After the shooting at the Navy Yard this week, of course the media turns to mental illness as a cause. Unlike many of the other recent shootings, there is documentation that the shooter, Aaron Alexis, probably had some form of mental illness. He did report hearing voices and other paranoid beliefs weeks prior to this event. However, for me, the key is not that there was documented possible mental illness (he had never been officially diagnosed) but that he also had documented past gun offenses and more importantly, he received poor mental health care. (I wonder why a person with previous gun offenses even had a gun, and those offenses apparently occurred before he ever reported experiencing paranoia or any mental health issues.) It is not the mental illness alone that causes an event like this, it is a combination of factors.
Apparently Alexis had spoken to police weeks before about hearing voices through the walls and the police reported it to the Navy and nothing was done. Then Alexis went to the Veterans Affairs ER twice for insomnia but did not mention the paranoia, and he was given sleeping pills. To give sleeping pills to someone with possible mental illness is just wrong. Clearly there is something wrong in the system that Alexis was given those pills, on two separate occasions, even though police had reported that he was experiencing paranoia. Some sleeping pills can increase risks of suicide and depression. Many medications can interact with mental illness negatively, such as how antidepressants trigger manic episodes in people with bipolar disorder. You have to correctly diagnose the mental illness before you start perscribing medications. To me it seems that previous issues with violence and gun offences combined with poor regulation of medicine is more of a possible cause of this shooting than just blamining it on mental illness alone.
When we just look at mental illness in general as a cause, we promote the idea that all people with mental illness are as much of a risk to society as Alexis was on that day. We assume if we never let anyone with a mental illness have a gun, there will be no more shootings. This is not true, especially since most shootings are not committed by people with mental illness. There are many factors which go into creating the perfect storm that lead to an event like this, and possible mental illness is one factor for this particular situation. However, I know many people who hear voices, think they are being followed, and have paranoia who are not violent, have never used a gun, and have never committed a crime.
I think we also need to look at the fact that the stigma against mental illness is terrible in our society, but especially bad in the military. This means most people do not even seek treatment for mental illness. We know that people in the military are not able to ask for help with mental health issues for fear of loosing their job, even for very mild mental health issues. Maybe Alexis could have gotten help earlier if he would have felt safe enough to get mental health care much earlier when mild symptoms probably presented themselves months ago, if not years ago.
I just wish we would look at each of these cases individually and not lump violence and mental illness into a category together which stigmatizes all people with mental illness. We need to look at each person individually.
Clearly we need better mental health care, not only because of events like this where poor mental health care is very likely to be a factor, but also for the 1 in 4 Americans with mental illness who need better care- and most of them are not violent. The need for better mental health care is not because of violence, it is because people with mental illness deserve good care and a chance at the best life possible.