Mental Illness and Mass Violence

On May 23rd, Elliot Rodger went on a killing spree in Isla Vista, California. Unlike many of America’s growing number of mass killers, Rodger not only used a gun, but also a knife.

Why do mass shootings/stabbings occur? 

Can anyone answer the question of why? The mass killers have several things in common. They are angry loners, usually isolated, usually paranoid (they detect some kind of personal meaning in the actions of others). However, many people with the same characteristics don’t go on killing sprees.

Some people say guns are the reason why massing killings occur. But Elliot also used a knife. Others say mental health funding is the reason. But Elliot was actively receiving mental health services.

I cannot dispute that a madman with an automatic weapon is a very dangerous thing. I cannot dispute that funding mental health clinics is important and necessary. These things are true.

But as a professional, treating some of the potentially dangerous individuals, I see another side. The truth of the recent killer in California was that he was showing signs of dangerousness, and people were concerned. His family, mental health professionals, and law enforcement took action. They tried to do something. The police went out to check on him. And here’s what I know that the general public does not: everyone did their job. They followed all the rules.

When the police went out to his residence on April 30th, they would have spent time observing Elliot Rodger. They would have looked for signs of dangerousness and mental illness that might impair his ability to take care of himself or make him a risk to others. Elliot held himself together long enough to reassure the officers. The officers left, and Elliot continued plotting until he carried out his plans on May 23rd, less than one month after the officers visited his apartment.

So why did this happen? Why didn’t they take Elliot into custody? Put him in a hospital? Protect the public?

The law requires officers personally to observe concerning behavior before taking an allegedly mentally ill person into custody. If they do not observe bizarre or threatening behavior first hand, officers cannot take a person in.

To understand why this is necessary, let us consider the scenario from another angle. What if my loved one could call law enforcement and have me taken into custody for mental illness, simply because my loved-one asserted that I was dangerous? What if my therapist could do the same? It would be a set-up for serious abuses of power. For example: what if my spouse could declare me mentally ill and have me hospitalized to prevent me from getting custody of our children in a divorce? Or what if my concerned loved one was paranoid, seeing mental illness in me instead if realizing he or she needed help?

Elliot’s parents did the right thing by asking police to go out and perform a safety check. The officers followed the law when they checked on Elliot but didn’t take him into custody because they found him to be calm, pleasant, and cooperative. 

I sit down with a family at least once a month and explain why I may not be able do anything to help their mentally ill or disturbed loved-one. The reason is this: in America, above all else, a person has the constitutional right to freedom. If a person with mental illness has not committed a crime or made a very clear threat, he or she has a constitutionally protected right to be free from incarceration. Even those with severe mental illness, if they are not hurting anyone, have this right to freedom.

America used to lock away the mentally ill in institutions, not so many years ago, in fact. And then lawmakers decided than institutionalization was expensive, most often unnecessary, and (most importantly) a violation of the civil rights of mentally ill people.

But we need a better system. has published a timeline of mass shootings/killings in America over the past 32 years. It is apparent from viewing the timeline that these types of horrific events are increasing in frequency. The result, in addition to the tragic loss of life, is that mental illness is further stigmatized. Patients fear a diagnosis like Schizophrenia or even Autism will evoke fear and discrimination. They shy away from treatment.

To end the epidemic of mass violence in America, we need to reduce stigma (without overlabeling normal life as mental illness.) We need treatment for the severely mentally ill. We need research to guide us, training for law enforcement and mental health personnel for reporting and treating potentially dangerous individuals, qualified professionals to assess for signs of dangerousness, and funding to provide people like Elliot Rodger with the treatment programs they need.


Dr. Deuter is a psychiatrist who specializes in the care of emerging adults.

Posted on May 26, 2014 .