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We Can’t Blame All Violence on Mental Illness

Nothing shakes us to the core like a school shooting. More often than not, follow-up investigations show that the person who pulled the trigger was suffering from a mental illness. But the narrative that often follows in media is that all mentally ill people are dangerous and capable of causing the violent deaths of innocent people.

This is simply not accurate. It’s like lumping together your grandmother who is mildly depressed, a 5-year-old with ADHD and Charles Manson. Mental illness is not a one-size-fits-all label. Yet when a tragedy the magnitude of a school shooting happens, there is a tendency to cast mental illness as the villain when, in fact, violence is not a characteristic of the vast majority of people with mental disorders.

More Likely to Cause Self-Harm

A bigger problem among people with mental illness is violence towards themselves. It’s far more common for them to commit suicide than to harm another person.

Other common consequences of chronic mental illness are poverty, homelessness and criminal involvement due to drug or alcohol use. It’s not typically the kind of violence that has sadly been witnessed in school shootings. However, when these incidents occur, it’s often at the hands of people who have longstanding mental disorders. Violence then becomes linked as a part of mental illness, which adds to the stigma that mentally ill people face and that often prevents them from seeking help.

We Can’t Predict Violence in Advance

After a school shooting or other act of violence, there is often discussion about how people may have missed the signs that a person was potentially dangerous. They wonder how a violent attack was not predicted, especially when classmates, teachers and police may have had problematic interactions with the person responsible for mass violence before the fact.

Even with the best police work and awareness of mental disorders, identifying someone who may perpetrate such a crime is like searching for a needle in a haystack. A psychiatric diagnosis cannot predict a gun crime. The single best predictor of violence is someone who says, “I’ve bought a gun and I’m going to do something violent.” Beyond that, it is difficult to predict for the following reasons:

  1. There is no accurate test. Even with all the psychological testing at our disposal and research into the psychological state of people who carry out mass violence, there is no test that predicts that someone will purchase weapons and show up at a school and begin shooting. You can’t pinpoint where or when, or if, a person will act out in that way.
  2. The pool of people is too large. Nearly one in five Americans, or 43.8 million people, has a mental illness in a given year, but having a disorder is not predictive of violence. Looking under the generalized umbrella of people with mental disorders would focus on a group much larger than the group likely to ever become violent.
  3. Childhood trauma is not always an indicator. While people involved in shootings may have had troubled pasts, not everyone becomes mentally ill or violent from early trauma. There are many children who have been abused but do not develop post-traumatic stress disorder, addiction, personality disorders, depression, bipolar disorder or schizophrenia. Even though they have the risk of that exposure, they don’t have the susceptibility or there may have been other protective factors that kept them from developing those issues.
  4. Not everyone who meets the profile acts on violent urges. Many of the characteristics associated with people who subsequently become violent are seen in a large group of people with mental disorders, and probably a substantial portion of the general population. So these characteristics are not accurate predictors of violence. People who have been bullied, publicly disruptive or have shown violent tendencies toward people or animals may be troubled, but they are not necessarily going to carry out a violent act of this magnitude.
  5. Schizophrenia does not always cause violence. It is especially damaging to assume everyone with schizophrenia is a danger. The proportion of violent crimes attributable to schizophrenia is consistently a small fraction of all the crimes committed. This means that the vast majority of crimes aren’t going to be explained by a serious mental disorder, and that finding the person who is going to commit a violent crime is going to be very difficult.

Universal Plans for School Safety and Mental Illness

There was a time in history when blood was collected without the use of latex gloves and the used needles were tossed into a trash bin. This was before we knew how dangerous it could be if someone’s disease-infected blood was transferred onto the person drawing the blood. Once the dangers were identified, a universal system for blood collection was put into place and it is followed around the world.

This is what is needed in this new age of school violence. Now that we know the danger to students and staff, schools need to develop a universal way of preventing violence; for example, through advances in security systems and designs that can keep out intruders.

Mental illness needs a universal system too – not because of a threat of violence, but because we know all the problems that can occur for individuals, families and communities when mental health goes undiagnosed and untreated. From homelessness and unemployment to medical and substance abuse issues, we know the devastation mental illness causes but we don’t put enough resources into treating it.

School shootings are tragedies on so many levels, but mental illness is not the culprit for every problem in society. Blaming mental illness alone is going to sweep many more people into the fold than should be, and won’t get us closer to the real roots of the problem.

We Can’t Blame All Violence on Mental Illness

David Sack, M.D.

Dr. David Sack is board certified in psychiatry, addiction psychiatry, and addiction medicine. As CMO of Elements Behavioral Health, he oversees a nationwide network of treatment centers including drug and alcohol rehab programs at The Ranch in Tennessee and The Right Step in Texas.

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APA Reference
Sack, D. (2019). We Can’t Blame All Violence on Mental Illness. Psych Central. Retrieved on July 10, 2020, from


Last updated: 3 Jul 2019
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