aaron-voices

Aaron and his uncle, Scott, could both speak to violence and mental illness. Scott was a peacemaker who also had schizophrenia. In 1998 he was en route from Texas to Kansas to study history. He stopped in Oklahoma City to visit a friend. He and his friend went out on Valentine’s Day and left the friend’s furious girlfriend behind. She collected a gun and bullets from the top of closets, loaded the bullets into the gun and waited for them to return. She shot Scott in the back of the head as he walked away from her. At the time she said she was angry because he would not respond to her yelling. At her trial, she changed her story and stated that she killed him because he was “weird and creepy”. A jury of 12 considered that threat enough to justify her killing him and let her walk. The reality for people living with mental illness in the USA is that they are much more likely to be victims of violent crime than perpetrators.

Gun Violence and Mental Illness edited by Liza Gold and Robert Simon is an important text to read to get an evidence based perspective on the relationship between gun violence and mental illness. In the first chapter, McGinty and Webster state that most people with mental illness are never violent, but that there are identifiable high risk periods including first episode psychosis and the period of time around psychiatric hospitalization. They also asserted that people with mental illness are much more likely to be victims of gun violence than perpetrators. They suggest expanding firearm prohibitions for people with a history of domestic violence and substance abuse, investing in early treatment for psychosis, and substance abuse treatment. Miller, Barber & Azrael advocate for attention to limiting access to guns for people with suicidal ideation. 65% of all gun deaths are the result of suicide. Suicide is the greatest risk for people with mental illness related to guns. Knoll and Annas state that gun restrictions that target people with mental illness will not make a difference in mass shootings because most of those perpetrators do not have a mental illness. Instead, they assert that mass shooters have long-standing feelings/thoughts of anger, persecution, revenge and egotism that the mental health field has no immediate treatment for. They recommend increasing resources starting in elementary school to build constructive coping skills for anger and conflict resolution, mental health and mental wellness education. Ash states that while there is no known profile that would allow early identification of school shooters, those actions are generally carefully planned and while adult perpetrators are less likely to tell others what they intend, youth tend to talk and often will tell someone else what they are planning which creates opportunities to intervene.

The Center for Disease Control and Prevention has an excellent website with lots of resources for violence prevention. Looking at violence as a public health issue allows for taking a broader perspective to try and prevent violence … it is process that works on identification of protective and risk factors and systematically implementing strategies. Look specifically at what they say about suicide and youth violence. Unfortunately their good work on preventing gun violence has been stopped/removed due to the politicalization of that specific means of violence. It is an odd gap.

The Cambridge Handbook of Violent Behavior and Aggression 2nd Ed., edited by Vazsonyi, Flannery & DeLisi is a collection of research based writings on current thoughts about violence and aggression. some examples follow. Speaking to preventive strategies at a whole population level, Vaughn, Salas-Wright, and Reingle-Gonzolez (p 206 -220) lay out biosocial foundations of drug abuse and violent delinquency. They recommend increasing resources starting in elementary school to build constructive coping skills for anger and conflict resolution, mental health and mental wellness education, and tier two strategies targeting individual level risk and protective factors. They present several theories that frame antecedents to violence that are within the person and their habitual ways of response as well as those that are part of the environments and either fan the flames or cool down the potential for aggression. They write about the increased risk living in a culture of honor which is a specific lifestyle where standing up for oneself and fighting whether or not one wins is part of deterring future violence. Both living on the streets and in prison were cultures of honor Aaron internalized that made his return to ordinary middle class life complicated.

Other authors speak to the Dark Triad which are personality traits that often accompany psychopathy and persistent antisocial behaviors. I recognize characteristics that Aaron shared, but they fall flat without a depth of understanding for how they developed, and how they protected him. Still, their models provided a way to frame behaviors and to identify their functions.