-0958, or use the online scheduling tool to set up an initial consultation.