Abstract

Excerpted From: J. Thomas Sullivan, Mass Shootings, Mental “Illness,” and Tarasoff, 82 University of Pittsburgh Law Review 685 (Summer, 2021) (543 Footnotes) (Full Document)

The Las Vegas mass shooting committed by Stephen Paddock, who killed himself after fatally wounding fifty-eight outdoor concert-goers and injuring approximately 500 more during a relatively short but extremely intense shooting spree using numerous assault rifles, now ranks as the single most violent mass shooting episode in United States history. Paddock unleashed his assault on October 1, 2017, firing from a room at the Mandalay Bay Resort and Casino into a crowd attending a music concert on the street below. In the aftermath of the dramatic assault, questions about the shooter's motivation remain unanswered. Apparently, however, there has been no evidence of neurocognitive disorders or mental illness uncovered, reflecting a common question posed in the wake of such events as to what would cause an individual to engage in this kind of horrible act.

President Donald Trump offered his view of Paddock's motivation to reporters at a Cabinet meeting:

I guess a lot of people think they understand what happened, but he was a demented, sick individual .... The wires were crossed pretty badly in his brain. Extremely badly in his brain. And it's a very sad event.

The sheer magnitude of the massacre committed by deceased suspect Stephen Paddock, apparently acting solo or without accomplice assistance, necessarily raised the question of why any individual would commit such a crime. What motivation could explain such a random act of mass violence? President Trump's characterization of Paddock as “a demented, sick individual” hardly seems unreasonable in light of the circumstances of the Las Vegas mass shooting.

Within a few months, other mass shootings had occurred, including one at a church in Sutherland Springs, Texas, on November 5, 2017. There, shooter Devin Patrick Kelley, dressed in tactical/military gear, shot forty-six people with an “assault-style” rifle, killing twenty-six churchgoers while they were attending Sunday morning services at the First Baptist Church. He had “escaped” from an inpatient facility in 2012 and had a history of domestic violence, suicidal behavior, and cruelty to animals.

Then, on February 14, 2018, seventeen students were killed and seventeen others were wounded during the shooting at Marjory Stoneman Douglas High School in Parkland, Florida. The mass murder was committed by Nicholas Cruz, a former student at the school armed with an assault rifle. Cruz had a long history of school and social service interventions due to behavior that was “moody, impulsive, angry, attention seeking, annoy[ing] others on purpose and threaten[ing] to hurt others.” In the aftermath of this shooting, which garnered national attention based on the students' demonstrations supporting gun regulation, President Trump commented on the need to provide additional security in schools and to “tackle the difficult issue of mental health.”

The Florida high school shooting continued the pattern of mass shootings dominating the news in the United States in recent years, all generating renewed public debate over the availability of firearms, specifically assault rifles, and the mental stability of the individuals perpetrating the violence. President Trump focused on the mental health of the offenders perhaps to deflect attention from the gun control debate and to avoid possible legislation. However, he also relied on a common perception that perpetrators of these mass murders must be mentally compromised--that rational individuals could not be responsible for these episodes of violence.

In the aftermath of the Parkland, Florida high school shooting, the New York Times related President Trump's responses to other recent mass shootings and his focus on mental impairment as the cause of these acts:

“So many signs that the Florida shooter was mentally disturbed, even expelled from school for bad and erratic behavior,” Mr. Trump said in a tweet hours before he addressed the public. “Neighbors and classmates knew he was a big problem. Must always report such instances to authorities, again and again!”

He delivered similar remarks in November, after a gunman with a military-style rifle mowed down more than two dozen parishioners in a church in Sutherland Springs, Tex. Mr. Trump told reporters that the problem “isn't a guns situation” and that the shooting signified “a mental health problem at the highest level.”

In October, after a gunman in Las Vegas killed 58 people and wounded hundreds in the deadliest mass shooting in United States history, Mr. Trump called the assailant “a very sick man” and a “demented person.”

The evidence that mental illness was responsible for the acts perpetrated by individuals who committed these mass shootings is not clear. But, over time, the motivations of individuals responsible for these episodes will become clearer in at least some cases. For instance, there is evidence developed in news reporting and in litigation arising from the Parkland shooting that the perpetrator had a lengthy history of involvement with mental health providers and had been prescribed psychoactive medication.

There is little evidence, however, that mental illness actually caused the individuals responsible for these mass shootings to engage in shootings or other acts of mass violence. Evidence shows that some perpetrators suffered from mental illness or emotional problems at some point prior to their homicidal rampages, but it is more difficult to establish a direct link that would permit the inference that intervention by mental health professionals would have prevented the mass shootings. Nevertheless, the suggestion has been continually advanced that the underlying problem reflected in these episodes is that mental health issues, rather than other explanations--such as ideological terrorism--should be the focus of the nation's response to these shootings. The response is itself unfocused, while the suggestions by President Trump and others of mental impairment as the cause for mass shootings implies that the mental health community can provide the solution.

