Mass Gun Violence
US has the dubious distinction of leading the world in mass gun violence, defined as four or more shootings in a single place. It is so common in the U.S., we actually have accumulated a database, Public Mass Shootings: Database Amasses Details of a Half Century of U.S. Mass Shootings with Firearms, Generating Psychosocial Histories. By averaging more than one every day, we have learned a lot about the mass shooter.
We know that only 4 percent of shooters have a treatable mental health diagnosis. It is apparent that the gun violence crisis is independent of a mental health crisis. Shifting the blame to a non-existent mental illness helps no one but the gun industry.
So what do we know and what can we do? Peterson and Densley in their book,The Violence Project: How to Stop a Mass Shooting Epidemic, propose that students who become school shooters undergo a consistent pathway. It starts with extreme bullying, rejection from peers, isolation and self-loathing and ends when their hate turns outward toward classmates, religious groups, immigrants or anyone they can blame. The authors have a $50 billion solution; hiring 500,000 psychologists.
Suicidality is a strong predictor of who might become a mass shooter. Thirty percent of mass shooters were suicidal before their shooting and another 39% during their shootings. School age shooters, using guns taken from family members, are almost always suicidal. Suicide prevention programs could be better funded than at present.
Most shooters are men with a prior criminal record (64.5%) and a history of violence (62.8%). They have ready access to firearms. At least 36% had been trained by the US military. Many act as if they’re still in the military, waging their own delusional wars against African Americans, immigrants, Jews, LGBQs or other groups. Many of them went to war to kill, received the training and still have that urge. They use military weaponry and many still dress in their military clothing. We have laws keeping dishonorably discharged men from owning guns but we can’t stop them from stealing one.
Further, they are often products of traumatic abusive childhoods and are in the midst of a personal crisis. We can’t confront the root causes of early childhood trauma. That would require massive public investments and programs and we already waged a war on poverty fifty years ago and lost it.
It needs to be said that none of the above is a mental health diagnosis. All males, mentally ill people, domestic abusers, Nazi-sympathizers, loners, and gun-purchasers are not mass-shooters. Vice Chairwoman of Community Psychiatry at the University of California Davis Amy Barnhorst said it best in a New York Times Op-Ed commentary, “there is no reliable cure for angry young men that harbor violent fantasies”.
What then can we do that is actionable? The most obvious common sense step would be to make access to firearms more difficult for at- risk men. That move is prevented by the powerful gun lobby and has little chance of success. Since four-fifths of shooters make their intentions known via social media or directly to their family, and often leaving a written record or manifesto, we can educate families and co-workers about red flag laws and how to recognize warning indications. Alerted families can seek a gun violence restraining order, (GVRO) from a court to remove any gun from a person deemed dangerous.
That is exactly what the mother of Nathan Cruz did when she learned that her son planned to buy an AR-15 rifle and “do the same thing” his cousin, Salvador Ramos did in Uvalde a year earlier. Nathan was arrested and the targeted school in San Antonio was spared.
Red flag laws work well in 19 states and the District of Columbia when law enforcement agencies are adequately trained and willing to petition the court. And people have to know such laws exist.
Only two red states, Florida and Indiana, have passed red flag laws. Florida enacted a red flag law in 2018 after the Marjory Stoneman Douglas High School massacre. In the three following years, their courts handled 8,100 red flag petitions. There’s no knowing the number of mass shootings those petitions prevented.
After the Uvalde massacre, the Texas legislature put the blame on liberal “wokeness”, fatherless families and videogames but refused to raise the age to purchase a gun from 18 to 21. That change would have prevented Ramos from murdering 21 people and injuring another 17.
Calls for improved mental health services and better school security are the standard responses. We have been there and done that. They didn’t help the Cobb Elementary School in Uvalde, a school with state of the art security and a full-time armed guard. We find ourselves doing the same thing and expecting a different outcome and that fits the common definition of insanity.
So at long last, there’s your mental health diagnosis.
Gilbert Simon MD is a Professor at the California NorthState College of Medicine and is the author of Ripped Off! Overtested, Overtreated and Overcharged: The American Healthcare Mess.