A Crime by Any Other Name Is Probably Not Mental Illness

Texas church-massacre shooter Devin Kelley (Texas Department of Public Safety)
Texas church-massacre shooter Devin Kelley (Texas Department of Public Safety)

Stop me if you have heard this before: A person with a gun walks into a church and shoots as many people as he can before being killed. What is to blame for this? Regarding the recent Texas church massacre, President Donald Trump stated that this was caused by a “mental health problem.”


In other words, guns don’t kill people ... yeah, let me stop you there and dispel that myth. In 2015, suicide was the 10th-leading cause of death in the United States. A total of 22,018 people used a firearm to commit suicide. Adding to that number, with the 12,979 homicides that were carried out using a firearm, there were 34,997 total deaths caused by firearm in the United States in 2015, according to the U.S. Centers for Disease Control and Prevention.

It’s only November, but 2017 has been considered the deadliest year for mass shootings in modern U.S. history. This despite the fact that the 1921 Tulsa, Okla., race riot; the 1923 Rosewood, Fla., massacre; and the 1890 massacre at Wounded Knee, just to name a few, all had greater tragic losses of life in a single instance in this country.

For the record, the current federal definition of a mass killing (pdf) is “three or more killings in a single incident and must occur in a place of public use.” So far, there have been 112 people killed and 531 people wounded in mass shootings this year. To put it bluntly, guns definitely kill people ... a lot of people.

However, Trump’s answer to these violent events is a very convenient and plausible excuse for the population as it pertains to mental health because of two things: 1) the population doesn’t know a lot about mental illness to begin with, and 2) they don’t want to know about mental illness. So this seems like it would make sense.

But people who have more than just a cursory knowledge of mental illness will tell you that this likely isn’t mental illness.


Trump’s line of thinking has been a popular excuse for people committing violent crimes and crimes in general. But mental illness is responsible only for 3 to 5 percent of violent crimes. This means that the people who are committing violent crimes are far more likely—19 times more likely—not to have a mental illness.

A good rule of thumb for most things is to understand one main concept: There is a difference between mental illness and bad behavior.


Just because someone does something that is unusual or not normal to you does not mean, by default, that someone is mentally ill. I get it—these events cause shock, disgust and make you feel sick. However, if there is no evaluation, you should probably err on the side of bad behavior. If the shooter was killed, there is little else to go off of other than family members, who might suffer from recall or responder bias, which makes any evaluation ultimately unreliable.

A person who has not previously been diagnosed with a mental illness and who commits a violent crime is likely not suffering from mental illness and is probably just evil. Yes, I know, there is no Diagnostic and Statistical Manual of Mental Disorders 5 designation for being evil. Which is why being a bad person isn’t a mental illness.


It is more likely that these are horrible people with poor coping skills ... and access to firearms. Don’t believe me? OK, consider this: If someone shot and killed your relative, what are you thinking of first? That the shooter had a mental illness or that the shooter was simply a horrible person? Exactly.

Need another example? OK. What if your roommate was secretly poisoning you and posting on Instagram step-by-step everything she or he did to you? Would you think that your roommate had a mental illness or that your roommate was a horrible person? Too easy.


Have you noticed that with respect to people who commit a violent crime, the benefit of the doubt about whether they’re suffering from mental illness is inversely proportional to the amount of melanin in their body?


If you have a lot of melanin, you are considered a thug, a terrorist and un-American. However, if you have very little melanin, you are mentally ill and are worthy of people suggesting that you had an undiagnosed, and unknown, mental illness, personality disorder or any number of other maladies, and you deserve some compassion.

After all, why else would someone with privilege commit a crime? Affluenza, anyone?


To be clear, I am not caping for terrorism, foreign or domestic.

However, the selective framing and cognitive dissonance that seems to dominate the narrative of these types of incidents makes the optics of perceptions of mental illness and mental health look bad, and it is the wrong way to address these events.


The ramification of using mental illness as a scapegoat increases the stigma that is attached to mental illness. This stigma makes people far less likely to seek out professional help to improve their mental health. Not to mention it also increases the criminalization of mental illness, when, in fact, people who have mental illness are 10 times more likely to be the victims of violent crime, not the perpetrators of crime.

I don’t expect Congress to do anything about it. It did nothing when the Sandy Hook Elementary School mass shootings occurred in Newtown, Conn. Hell, members of Congress were actually shot at and kept right on going like nothing happened. If they don’t care about their own lives, I am certain they don’t care about yours. But, hey, thoughts and prayers.


Neither thoughts nor prayers are going to be able to stop a bullet or people’s suffering.

By the way, those survivors and family members of the victims? They are dealing with mental health challenges as they struggle to understand why their loved ones were tragically taken away and why the government repeatedly fails to prevent these senseless losses of life caused by people behaving badly.


Although, if this is a mental health problem, perhaps Trump is to blame, because he did sign into law a bill that rolled back an Obama-administration measure that had made it harder for people with mental illness to procure firearms.

But when you have shock, disgust and emotion, who needs facts?

Terrance McGill, M.D., MPH, specializes in preventive medicine, mental health and addiction medicine. In addition to practicing medicine, McGill is an author and journalist who tries to find new ways to save the world, no matter how much it doesn’t want to be saved.  


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As a victim of domestic violence I am tired of the narrative about mental illness as well. The funny thing is, you never actually hear what mental illness the person supposedly has. Depression? Anxiety? Bipolar disorder? One of the many lovely personality disorders that may or may not be classified as mental illnesses?

Nah, you never hear that because mental illness when used in this context is a catchall term for somebody doing something you would never do and you can’t understand why. You know what else is like that?

Domestic violence.

It’s part of the reason that people like me stay in situations that are awful. Because you spend so much time being absolutely confounded that someone can treat you so horribly. They don’t start out hitting you. They start out torturing you in subtle ways that you brush off because it can’t be on purpose, can it? And the fact that you are not an abusive person and you literally cannot empathize with an abuser’s mindset means that it is confusing. YOU wouldn’t do something like that on purpose so he must not have meant it like that, right?

It numbs you after awhile. But it is not mental illness. It’s entitlement. That’s what is at the root of a lot of domestic violence and that is why some people who abuse their partners and children go on to do things like shoot up concerts and churches. I guessed that Stephen Paddock had probably been abusive to his two wives and I wasn’t surprised to hear this asshole was abusive.

They feel entitled to get whatever they want in life and they will torture, maim, and beat the people who they perceive are standing in their way. Many times it’s the women and children in their lives, but sometimes it goes past that and they take it out on society at large. Few women who experience abuse are surprised when shit like this happens. We have been telling everyone it is coming for ages.

My ex is one of the people I would not be surprised to see on the news for something like this. If I survived his attempt to kill me, that is. But even if I did survive, no one would ever hear about the years I spent trying to warn everyone because no one ever believes abused women until it’s too late.