Sandy HookOur hearts throb with the pain of the Newtown parents. I consciously refrained from posting yesterday, a year to the day since the massacre at Sandy Hook Elementary School, to give the families their requested space.

One day later, however, it’s time to weigh in with the reminder that the shooter who murdered 20 children and 6 adults was not suffering from schizophrenia.

Not that people under the influence of command hallucinations are incapable of mass murder. It’s just that no amount of risk assessment can catch an easily armed man plagued by any one of a myriad of mental illnesses.

Gun ControlMental illness, by nature, is something that we may never have complete control over. So gun control, as politically intractable as it may be, could actually be far easier to figure out.

Still, Newtown killer Adam Lanza should not be confused with, say, Jared Lee Loughner, the Tucson man who took six and wounded 12 more, including then-Congresswoman Gabrielle Giffords, nearly three years ago.

Loughner left a long trail of online clues indicating that he’d been under the spell of the paranoid delusions that are symptomatic of schizophrenia.

As it transpired, acquaintances said Loughner’s personality had changed markedly in the year prior to the shooting–rapid onset being another hallmark of schizophrenia.

He was being treated with psychotic medications, which did not appear to help. He pleaded guilty and has been sentenced to life in prison without parole.

No Signs of Schizophrenia

The Newtown shooter we know far less about, chiefly because he destroyed his computer before going off. Why the 20 year-old Lanza became so deranged he had to kill kindergartners before taking himself is anybody’s guess.

We could speculate all day about whether a troubled childhood or some deeply misanthropic inborn impulse possessed him. There are no signs, though, that he had schizophrenia.

All research shows that members of the public exaggerate their own personal risk at the hands of people with schizophrenia in particular.

Although the public correctly ranks risk of violence highest among substance abusers, it overestimates it from those suffering from schizophrenia and depression by quite a wide margin.

The numbers are in. You are far more likely to be attacked by a drug addict or alcoholic than a schizophrenic.

What cannot be denied, however, is the random nature of the killings motivated by the command hallucinations of untreated schizophrenia.

While such tragedies occur, our fears of them are mostly vicarious. Through movie depictions of crazed killers or real life dramas on the nightly news, we tend to forget that the number of victims of mass shootings is dwarfed by the overall gun violence, the vast majority being single murder victims, often as a result of domestic troubles, or suicide.

A mass shooting is far less likely than a car crash to end your life.

Keep in mind that one of four of your neighbors is disturbed by some mental health problem. One in four adults—roughly 58 million Americans—claims at least one mental illness in any given year.

That’s the real threat group.

A much smaller number—about 6 percent, or 1 in 17—has a severe mental illness.

Nearly half have of them have two or more disorders at once. Overlapping mental illnesses do not raise risks appreciably. Of the five major mental illnesses, the overlap is widest between schizophrenia and bipolar disorder; moderate for bipolar disorder and depression and for ADHD and depression; and slimmest between schizophrenia and autism.

The distinctions aren’t just academic. A greater appreciation for shared risk factors moves diagnoses closer to their biological nature, which sheds light on the workings of mental illness, which helps treatment, which curtails violence, which saves congresswomen and kindergartners and all of us everywhere all over.

 Inevitability of Next

Murder is murder.  At some point it matters little which mental illness motivates it. What matters are the shrieks of horror we will be hearing at the next mass murder. We all know it’s coming, and we’ll be sitting passively before our TV screens, numbed by the sameness, accepting the carnage philosophically until the violence hits home.

That’s what’s known as compassion fatigue. That’s what other channels are for.

Let’s face it, stricter background checks are not in the offing–the National Rifle Association is far too powerful.

Absent better gun control, better mental health care treatment seems to be the only game in town. But better mental health treatment can only go so far in stopping the next rash act.

Absent gun control, you don’t need field glasses to see mass shootings multiplying no matter what over the horizon of Columbine, Virginia Tech, Aurora, Tucson, Seattle, Fort Hood, Oak Creek, and Newtown.

Too bad the American people don’t have the attention span, much less the guts, for this fight. We’re all too isolated in own private Idahos.

Where does that leave us? With the families, as always. We are the only ones able to explain mental illness. We are the ones who must speak up.

Soon after Newtown, a HuffPo post titled “I am Adam Lanza’s mother” went viral, nailing one very brave mom’s anguish over the stigma of having a mentally ill child.

She is right–and yet, in a wider sense, all Americans will be the next mass killer’s mother.