海角大神

The day after Devin Kelley perpetrated America鈥檚 worst mass shooting in a place of worship 鈥� killing 26 and wounding another 20 at the First Baptist Church in Sutherland Springs, Texas 鈥� President Trump called it a 鈥�.鈥�

Some mass shooters have been diagnosed with mental illness. Jared Loughner, who killed six and severely wounded then US Rep. Gabrielle Giffords in 2011, was found by psychiatrists to have a mental disorder. Ditto for James Holmes, who killed 12 people at the Century movie theater in Aurora, Colo., in 2012.

Mr. Kelley himself escaped from a mental health facility in New Mexico in 2012, after being accused of assaulting his wife and severely beating his baby stepson while serving with the US Air Force.

But few mass killers have a clinically diagnosed mental illness. Thus, pointing to mental illness as the cause of gun violence is not only misleading, say mental health and gun violence experts, it could also increase the stigma around it and make people less willing to seek help.

鈥淚magine if [Mr. Trump] had said, 鈥榲eteran鈥� 鈥� that this was a 鈥榲eterans鈥� issue,鈥� says Jeffrey Swanson, a professor in psychiatry and behavioral sciences at Duke University School of Medicine in Durham, N.C. 鈥淗e鈥檇 besmirch the whole community. Well, that鈥檚 what he鈥檚 doing with mental illness.鈥�

The best indicator of future violent behavior is past violent behavior, experts say. A history of animal cruelty, childhood maltreatment, access to guns, and being young and male are also more reliable indicators of future violence than a diagnosed mental health disorder, they say.

Perpetuating stereotype

Only of violent acts can be attributed to a person living with a severe mental illness, according to the Department of Health and Human Services, while people linked to those illnesses are actually 10 times more likely to be victims of violent crime than the general population. Of 88 mass shooters 鈥� those who had killed four or more people in the US 鈥� since 1966, only 14.8 percent were diagnosed as psychotic, according to by Northeastern University criminologist James Alan Fox, a gun violence expert who maintains a database of indiscriminate mass shootings.

Trump is not the only one to suggest that improving mental health services could prevent mass shootings. Last year, President Obama in a speech that recalled the 2012 shooting at Sandy Hook Elementary School in Connecticut. Days after last month鈥檚 mass shooting in Las Vegas 鈥� the deadliest in US history 鈥� House Speaker Paul Ryan .听听

It 鈥減erpetuates a stereotype of the mentally ill as dangerous,鈥� says Dr. Fox, author of several books on mass shootings, including 鈥淓xtreme Killing: Understanding Serial and Mass Murder.鈥�

That stigmatization may make it even more difficult for professionals to find the people who do need help.

鈥淪uggesting that this is what people who have mental illnesses do likely means that if I鈥檓 someone with mental illness, I鈥檓 less likely to reach out and seek help,鈥� says Arthur Evans Jr., chief executive officer of the American Psychological Association.

Staffing shortage

The ability to help is further hampered by a serious lack of resources and manpower, often leading to long wait lists for treatment. Two-thirds of Texas counties have no working psychiatrist, according to the Texas chapter of the National Association of Mental Illness (NAMI), a situation similar to other parts of the US.

And with more than half of mental-health providers aged 55 and older and nearing retirement, there are few people to take their place. Only 4 percent of US medical school graduates have been applying for residency training in psychiatry, according to .

These factors help explain why, according to NAMI, of adults with a mental illness don鈥檛 receive any mental-health services in a given year. That increases the risk that someone diagnosed with mentally illness may commit a violent act.

鈥淚f [someone] has a psychotic episode, they don鈥檛 have time to wait and get help, and that鈥檚 when violence happens,鈥� says Sarah Feuerbacher, director of the Center for Family Counseling at Southern Methodist University in Plano, Texas.

There are some examples of state-level reforms. In November 2013, a mental-health facility in Virginia discharged Austin 鈥淕us鈥� Deeds because no psychiatric bed was available and he for more than six hours. Less than 24 hours later, he attacked his father with a knife and committed suicide.

Six months later, the father 鈥� state Sen. Creigh Deeds 鈥� got a law passed reforming several elements of Virginia鈥檚 emergency mental-health system.

Back in Sutherland Springs, scene of the latest mass shooting, Eileen Anderson, who helps run the local historical museum, has been looking at her own family鈥檚 situation in a new light. Decades ago, her daughter was diagnosed with bipolar disorder, and still sees a psychiatrist, takes medication, and, most important to her mother, continues to communicate with her.

鈥淭he love has kept us together, that鈥檚 the main thing,鈥� she says. 鈥淲ith the things that happened to this guy [Kelley, the shooter], I mean it鈥檚 just carried over and over and over, until it just鈥︹��

Her voice trails off. 鈥淭hey need to love their family,鈥� she says, after a while.