The Medical Director Institute of the National Council for Behavioral Health convened an expert panel to examine the extent to which mental illness plays a role in mass violence and offer recommendations from a behavioral health perspective.
“Mental illness is not a major cause of mass violence. Mass violence is caused by the social illnesses of hate and anger, not mental illness,” Joe Parks, MD, medical director of the National Council for Behavioral Health, told Healio Psychiatry. “Mass violence is a complicated issue with complicated causes that will require multiple solutions — anyone who says it's about a single cause or suggests a simple solution is wrong.”
The report revealed that people with serious mental illness were responsible for less than 4% of all violence and less than one-third of mass violence, according to the press release. However, in the wake of mass violence, policymakers and the public often point to mental illness as a key contributing factor.
The experts stressed that “lumping all mental illness together, and then assuming that acts that seem incomprehensible to the average person are due to mental illness, results in millions of harmless, nonviolent individuals recovering from treatable mental health conditions being subjected to stigma, rejection, discrimination and even unwarranted legal restrictions and social control,” according to the executive summary.
For health care organizations, they recommended:
- establishing multidisciplinary threat assessment and management teams with representatives from security, human resources, legal and law enforcement;
- quality improvement relating to issues of violence risk assessment and threat assessment and management;
- teaching staff in lethal violence reduction, which is helpful in combating suicide; and
- training staff to prepare for vicarious trauma and compassion fatigue and providing resources to support staff and their self-care.
“Health care confidentiality laws are not a barrier to communicating when you believe someone is dangerous,” Parks said. “There are multiple legal pathways to communicating potential risk and imminent danger. Threat assessment and management teams, one of the report’s many recommendations, are multidisciplinary and include behavioral health professionals — educate yourself on how they work so you can start one at your organization or contribute to an existing one.”
The experts also noted that future research should focus on the neurobiological, psychological and sociological factors underlying mass violence; creating a standardized investigation/analysis of each mass violence incident (conducted by a multiagency team lead by the Department of Justice); and assessing extreme-risk protection orders.
In situations where mental health plays a role in mass violence, Parks told Healio Psychiatry that a solution is to “ensure prompt access to care by expanding certified community behavioral health centers nationwide.” – by Savannah Demko
National Council Medical Director Institute. Mass Violence in America. https://www.thenationalcouncil.org/wp-content/uploads/2019/08/Mass-Violence-in-America_8-6-19.pdf. Accessed on Aug. 7, 2019.
Disclosure: Parks is medical director of the National Council for Behavioral Health.