Why it’s wrong to blame mass killings on mental illness

August 16, 2019

Donald Trump has tried to lay the blame for America’s mass shooting epidemic on history’s most convenient scapegoat: mental illness. Or, as he has taken to calling people with psychiatric disease, “mentally ill monsters.” (He’s also referred to “nut jobs,” “lunatics,” and “wackos.”) 

Trump, reading to Americans from a teleprompter, declared that “mental illness and hatred pulls [sic] the trigger, not the gun.” Less than 24 hours later, the National Council on Behavioral Health came out with a 96-page report, a year in the making, that looked at the cause of mass violence very differently. 

“Simplistic conclusions ignore the fact that mass violence is caused by many social and psychological factors that interact in complex ways,” the report’s authors write. “Many, if not most, perpetrators do not have a major psychiatric disorder; and the large majority of people with diagnosable mental illnesses are not violent toward others.” 

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The council, the largest organization of mental health and addiction specialists in the United States, convened panels of experts—including clinicians, policymakers, researchers, educators, advocates, law enforcement officers, judges, parents, and patients. They looked at the proliferation of mass violence in America to see how it correlates with mental illness. The experts examined data and offered analysis about known causes of mass killings. Their findings dramatically contradicted Trump’s narrative: four out of five mass killers had not been diagnosed with a mental illness. There is no particular diagnosis that makes a person more inclined to commit mass murder. 

The investigators identified common patterns: most mass shooters are men, often hopeless and harboring grievances related to work, school, finances, or interpersonal relationships. They feel victimized and sympathize with others who they perceive to be similarly mistreated. They express an indifference to life and often to dying by suicide. They typically plan and prepare for their attack and often share that information with others— but not their intended victims. 

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Jillian Peterson, a psychologist at Hamline University, and James Densley, a sociologist at Metropolitan State University, both in Saint Paul, Minnesota, spent the past two years building a database of more than 50 years of mass shootings. The pair searched for new data-driven pathways to prevent such shootings. They found four common traits— childhood trauma, harboring a grievance, a fascination with others who committed these types of killings, and easy access to lethal weapons. None was a mental illness diagnosis. 

People with mental illness have always been easy targets for scorn and blame. In early America, they were demonized, locked in cages, and put on display in town squares as a form of cheap entertainment. Later, some were carted off to asylums built on the outskirts of town to live out the rest of their days in oppressive conditions, often with no more cause than the signature of a relative and a willing doctor. 

Vilifying people with mental illness in the wake of a mass shooting is in line with that historic cruelty. “Blaming ‘mentally ill monsters’ for such carnage is a morally repugnant, if time-tested device for shifting the public’s passion for safety away from gun control and toward the presumed demons in our midst,” Ron Powers, author of No One Cares About Crazy People (2017), says. Powers, who lost a son to suicide and has another son with schizophrenia, observes that the “cost of this cluelessness is felt through society.” It “draws in and ravages parents and siblings of the stricken,” he says. “It can cripple the finances of families without adequate insurance to cover treatment and medications. It drains human capital from the workforce, and thus economic revenue.” Hospitals don’t get adequate reimbursement for their mentally ill patients, he adds. Police, who often lack sufficient training, are overburdened by the number of people with mental illness on their beats. Cops hustle the mentally ill into jails where they await trial—often for weeks, without proper medication. 

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These are the problems that reporters should be pressing politicians on. Trump says he’s pushing for tighter restrictions on gun sales to people with a history of mental illness, yet he reversed an Obama-era rule that did just that. We know that shooters are volatile and easily manipulated. What role do Trump’s tweets play when he calls Mexicans “rapists” and “bad hombres” and talks of them “invading” our country? For years, psychiatrists have wrestled with the question of whether extreme racism should be classified as a mental illness. It is not listed in the Diagnostic and Statistical Manual of Mental Disorders and there is no plan to add it, Paul Appelbaum, a Columbia University psychiatrist and member of the manual’s steering committee, says.

Peterson and Densley suggest changing how we consume, produce, and distribute violent content in news reports and on social media. “Don’t read or share killers’ manifestos or other hate screeds posted on the Internet,” they wrote in a recent op-ed in the Los Angeles Times

The authors of the National Council report offer good advice for reporters, too. “Help educate the public about mental illness by dispelling myths about mental illness and violence,” they wrote. “Provide a framework for understanding these rare but disturbing events. Offer information about treatment and services and the problems caused by lack of access to them.” 


I spent decades interviewing people with severe mental illness, including Alberta Lessard, the Milwaukee woman whose civil rights case established a national standard for civil commitments. The violence, scandal, and outrage of the stories I heard was not usually what people with mentally illness did to others, but what was done to them. My advice to fellow journalists:

Know your limitations. You can find the who, what, when, where, and how of these mass killings. The “why” is a lot more elusive. 

Try to get medical records of the killers. Ask relatives. If there was a mental illness diagnosis and the person had trouble getting proper care (as often is the case), parents and siblings may be eager to air that fact. 

Don’t let amateurs, such as neighbors of a shooter, weigh in with their theories. Only doctors who have examined the person can say with authority if mental illness was a factor. 

Don’t be tempted by the pressure of the 24-hour news cycle and theories floated on social media. 

Question the motives of those who are quick to blame people with mental illness for these killings. It’s worth noting that, according to Open Secrets, the National Rifle Association spent more than $5 million in lobbying fees last year, compared to less than $5,000 for the National Alliance on Mental Illness. 

When we speciously blame violence on people with mental illness we are adding to a stigma. Many who suffer will be less inclined to seek treatment because they fear others will assume that they are dangerous. 

Mental illness is an awfully big tent. It includes parents depressed after the death of a child and students with panic attacks at the idea of taking a midterm exam. They are people with full-blown delusions from schizophrenia, and soldiers coming home with post traumatic stress. They’re adults and children who have been sexually abused. When Trump and other politicians call mentally ill people “monsters” and try to pin the mass shooting epidemic on them, they are not just engaging in bigotry. They are distracting us from important clues that might spare a family a knock on their door from a police officer with terrible news.

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Meg Kissinger is the Joan Konner Visiting Professor at Columbia University’s Graduate School of Journalism. She teaches an investigative reporting class on the mental health system. Kissinger won the George Polk Award for her coverage of Milwaukee’s troubled behavioral health system and a Robert F. Kennedy National Journalism Award for her examination of the nation’s imminent danger standard.