By
Melissa Chan
and
Elizabeth Chuck
-
NBC News
In the wake of another massacre, some Texas politicians have called for more mental health services to help prevent the next tragedy.
But experts in the field warn that there is no completely effective solution from mental health care to stop these shootings and some say that blaming it on this is a deviation from the fact that
gun control is a necessary part of the prevention.
“We can do everything we can to help students, but at the end of the day, if a student has the idea of going to shoot up a school and has access to weapons to do it, I'm not sure what measures taken or not would necessarily prevent it,” said Jill Cook, executive director of the American Association of School Counselors.
Altar for the victims of the shooting in Uvalde, Texas, on May 27, 2022. Anadolu Agency / Anadolu Agency via Getty Images
"If someone comes to the door with a semi-automatic weapon," Cook said, "then that's it."
On Tuesday, 19 children and two teachers were shot to death at Robb Elementary School in Uvalde, Texas, by an 18-year-old gunman.
State authorities have said that within days of his 18th birthday earlier this month, the shooter had purchased two semi-automatic rifles at a local gun shop.
He also bought 375 rounds of ammunition.
[“The city of Uvalde is very disconsolate”: Latinos worry about the effects of the shooting on their mental health]
Although Texas Gov. Greg Abbott claimed Wednesday that a "mental health issue" had played a role in the massacre, the gunman had no known criminal record or history of mental health issues.
And Abbott wasn't the only one to point to mental health.
In the days after the shooting, Uvalde Mayor Don McLaughlin told News 4 San Antonio that the tragedy could have been prevented had more mental health resources been dedicated to his region.
“Maybe we could have caught him,” he
said.
"Maybe if we had counselors, maybe if we had mental health staff, we could do it."
Obstacles to Accurately Predicting Violence and Ensuring Treatment
Dr. Ziv Cohen, a New York City-based clinical and forensic psychiatrist, said boosting mental health services in communities and making them more affordable could help reduce gun deaths, particularly suicides, But there is no completely effective mental health solution to stop mass shootings.
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May 28, 202201:52
That's largely because they can be difficult to predict.
Attackers rarely show overt signs of serious mental illness, such as having hallucinations or being completely out of touch with reality, Cohen explained.
Instead, of those who show signs of mental illness, the vast majority share common ground with many people who do not become killers.
Those characteristics include depression, isolation from family and classmates, narcissism, paranoia and suspicion, Cohen said.
Many can easily feel threatened or insulted by others or feel that they are on a mission to prove a point.
"If you look at a group of people with these mental health issues,
it's almost impossible to pick out the one that's actually going to commit a mass shooting
," Cohen said.
"That's why we haven't really found a solution."
A 2015 article in the American Journal of Public Health notes that “psychiatric diagnosis is largely an observational tool.”
"Largely for this reason, research dating to the 1970s suggests that psychiatrists who use clinical judgment are not much better than laymen at predicting which patients will and will not commit violent crimes," the authors wrote.
[The timeline of the attack on the primary school in Uvalde: what is known about how the tragedy unfolded]
Cook said no test, assessment or metric alone could identify a multi-homicide early enough to seek mental health treatment.
Schools must ensure that all adults in the system (teachers, bus drivers, coaches, custodians, and cafeteria workers) understand the warning signs of someone at risk of harming themselves or others and have systems in place to report threats potentials.
But even then there are obstacles, he warned.
Mental health providers are limited when a person suspected of being at risk refuses help or lies through a psychiatric evaluation.
This is how Abbott defends the legality of buying a long gun at age 18 in Texas
May 25, 202201:20
Earlier this month, authorities said a white teenager in upstate New York underwent a mental health evaluation after a teacher reported a chilling comment he made in class about a murder-suicide.
But he wasn't stopped and he ultimately shot and killed 10 black people in a racist attack at a supermarket in Buffalo, according to authorities.
And last year, before a shooting at Oxford High School in Michigan that left four dead, a teacher alerted school officials to drawings found on the 15-year-old suspect's desk that depicted scenes of violence.
A counselor showed the drawing to the suspect's parents, who were told they needed to get their son to therapy within 48 hours.
The parents, who purchased the gun used in the shooting and have since been charged with involuntary manslaughter, refused to take their son home and returned him to the classroom.
The teenager allegedly perpetrated the massacre later that same day.
His parents have pleaded not guilty to the charges.
And the idea that mental health counselors can identify threats and prevent shootings is not clearly supported by research.
[“They were good people”: a girl remembers her friends]
In an article published last year in the Harvard Review of Psychiatry, the authors argue that defining the role of mental health providers in massacre prevention is "inherently difficult."
“The assumption that mass shootings are driven solely or primarily by diagnosable psychopathology borders on the limit of mental health expertise,” the article states.
"It also sets up a false expectation that advancing neuroscience and better therapies to manage psychiatric symptoms will provide 'the answer' to solving gun violence."
"There is no existing or future unified theory of impaired brain function or cognitive, mood, or behavioral dysregulation that can adequately explain multiple-victim shootings or firearm homicides," he added.
Avoid stigmas
The topic is complicated, but the public discourse around it "tends to be very simplified," said Peter Langman, a psychologist who has studied armed attackers and is the author
of Warning Signs: Identifying School Attackers Before They Hit Themselves. let them attack
Uvalde's murderer had threatened to rape and kill several young women on social networks
May 28, 202200:28
"We have to be careful not to stigmatize mental health issues and associate them with gun violence because that's wrong," he said.
"On the other hand, happy, well-adjusted people don't commit mass murder."
But behavioral health treatment hasn't been a one-size-fits-all solution to preventing killings, he added.
Langman said a multi-pronged approach is required, including
putting more threat assessment teams in schools and restricting access to firearms
, particularly in homes with minors.
"There have been school shooters who were receiving mental health treatment and still carried out attacks because they wanted to, and didn't reveal what was going on in their minds to health professionals," Langman said.
[Ted Cruz is the senator who has received the most money from pro-gun groups. This he did when a reporter confronted him]
Cook assured that millions of people in the United States have mental health problems, but the percentage of those who commit mass murder is minuscule.
"Equating this solely with mental health is a misstep and a misstep," he
said.
Fewer than 10% of shootings nationwide involve a suspect who has a mental illness, according to the National Alliance on Mental Illness.
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Experts explained that there's not much mental health providers can do, because gun violence and firearm purchases are on the rise across the country.
"Mental health is not going to get us there," Cohen said.
“The mental health community cannot solve the problem of gun violence in America,” he added.