The issue of the shooter's intent is complicated by evidence at least suggesting alternative theories that may reflect sociopathic personalities. For example, the shooting at a Jewish synagogue, The Tree of Life Congregation, in which eleven worshipers were killed and six injured, was perpetrated by Robert Gregory Bowers, whose social media posts indicate white supremacist, anti-Semitic, neo-Nazi beliefs. Similarly, social media posts linked to Patrick Crusius, arrested after the fatal shooting of twenty-two people at a Walmart store in El Paso, Texas, on August 3, 2019, with at least twenty-four others known injured at the time, included the shooting suspect's white supremacist manifesto. His post discloses that the attack was a “response to the Hispanic invasion of Texas.”

The El Paso shooting followed on the heels of a shooting that killed four and injured thirteen, including the shooter, at the Gilroy Garlic Festival in Gilroy, California, on July 28, 2019. The Gilroy shooter, a nineteen-year-old white male, had no known history of mental illness and had posted a message on social media immediately before the shooting directing people to read Might Is Right, a book commonly used to “justify racism, slavery and colonialism.”

Following the El Paso attack and another mass shooting at the Ned Peppers Bar in Dayton, Ohio the following day in which ten people were killed, including the shooter, and twenty-seven others were wounded, President Trump again blamed mental illness for the mass shootings. He explained, “This is also a mental illness problem .... These are people that are very, very seriously mentally ill.”

While President Trump's pronouncement of mental illness as the cause of mass shootings is not based on expert opinion, education, or training in mental health--his background is in real estate development--his characterization of the mental state of shooters in these events undoubtedly would be echoed by others. However, there is a danger in simplifying causation and attributing a common, though general, diagnostic explanation to individual behavior not individually examined. Incidents of mass violence, including mass shootings, logically raise questions about the mental state of the perpetrator, or perpetrators, or accomplices, particularly whether these acts could have been prevented by professional intervention.

The consistent theme in the aftermath of the recurring episodes of mass violence involving firearms in the United States over the past few years has been the typically unanswered questions about the shooter's state of mind. Speculation has focused on symptoms of major mental illness and aberrant thinking or behavior exhibited by perpetrators prior to these episodes. Evidence of prior treatment by mental health professionals is offered to suggest that the tragic deaths of victims, often children targeted in attacks committed at schools and other public forums, could have been prevented by appropriate intervention. The gun lobby, resisting calls for greater regulation of firearms, has traditionally argued that mentally-impaired individuals are excluded from Second Amendment protections and that more aggressive identification of those individuals would prevent many acts of gun violence. Ironically, among the first important actions taken by the Republican-dominated Congress following the 2016 national election was the reversal of an Obama administration policy limiting access to gun purchases for individuals who had been determined to have mental disorders. As Americans struggle with these scenes of violence and seek solutions, the role of mental health professionals in identifying potential perpetrators and preventing otherwise irrational acts of mass violence has necessarily become the subject of debate.

[. . .]

If, in this instance, they conclude that “gun ownership statistics alone do not explain what makes America different,” the logical conclusion is that something in the American character, or a value shared by many in the American community, is more likely responsible for mass shootings than simply access to firearms. A tiny minority of individuals commit acts of mass violence, yet there is still a hesitance to regulate firearms more aggressively. That hesitance suggests nothing less than a tolerance for violence, as they note in the conclusion of their essay:

“In retrospect Sandy Hook marked the end of the US gun control debate,” Dan Hodges, a British journalist, wrote in a post on Twitter two years ago, referring to the 2012 attack that killed 20 young students at an elementary school in Connecticut. “Once America decided killing children was bearable, it was over.”

The end of the pandemic and relative normalization of social interactions, particularly in public spaces, will offer additional perspective on the factors that may be at the root of mass shootings. Regardless, understanding the motivations of perpetrators will likely have little impact on prevention given the likelihood that they will continue to die in the conclusion of their acts of mass violence, whether as a result of suicide or intervention by law enforcement or civilians, who will also be armed with firearms. What does seem clear is that the circumstances in which Tarasoff duties to warn or protect, regardless of their precise parameters within any given jurisdiction, will not prevent the overwhelming number of mass shootings even if prevention occurs in some cases. Even when mass shootings may be linked to mental illness or mental disturbance, the likelihood that perpetrators will themselves be linked to mental health evaluation or treatment would appear dim, at best.

Distinguished Professor of Law, University of Arkansas Little Rock School of Law; Adjunct Professor of Law and Psychiatry, University of Arkansas for Medical Sciences.