Saturday, July 21, 2012

Aurora - the rational response is better schizophrenia management

Robert Ebert:  "Here is a record of mass shootings in the United States since 2005. It is 62 pages long ... The hell with it. I'm tired of repeating the obvious."

Gail Collins: "Did you catch the one last week in Tuscaloosa? Seventeen people at a bar, hit by a gunman with an assault weapon."

Well said, but both Collins and Ebert know we're not going to get meaningful gun control in the United States any time in the next twenty years. We'll get a Carbon Tax long before we'll get weapon management.

American gun control died when the NRA pushed Bush to a statistical tie with Gore, and brought us the torture presidency.

In any case, it's not clear even strict gun control would be more successful than the American War on Drugs. There are vast numbers of inexpensive and effective weapons of mass murder in the US. The cost of havoc is low.

As a nation, we've gone a long way down a rough road.

That doesn't mean we can't do anything. It's almost certain that the latest killer is mentally ill, probably paranoid schizophrenic. As a nation, our care of the mentally ill is abysmal in blue and red states alike. Physicians have fled the specialty of psychiatry and we're dramatically short of the family physicians who might fill the gap.

If we're going to get anything of value from this soon-to-be forgotten nightmare, it won't be from some incremental and soon eroded change to Colorado's gun control laws. It will come from leveraging Obamney Care's new financing for mental illness. We need to make it much easier for friends, family, and teachers to get help for paranoid schizophrenics, and we need to provide support for treated schizophrenics to stay well.

Update 7/22/2012: A slightly different take from a Columbine book author:

The Unknown Why in the Aurora Killings - David Cullen -

... Dylan Klebold was an extreme and rare case. A vast majority of depressives are a danger only to themselves. But it is equally true that of the tiny fraction of people who commit mass murder, most are not psychopaths like Eric Harris or deeply mentally ill like Seung-Hui Cho at Virginia Tech. Far more often, they are suicidal and deeply depressed. The Secret Service’s landmark study of school shooters in 2002 determined that 78 percent of those shooters had experienced suicidal thoughts or attempts before mass murder...

It's a bit odd to say that someone who is suicidal and has delusional symptoms of major depression is not "deeply mentally ill", but Cullen is not a physician.

I think what he's trying to say is that most shooters are mentally ill, but that psychotic or severe depression is more common than schizophrenia.

I haven't been able to find any public health literature, but it's important to note that many shooters don't survive to get to a full psychiatric evaluation. One of the best responses to the Aurora shooting would be to fund a review of psychiatric issues in shooters and identify intervention opportunities.


Yehuda said...


First, don't express premature asumptions on the illness of the killer. Especially if you don't know what you are talking about.

Paranoïd schyzophrenic are very rarely dangerous for anyone else than themselves.

Paranoïd schyzophrenic don't have multiple personalities nor personality disonance.

A paranoïd schyzophrenic wouldn't have been sure to be the Joker.

You really are saying crap, you should better be aware that what you are saying could be dangerous.

JGF said...

Given the killer's age and lack of a record, the probability of paranoid schizophrenia is fairly high.

I know more about this topic than you imagine.