We are all horrified when a shooting happens. We cannot begin to imagine what goes on in the mind of someone who would plan and execute the violent deaths of innocent people just going about their lives. Only a truly and devastatingly pathological person is capable of such acts.
But to label that person as “mentally ill” doesn’t help – and in fact, can do a good deal of harm.
The problem begins with the misuse of the term, “mental illness.” Though the term is meant to refer to diagnosable psychological conditions, in this context, it’s being expanded to include hateful and twisted thinking of people who endorse radical fringe political or religious beliefs and see violence as a necessary means to shape the world they envision. Many of these people have no apparent diagnosable condition. Blaming mass shootings on a problem in someone’s head is kind of like saying that weather causes hurricanes—while technically true, it’s not very useful for understanding the phenomenon.
Even when a shooter has been diagnosed with an actual psychiatric disorder, the “mental illness” label isn't helpful because it's overly broad, encompassing a vast range of conditions like posttraumatic stress, obsessive-compulsive disorders, anxiety, depression, autism spectrum disorders, eating disorders—around 265 specific kinds of illnesses by last count. And in each of these diagnoses, the symptoms and severity can vary greatly.
Furthermore, research shows that knowing someone’s psychiatric diagnosis does not help predict future violence, except for those with drug or alcohol problems. Some conditions, like a form of obsessive-compulsive disorder, even make a person especially horrified by the thought of acting violently. As such, the label of mental illness adds little information to understand a killer’s motivations or to predict future shootings.
If you have a psychiatric condition, you might be experiencing the effects of the mental illness argument on a personal level. Perhaps like countless others dealing with legitimate mental health issues (and are not violent), you’ve felt self-conscious about your condition, not wanting others to see you as a potential threat because of a diagnosis like anxiety or depression.
I’ve certainly heard from some of my therapy clients that they’re reluctant to let people know about their condition for exactly this reason. Some have even worried about their own potential for violence, because of their “mental illness.” Unlike the shooters, though, they’re sickened by the thought of hurting others.
I suppose my own history of major depression and chronic insomnia could cause some to consider me a potential mass shooter. Both of these conditions are listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, the diagnostic “Bible” for psychiatry in the US. However, it never occurred to me that my mental illness could make me a threat, or that others would perceive me as such—any more than my being male should be a red flag (given that nearly all shooters had a confirmed history of maleness).
Unfortunately fears about the way others might perceive your psychiatric status are not unfounded in a society where stigma against everyday (nonviolent) mental illness is still alive and well. Indeed, a significant percentage of the public—regardless of gender, education, and other demographic variables—still believe that people with a psychiatric condition (especially ones like schizophrenia) are likely to act violently.
To be clear, the problem with the “mental illness” argument is not that it hurts people’s feelings. When there is a meaningful connection between a condition and negative outcomes, we need to be able to speak openly about that link. For example, it’s important to know that a substance abuse problem raises the risk for violence.
The problem with the mental illness argument in this context is that it doesn’t further our understanding of what we’re trying to prevent. And in the process of aiming our attention in the wrong direction, it unfairly targets those who are clearly not a threat. It’s time to be more precise in how we talk about those who commit these crimes. Let’s drop the mental illness argument.