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About Mental Health

The shooting in Las Vegas Sunday night has killed at least 58 people and injured more than 500, and is being called the deadliest mass shooting in modern U.S. history. Many are still being treated with life threatening injuries.

This is just the latest in a string of mass shooting events. With so much tragedy in the news recently, we often look for answers to make sense of it all. What we don’t know scares us. If we can pinpoint just one cause of tragedies such as this, our minds can begin to rationalize them. Or so we hope.

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Of course, gun control is a prominent discussion that takes center stage. As are acts of terrorism. But equally prominent is the discussion of mental illness. What kind of person does something like this? Surely they must have a mental illness. But do they really?

Surveys have found that the majority of people believe that mental illness is directly correlated to violence. While it seems an easy place to point the finger, the reality is most individuals with mental illness are not violent.

Research supports that only three to five percent of all violent acts are committed by someone with mental illness. Instead they suffer from symptoms that cause a state of internal hell, not one they are wanting to push onto others. And in cases where the suspect ends up dead, we are left with whatever psychiatric records exist, if any. Without being able to conduct a psychiatric evaluation after-the-fact, we are only left with speculation.

In reality, people with mental illness are actually considered a vulnerable population. As a result they are more likely to experience an act of violence against them. People with mental illness are more likely to die from homicide than those without mental illness. They may have a harder time getting and maintaining employment. The average lifespan is decreased. Many are financially exploited. This population most often becomes the victims; they are not the ones victimizing.

Let’s get a few things straight. Mental illness cannot be lumped into one distinct disorder with a set of symptoms that definitively leads to violence. There are a variety of different mental illnesses.

When people have depression, they have a sad mood, loss of interest in things they used to enjoy, changes in sleep and appetite, and may even have thoughts of hurting themselves. With anxiety disorders, people feel excessive worry and can experience physical manifestations of this worry such as increased heart rate and stomach upset. With psychotic disorders such as schizophrenia, people have a reality that may be different than the reality of others. They can experience hallucinations in which case they may hear voices. However, hatred is not a mental illness. Terrorism is not a mental illness. Blaming violence on mental illness, used as an umbrella term, is dangerous in and of itself.

We as a society are largely uncomfortable with mental illness since we do not have a thorough understanding of why these symptoms occur. We have a blood test to monitor sugar levels for diabetics. We have imaging that can see broken bones. But we aren’t there yet with the brain. New research and technology has linked certain chemicals and areas of the brain to mental illness. But it is still largely misunderstood.

As such, mental illness is plagued by stigma. Stigma makes it less likely for people with mental illness to feel understood by family, friends, and their community and to seek treatment — which can make symptoms worse. Even more troubling, some of the side effects from the psychiatric medications we use to treat mental illness can cause some of this very stigma.

For example, certain antipsychotic medications can cause people to have uncontrollable tics, tremors, and muscle movements, and these behaviors can look strange to others. Making blanket declarations that anyone who commits a mass shooting must have a mental illness only contributes to this stigma.

It would be negligent to not acknowledge that serious mental illness has been identified in some mass shooters. With the rate of mental illness being 1 in 5 people, this is no surprise. In some cases, the shooter’s symptoms may have more directly caused them to act in that way.

For example, if someone is delusional they experience false, fixed beliefs. If these beliefs cause them to become paranoid they may act out in a violent way. James Holmes, the Colorado theater shooter, was diagnosed with a mental illness that may have led him to be paranoid, possibly contributing to his actions.

Tragedies such as the one that happened in Las Vegas represent opportunities for us as a nation to start, or at least resume, important conversations. However, these conversations should be educated, not perpetuating the hatred and discrimination that get us into these very situations in the first place. Not all mass shooters are mentally ill.

Not everyone with a mental illness is violent. This vulnerable population needs our protection from the stigma that works to bring it down. While the mental health system is plagued with issues from shortages in providers to funding cuts, lack of mental health treatment should not be the central focus of blame for perpetrators of mass violence. It’s time to take a more realistic look at the various factors driving these tragedies and shift our focus to real solutions.

The views expressed by contributors are their own and not the view of The Hill

Dr. Michelle Heyland is an Assistant Professor of Community, Systems, and Mental Health Nursing at the Rush University College of Nursing, a Psychiatric Nurse Practitioner, and a Rush Public Voices Fellow.