The nation is once again riveted by the horror of a mass murder.  Viewing the tragedy in the national media coverage, talking about it on Facebook, Twitter and other internet venues is  how we come together in modern society to share our anxiety and our grief.  Prominent in all the discussions is the question of WHY-as if there is some rational answer to such irrational behavior.  I suspect that in trying to answer “why”, we seek to comfort ourselves that there are ways we can find protection from such terror.

To me, the WHY is simple to answer; a person with some form of severe mental illness combined with our society’s ease of access to the weaponry of mass murder allowed this to happen, will continue  to allow it to happen.  I will certainly agree that guns are not the only source of mass terrorism-the Kansas city bombings and September 11 prove that theory easily.  Dedicated terrorists interested in wreaking mass destruction can always find ways to harm us although Federal and state law enforcement agencies are growing more sophisticated in the types of behavior they monitor and actions they track.  It is the solitary gunman who continues to prey upon us with alarming frequency and which current laws render society fairly helpless to circumvent.   The incidents seem to be escalating; Pulse Nightclub, Las Vegas, Douglas High School.

The relationship between violence in general and mental illness has been studied extensively and the mentally ill do NOT seem to commit acts of violence at a greater rate than the general population.  It can be argued that much violence, even murder, is enacted by people who do not meet any commonly recognized descriptions of mental illness.  Violence by members of the general population includes gang members ( one of the highest urban sources of murder) organized crime members, persons involved in drug crime and jealous domestic partners.  As an example, one third of women who are murdered according to  recent statistics  are murdered by a domestic partner or spouse.

Those of us in the mental health field have an obligation to help reduce the stigma of the mentally ill by emphasizing that emotional disturbance and violence do NOT go hand in hand.  Most people with mental illness, even severe mental illness pose no danger to society, rather they are more likely to pose a danger to themselves.  The risk of suicide is much higher than homicide in chronic mental illness.  Other concurrent dangers of severe mental illness are homelessness, substance abuse, an inability to build enduring relationships and poverty. These are the primary risks of severe mental illness.  People with mild and moderate degrees of mental illness, those with moderate depression, anxiety disorders, ADHD, obsessive compulsive disorder, etc can be among the most talented and productive members of society.  Abraham Lincoln and Winston Churchill are two famous world leaders who suffered from depression.

When I hear about Aurora, Colorado, the mass shootings of Anders Breivik in Norway, the Virginia Tech shootings, the assault on Congresswoman Gabby Giffords in Tucson,  the tragedy at Columbine, I have no doubt in my mind that the “WHY” of these incidents is severe mental illness.  Inevitably in these cases we find notebooks or videos or online ramblings that are deeply paranoid and delusional.  The delusion often attaches to some personal or political frustration-anger at being fired, a romantic rejection, an academic failure or attraction to the most extreme political movements which demonize different ethnic groups or, as with Congresswoman Gifford’s assailant, actions of the government.  In all these cases the fairly common setbacks of life or social or political frustrations become magnified through delusion and self- absorption into a rage capable of attaching itself to innocent victims and punishing them for the individual’s fury and sense of impotence.  Self-aggrandizement or, conversely, suicide are also often part of the underlying distortion of thinking we find in these people, thinking patterns that are all too commonly seen by those of us who work with the mentally ill.  In the case of the mass murderer it explodes at a terrifyingly dangerous and severe level leading to a tragedy experienced far beyond the internal world of the sick individual.

So why did Nikolas Cruz go to Marjorie Stoneman Douglas High School and randomly slaughter?  To my thinking, the answer is obvious; his thinking was deeply deranged and distorted.  In his paranoia events in his personal life somehow connected and made sense and solved some unbearable problem in his life.  In other words there is no rational explanation for an act of such unspeakable horror other than the ability of the human mind to fracture and rearrange reality in such dangerous ways.