Dr. Hal Pickett's Thoughts on Intervention Before Mental Illness Leads to Violence

Why do we often ignore signs that someone we know has become dangerously unhinged? Intervention is the only way to stop violence, like the recent shooting in Colorado, from happening.

A few weeks ago we watched again in horror at the aftermath of a mass shooting in Colorado. And we asked, as we always do, how we can stop this kind of thing from happening again.

Some people get caught up in the personal rights and confidentiality of the shooter.  Some discuss his mental illness as if it is an excuse.  The shooter’s mental illness may have been a reason, but it is not an excuse to let him slide, look the other way or feel sorry for him.  What we must look at is how we failed him as a society by not getting him the help he needed before it was too late, as surely as we must look at the rights of those shot during a leisurely evening of movie-watching.  What about their rights to protection from a murderer?

What didn’t happen, and should have long before this particular shooter entered graduate school, was recognition by someone close to or familiar with him that he needed mental health treatment especially since he was incapable of seeking care on his own.  Many times, we give the extremely bright students more leeway with their behaviors because they are “eccentric,”  “highly creative,”  “a little odd.”   But those are also characteristics that form the infrastructure for becoming antisocial, developing delusional paranoia, and in some extreme cases, master-minding arsenal attacks on innocent people.  I am not saying that there is a fine line between genius and madness.  But those with extremely elevated intelligence have trouble fitting into the world around them, because they are different than 99.9% of their peers.  Constantly feeling different is not an easy place to live.

For the recent shooter, there were signs of instability as early as the video of him receiving recognition for his research as an 18-year-old.  The announcer quotes his goal to own a Slurpee machine which received laughter and applause, passed off as creatively eccentric.  I think this was a young man communicating that his intelligence and his immature social development were creating dissonance within him.  I do not know the whole history, but his decline in functioning in graduate school is a huge red flag.  A high-functioning graduate student in neuroscience does not suddenly become unable to function academically.

For those around a person who is visibly deteriorating, getting involved instead of assuming that someone else will deal with the problem is the first difficult step.  The second is trying to find or access services for someone in trouble, and sometimes hardest of all is getting that person to use available services.  Once a person is in appropriate treatment, identifying dangerousness to self and/or others is not easy -- the mental health professional in general does not have tools that are terribly helpful in this regard.  Mostly they must rely on the person’s word and their gut instinct.  And after identifying that someone is at risk for acting out in a dangerous way, predicting if and when anything will happen is next to impossible.

But in the case of the shooter in Colorado, I have a hard time believing he was deteriorating under the radar.  He was buying assault weapons, ordering explosives, failing in school and isolating from family.  When are we going to learn that these are gigantic red flags that someone needs help?  I have no desire to live in the land of Big Brother watching, but this young man deserved timely, appropriate care just as his victims deserved the right to go to a movie theater without having to fear for their lives.

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Dr. Tom Spicer August 15, 2012 at 06:49 PM
I wonder what prescribed medications this person was on. This always get's left out of the media due to patient confidentiality issues, however, it has been documented that it is a common side effect for patients to loose touch with reality when on the drugs their therapists hand out like candy. Columbine comes to mind. Food for thought!
Hal Pickett August 15, 2012 at 09:29 PM
Yes, Dr. Spicer, it is difficult to monitor and manage the side effects that may come with medication prescribed by the Psychiatrist. It can also be very dangerous when these medications get mixed with recreational drugs and alcohol. Unfortunately Psychopharmacology relies on the intuition of a well trained Psychiatrist mixed with a little trial and error.


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