Editor’s note: Five years ago, Stacey Freedenthal, PhD, LCSW, a professor at the University of Denver, wrote a guest commentary in response to the mass shooting at Virginia Tech, where Seung-Hui Cho killed 32 people. Its message rings just as true today in response to the Aurora, Colorado, movie theater shooting in which 12 people were killed and 58 wounded by accused gunman James Holmes. With Dr. Freedenthal’s kind permission, we repost her commentary, which originally appeared on www.denverpost.com:
Treating mental illness
In 1999, when two teenagers shot 13 people to death at Columbine High School and then killed themselves, a memorial was proposed for all the victims – including the shooters.
Outrage ensued. Many parents of the teenagers killed by Eric Harris and Dylan Klebold argued that the boys were murderers, not victims. I can understand their outrage. A memorial for the murdered should inspire loving memories and cleansing grief.
That said, a sad fact remains: People who kill while in the throes of mental illness are victims themselves. Seung-Hui Cho, the shooter at Virginia Tech, stole 32 lives, but it is clear that his life, too, was stolen years ago. I cannot diagnose a stranger from news accounts, but definitely there are signs that he was deeply depressed and probably psychotic, too.
The overwhelming majority of people with mental illness, including those with exceptional disturbances such as paranoid schizophrenia or psychotic depression, do not ever become violent toward others. In fact, violence toward oneself is a larger problem, with more than 30,000 people in the United States dying by suicide every year. But when people with mental illness do kill others, the question becomes not so much who is at fault, but what?
When I have worked with suicidal clients, I have warned them that their minds can play tricks on them. Diseased and untreated (or inadequately treated), the mind can tell outrageous lies. I had a teenage client once who firmly believed that her parents would be happier if she killed herself, and that her suicide would be a gift to them. Imagine! Her parents were not abusive or neglectful monsters. Indeed, the teenager believed her parents would be better off with her dead precisely because they cared so much about her.
For whatever reasons, Seung-Hui Cho’s brain, with its toxic lies, led him to believe that he had to slaughter innocents.
Feeling compassion for a mass murderer does not mean excusing his actions, or necessarily sparing him punishment. It does not mean forgoing feelings of hatred, anger and incalculable grief. It does mean directing feelings of anger at their proper causes: mental illness and the barriers to treating it effectively. Gun proliferation and our culture of violence also undoubtedly contribute, but the underlying problem remains the brain’s uncontrolled impulses and false rationalizations to initiate violence in the first place.
By remembering that mental illness ultimately wrought this tragedy, we can be empowered to create at least one good consequence. As a society, we need to make it easier for people to ask for help with emotional problems, to provide that treatment, and to receive inpatient psychiatric hospitalization when necessary.
So far, we do none of those things. Young people do not seek help for emotional problems, possibly because of the stigma attached. We as a society can send the message that seeking help for emotional problems is no less acceptable or necessary than for the flu.
Other barriers to receiving effective help include a dearth of psychiatric hospitals; difficulties being admitted to a psychiatric hospital or staying beyond a few days; mental health professionals who rely on treatments with no documented effectiveness; insurance companies that provide few benefits for mental illnesses; insurance companies that require doctors to select medications based on costs rather than individual needs of patients; and lack of health insurance altogether.
We cannot change what Cho did at Virginia Tech. We can, however, do what we can to prevent it from happening again. Doing so requires that we keep several things in mind:
Mental illness, though not always curable, is treatable.
Stigma and lack of resources make it difficult for people to receive sufficient, effective treatment or any help at all.
The more we ignore the needs of people with mental illness, the more they will suffer – and, sadly, the more society will suffer, too.