The Mental Illness Stigma

How do mass shootings impact people's attitudes toward the mentally ill?
By Melanie Tannenbaum,
The campus of Umpqua Community College in Roseburg, Oregon. (Photo: Wikimedia Commons)

Christopher Harper-Mercer, the Umpqua Community College gunman, was, by all accounts, a loner. A recluse.

Of course, this is no surprise. From Adam Lanza to Elliot Rodger, practically every mass shooter over the past several years has been described using a special set of Isolated Gunman Adjectives, all of which revolve around his troubled status as a social outcast. Someone who was unsociable, disturbed.

When news outlets provide this information about mass shooters, does it really help our quest to understand, predict, and ideally prevent these tragedies by identifying risk factors for violence?

Blaming mass violence on mental illness is misleading at best. Mentally ill people are far more likely to be the victims of violence than they are the perpetrators. Only about four percent of violence can be attributed to those suffering from mental illness. Drug and alcohol abuse is a far greater predictor; people who abuse alcohol or drugs but have no other mental illness diagnoses are almost seven times more likely to be violent. Even if we’re only looking at the “awkward recluse” angle, socially isolated children are also significantly less likely than their more social counterparts to engage in delinquent behavior during middle and high school—mostly because many adolescent crimes are egged on by delinquent friends, or committed while under the influence of drugs or alcohol at parties. Loners don’t really have friends. Or go to parties.

Media coverage that mentions “mental illness” can end up reinforcing stigma directed toward the mentally ill, and, in turn, toward those who may be a little socially awkward or reclusive.

At any rate, being socially awkward or reclusive is not actually a risk factor for violence—and neither is mental illness. In fact, sadly, it’s suicide for which mental illness is the strongest risk factor—not homicide. That certainly isn’t the picture we usually get from the news media, which loves to paint a picture of either “mental illness” or the “reclusive outcast” (or a combination of the two) as catch-all bogeymen for mass violence. Unfortunately, those portrayals don’t occur without consequences.

When the media mentions certain groups (or types) of people in the context of trying to find a logical source to blame for mass violence, it has serious consequences for the general public’s perceptions of those groups. Media coverage of Islam after 9/11 dramatically shifted public opinion toward seeing Muslims as “violent,” and the ongoing disproportionate focus on crimes committed by African Americans results in people thinking (even subconsciously) that they're more “dangerous” than whites. News coverage doesn’t even need to outright link an identity with violence to create negative associations. A 2013 study conducted by Emma McGinty, Daniel Webster, and Colleen Barry found simply mentioning “mental illness” in a newspaper article about a mass shooting immediately made readers significantly more likely to say they would refuse to work closely with or live next door to someone mentally ill, and also made them more likely to say they see all mentally ill people as “dangerous.” This negative generalization occurs even though, of course, "mental illness" is an incredibly broad umbrella, covering everything from anxiety and depression to schizophrenia and bipolar disorder to autism and ADHD—all drastically different diagnoses with different prevalence rates and different symptoms.

Media coverage that mentions “mental illness” (either broadly or focused on more specific diagnoses) can end up reinforcing stigma (a.k.a. the process of de-valuing members of a group because that group seems to deviate from typical social norms) directed toward the mentally ill, and, in turn, toward those who may be a little socially awkward or reclusive.

Stigma matters. People with stigmatized identities have lower levels of self-esteem, higher levels of stress, poorer health, a lower quality-of-life, fewer close relationships, and experience higher rates of discrimination in the workplace. When it comes to mental illness, stigma is one of the biggest barriers to seeking treatment, can quickly lead to relapse, and can hinder recovery. Experts have even expressed concern that mental health-centered gun control laws might backfire in a very dangerous way because of stigma-related concerns: If potential clients are worried their psychiatrists might turn them in to the government and take away their guns because of something they say, they may be less likely to seek help or disclose important information in therapy. Of course, it doesn’t just end there: Members of stigmatized groups often face ostracism, bullying, and name-calling.

We can’t figure out some magic formula for identifying a Dangerous Shooter, and in the process of trying to do just that, we’re hurting real, innocent people. Apparently, presidential candidate Ben Carson suddenly wants to know why there isn’t a “national push to study [mass shooters],” to figure out what they all have in common with one another. But there have, in fact, been massive studies on those shooters, and the data reveals nothing helpful. As Dr. Jeffrey Swanson, one of the leading experts on the link between violence and mental illness, notes in a 2014 interview with ProPublica, “the risk factors for a mass shooting are shared by a lot of people who aren’t going to do it ... if you paint the picture of a young, isolated, delusional young man ... that probably describes thousands of other young men.” Most of these massive studies can get slightly more specific; the majority of the research also suggests that mass shooters tend to share issues with substance abuse, easy access to guns, and a history of being victimized or bullied. But these don’t exactly narrow down the suspect list much either—especially in a country where there is roughly one gun for every person, making firearm access exceptionally common.

To be very clear—most stigmatized, bullied, and/or ostracized people do not become mass shooters. But what we can say, for sure, is that there’s nothing about stigmatization that could actually be seen as helpful. As we spend all this time in the wake of mass shootings talking about the Second Amendment, we’d do well to remember that there is also a Fourth—we can’t exactly round up and detain every angry, ostracized young man who knows where to quickly find a gun without probable cause, so pointing fingers at entire swaths of people who we deem “suspicious” is an ultimately futile exercise.