Sometimes They're Crazy, Sometimes They Aren't

I’ve spent this week and weekend driving across the country again; as it happens, I drove through El Paso two days before the recent shooting there. As of this writing, the mass-murderer managed to kill twenty people on the scene, and wound nearly thirty more, but I expect that some of those thirty-odd will die, or will have died already by the time that you may be reading this. I haven’t looked up an absolute ranking in terms of fatalities and injuries and terror, but this is a massacre which, even in a country largely numb toward these events, was terrible enough that it provoked no fewer than four people to get in touch with me because they remembered that I was in Texas somewhere.

I was in Big Bend National Park during the shooting itself, and so didn’t watch it unfold in the news. I’ve been driving since — I’m in Oklahoma now — and so I haven’t followed too closely since. But I have seen that, as is always the case after a shooting like this, a series of dull takes and counter-takes about what role (if any) “our mental health crisis” played, and how urgently, if at all urgently, we need to “fix mental health care in this country”. Who happens to be fixated on mental health after any given shooting tend to depend on the circumstances of the shooting itself. In this case, it is reactionaries (including the President) who have stressed the mental health angle because the shooter was himself a reactionary. They’ve also raised violent video games, and, I imagine, rap music as possible culprits, which feel a bit like a throw-back affectation, given that “mental illness” was the extrinsic non-firearms-related-factor which largely replaced the Grand-Theft-Auto-and-Eminem explanation over the past decade in virtue of sounding significantly less ridiculous if you needed to avoid talking about NRA money and neo-nazi websites.

Of course, liberals have also trumpeted the “mental health crisis” alarm after certain shootings, which is to say, after shootings where the ideology of the shooter is less transparently attributable to the right. Liberal invocations of the "mental health issue” are less transparently cynical than their ring-wing counterparts, but it doesn’t feel entirely beyond cynicism. Worrying over mental health as a cause of mass shootings can, after all, lend a kind of sensitivity and sophistication to your post-shooting Facebook update that just going on about the NRA for the hundredth thousandth time can’t manage on its own.

Regardless of who is blaming mental illness after a given shooting, they are inevitably met with the woke retort: it’s stigmatizing to be talking about mental illness here at all. These shooters are evil not ill, and in fact, it hurts mentally ill people who are actually did you know like, more likely to be the victim of a violent crime than the perpetrator? to act like a symptom of insanity is buying an assault rifle and shooting up a school. They point out, correctly, than the vast majority of gun homicides are not committed by people with a serious mental illness. But this point is about as valuable as the point that the National Alliance for Mental Illness is making when it points out that actually, the majority of violent crimes aren’t committed by schizophrenics. Which is true. Schizophrenics make up less than 2% of the population. They are not committing 51% of the violent crimes.

I’m on the road and don’t want to dig, at great length, into parsing what we mean by “mental illness” and what we mean by violence. Are we talking about all mental illness, regardless of severity? Or do we mean only “severe” mental illnesses, like bipolar disorder? Only do we mean what most people probably imagine when we talk about “mental illness” after mass shootings, i.e. largely psychotic illnesses which involve elaborate delusions, hallucinations, and bizarre behavior? Are we talking about all violence? Are we talking about all violence plus the non-violent acts rhetorically refigured as “violence” by humanities graduate students? Or do we mean only serious violent crimes? Or only homicides? Or only gun homicides? Or only this particular genre of American massacre: the mass shooting?

(And when we gather these statistics, are they based on patient reports? Police reports? Are we only including those crimes for which charges were filed? Or only those crimes where a conviction was obtained? If a schizophrenic proffers a defense of not guilty by reason of insanity, and this plea is rejected, not because the defendant is a malingerer, but because their illness doesn’t satisfy the strict legal boundaries of “insane” at the time of a crime, do they count as a mentally ill criminal, or is there crime added to the pile of those committed by people without mental illness? What if their illness is only diagnosed after they enter the prison system, and are, for the first time, able to see a psychiatrist at all? Are the statistics updated? Are we sure they ought to be updated? After all, it may have been the extreme stress prison which brought on the first episode, as is often the case, meaning that the illness was not present at the time of the crime.)

You could combine any set of answers to these questions and get a wildly different account of the relationship between mental illness and violence, and I don’t propose to get into all of the permutations right now. Suffice it to say, according to the best meta-studies, people with severe mental illness commit violent crimes at a slightly higher rate than the general population, although these are usually more impulsive acts of violence. Mass shootings, which tend to involve quite a bit of planning, are not the ordinary domain of manic depressives and schizophrenics.

But that doesn’t mean that the mentally ill never commit mass shootings. James Holmes, the Aurora theater shooter, appears to be a clear case of clinical insanity. John Hinkley Jr., who shot Ronald Reagan, was schizophrenic as well, and while his crime wasn’t a “mass shooting” in the traditional sense, it did involve a good deal of preparation and planning. (Indeed, Hinkley was remanded to a psychiatric hospital after the assassination attempt, and back then it was Republicans insisting that mental illness is an ‘excuse’ we ought not to fall for, rather than liberals). The woke scolds are right that handwringing over a “mental health crisis” is a cheap way of avoiding the fact that the vast majority of these crimes are committed by the perfectly sane. But the woke scolds are wrong to pretend that insanity is never the cause of large-scale violence. It is. Every time a shooting like this occurs, it feels as if one gets to choose between believing that “mental illness” is a significant sufficient cause of the American gun nightmare, or believing that mental illness has nothing to do with it at all. But that’s a bad choice. Sometimes they are crazy. Sometimes they aren’t.

There are of course a good number of people who believe that in order to murder dozens of strangers, you must, in some sense, be insane. It’s the same reasoning that gets all serial killers called “crazy.” Very few of them have an actual biological mental illness — for the most part, serial killers are just sadists with a cluster of other undesirable personality traits — but how sane can you be if you chop up co-eds in your cabin? No matter what the doctors say, how sane can you be if you decide to walk into a high school, or a Walmart, or a movie theater, and open fire?

You might think of it like this: all mass shooters are insane. Only a few of them are Insane. The capital-I Insane ones are mentally ill; their trouble is that they are not accurately perceiving reality. They might start firing into a crowd because they’re convinced that everybody in that crowd is an alien, or out to get them, or is already not alive at all. The crime they commit is a tragedy because innocent people are killed, but the Insane murderer does not really know that. If the delusion were true — that is, if it were actually the case that everybody in the room was a dangerous alien on the verge of attack — then opening fire might be the right move. The Insane shooter is reacting appropriately to imaginary circumstances.

The insane shooter, meanwhile, is reacting inappropriately to real circumstances. Their insanity is not found in any confusion in their senses, but in the fact that they correctly apprehend a real fact — let’s say the fact that the United States is home to a great number of Latino immigrants — and conclude that this is a terrible thing that can and should be corrected by the random execution of two dozen people. This does not require mental illness. It only requires exposure to the dominant political climate of the United States and easy access to firearms. The El Paso murderer is, of course, insane. But he isn’t Insane. Maybe the next one will be. Probably not. But sometimes they are.