Mass shootings and mental illness: It's complicated

"Shooting in Copenhagen, Denmark where guns are BANNED?" This is what Lavern Spicer, a Republican Congressional candidate from Florida wrote in a tweet that went viral the day after last Sunday's deadly shooting at a mall in Copenhagen.

She was one of several US politicians who seized on the incident to argue that stricter gun laws do not prevent mass shootings. The argument is one that gun rights advocates repeat after almost every mass shooting: Mental disorders are to blame for violence, not weapons.

The media tends to promote this oversimplified narrative, according to multiple studies, even though it does not treat all perpetrators equally: Muslim mass shooters are often perceived as less mentally ill and more motivated by religion, a 2018 study found, while Black men and Latinos are cast as violently inclined, as opposed to white men, who are characterized as victims of their mental health conditions, another piece of research shows.

But the link between mental health problems and committing acts of mass violence is more nuanced than many politicians and media commentators suggest.

Mental health is only one risk factor

"Mental illness is definitely a key risk factor," Lisa Pescara-Kovach, a professor of educational psychology and Director of the Center for Education in Mass Violence and Suicide, told DW. "But that's not the only factor, and we should not solely focus on that."

 After the mass shooting at an Independence Day parade in Chicago on Monday, Pescara-Kovach began looking into the background of the alleged perpetrator. His profile has a lot of similarities with many others who have committed the same type of violence, she noted.

The suspect was depressed, Pescara-Kovach said. He attempted suicide in 2019 and threatened to kill members of his family several months later.

But depression does not explain why he opened fire on people.

First of all, proper risk assessment could have prevented the attack. "He had numerous behaviors of concern, but somehow it never really made it to a formal complaint," she noted. On social media, he regularly posted extremely violent content, some of which was related to school shootings or assassinations.

"If someone would've done a proper threat assessment, somewhere along the line, we could have gotten him some sort of case management," Pescara-Kovach said.

More importantly, it was the easy access to rifles that make such attacks possible. "No civilian should have" the high-powered weapons owned by the suspect, she said.

Guns versus mental illness

Singling out mental disorders as the main cause of gun violence disrupts efforts to identify potential shooters and stop their rampages from happening. "The main issue is it becomes guns versus mental illness," Pescara-Kovach said.

This narrative portrays the perpetrators as victims rather than those who victimize other people, she pointed out, adding that this discounted many other important factors such as social neglect.

The US National Threat Assessment Center has published a guide for preventing school shootings and periodically updates it. The document lists factors that school and health officials must keep an eye on. It includes family and school dynamics, weapons access as well as mental stressors.

What do the numbers say?

The precise figures of the presence of mental illness in mass shootings are hard to come by. Only 25% of all the mass shooters between 2000 and 2013 had been diagnosed with a mental illness prior to the attack, according to one research paper published in 2018 that surveys incidents in that time period.

Several other studies focusing on different data sets also suggest that perpetrators have had serious mental illness only in a minority of incidents.

But a study released in 2020 shows that about two-thirds of US mass shooters who attacked from 1966 to 2019 exhibited signs of mental illness.

However, several researchers say that mental illness, even in serious forms, is neither a necessary nor sufficient condition for mass violence.

Jennifer Skeem, a professor at the University of California, and her colleague studied serious mental illnesses like schizophrenia, bipolar disorder, and major depression, which are not the same as emotional distress from life circumstances and problematic personality traits. "There is an association between serious mental illness and violence — but it is weaker than the public imagines or the media portrays, and rarely causal," they found.

In their paper, which was published in 2019, they acknowledge that most mass shooters do fall somewhere on the spectrum of mental illness, defined broadly, but "that's merely a testament to how common mental illness is," they wrote.

What turns a person into a mass shooter?

"The issue isn't severe mental illness," Pescara-Kovach explained. "The specific feelings experienced by these individuals are hopelessness, desperation, and suicidality."

Identity issues, and insecurity about body image, are shared feelings among many shooters, an overwhelming majority of whom are young men. They are also prone to espouse extremist views and share a fascination with Nazi and hypermasculine imagery.

Also common between the mass shooters are fame- and attention-seeking motives.

"Often times, perpetrators …feel that their life is small, and they want to be part of something big and they want to be part of history," Pescara-Kovach said.

"The key to preventing these attacks is reducing risk factors and increasing access to mental health support," she noted. However, we should not confuse psychological assessments with violence risk and threat assessments, she cautioned.