Guest Column: Learning lessons from the Santa Barbara shooting
June 5, 2014
Is there anything more to say about the tragedy in Santa Barbara some weeks ago? Hasn't the mass media thoroughly chewed through this issue by now? Isn't it time to move on?
After all, the basic "facts of the case" are clear: A deranged young man in counseling of some sort obtains enough weaponry to kill scores of his fellow citizens. His mother, warned about his mental instability, conveys this warning to the counselor who in turn notifies the police.
The young man posts an Internet video in which he calmly explains that he plans to kill many women because he is sexually frustrated in a cruel and unjust world. The police have a brief front door talk with the young man who calmly convinces them that nothing is amiss.
In time, the young man proceeds to slaughter his roommates and the better part of a dozen other people before killing himself.
Another mentally ill mass murderer suicide. The media reports. The pundits pontificate. The politicians propose. Experts explain. Families grieve. Life goes on. And nothing changes.
Nothing changes because we are taught to believe that nothing can change. Former Arizona Governor and current University of California President Janet Napolitano remarks, "This is almost the kind of event that's impossible to prevent and almost impossible to predict."
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Intones Dr. Richard Friedman, professor of clinical psychiatry at Cornell Medical College, "We have to acknowledge that our current ability to predict who is likely to be violent is no better than chance."
And addressing the killings in Santa Barbara, "even the best mental health care is unlikely to prevent these tragedies." And, "A normal-appearing killer who is quietly planning a massacre can easily evade detection."
Nothing changes because politicians have an uncanny ability to undermine each other's good ideas. Example: Both Representative Tim Murphy, R-Pa. and Representative Ron Barber, D-Ariz., have submitted different bills to Congress that, in part, address the issue of mental illness and violence.
To date, each party rejects the others bill … and nothing changes.
Nothing changes because otherwise smart people espouse a fatalistic view of the future: Example: Dr. Thomas Blumenfeld, associate clinical professor at the University of California, Davis asserts, "Unfortunately, I think killing sprees in advance of an individuals suicide are likely to become more common."
My position: These killings did not have to happen. The future does not have to repeat the past.
Here's what I know. In the 1960s, 70s, and into the 80s, the United States at both a federal and state level was building a comprehensive mental health delivery system. That system has been systematically eviscerated in the past 40 years.
Bernard Harcourt, law professor, observed, "Over the past 40 years, the United States dismantled a colossal mental health complex and rebuilt — bed by bed — an enormous prison."
Adds Martin Horn, former correction commissioner for New York City, "The deinstitutionalization of the mentally ill was supposed to be accompanied by the creation of a robust community mental health system. This never occurred…"
Finally, Mary Giliberti, executive director of the National Alliance on Mental Illness, reports that between 2009 and 20012, budget cuts in public mental health exceeded $4.2 billion, devastating an already underfunded system.
I also know that violent and suicidal behavior correlates with a host of other variables including a history of depression, other severe mental disorders, a history of drug or alcohol abuse, a history of antisocial behavior, a history of antisocial personality traits, and yes, the ready accessibility of lethal weapons.
Correlation is not causation, but knowledge of these variables in the context of an expert clinical interview improves the probability of identifying potentially lethal behavior.
So what can we do? Here are a few thoughts. Ensure that quality mental health care is available on demand. Help this ambitious idea along by creating a litmus test for you favorite politicians as in, "How will you work to build adequate substance abuse and mental health treatment resources in our community?"
Fundraise for mental health services. Here, consider the millions raised by communities for good causes. Where do mental health and substance abuse services rank on the list?
Talk about these issues in the community. If we have learned nothing else from the Columbine High School massacre, the Aurora killings, the shootings at Sandy Hook Elementary School, and now Santa Barbara, it's that the tired and torn mantra of, "It can't happen here," just doesn't play any longer.
Lastly, insist that your local law enforcement agency have a highly skilled mental health professional on staff readily available to accompany deputies faced with having to assess a potentially violent or suicidal person.
Law enforcement officers are not well trained to make these assessments and should not have to make them alone.
It's an unwelcome and unhealthy burden to carry, made more so when things go horribly wrong as they recently did in Santa Barbara.
Incline Village resident Andrew Whyman, MD, is a clinical and forensic psychiatrist. He can be reached for comment at firstname.lastname@example.org.