To prevent gun deaths, recognize despair

On Monday, President Donald Trump said during a White House meeting that Nikolas Cruz, the accused shooter in the Parkland, Florida, high school tragedy, exhibited “39 red flags” prior to February 14. Trump suggested that law enforcement could have been more responsive to the red flags and the violent attack could have been prevented.

Many in the behavioral health profession know through experience that it’s exceedingly difficult to predict human behavior. Even more so, clinicians know that it’s unethical to categorically label individuals as potentially violent based on a diagnosis.

Clinical psychologist Joel A. Dvoskin, PhD, ABPP, fellow of the American Psychological Association, tells Addiction Professional that warning signs are not the issue.

“Most of the common characteristics of mass shooters are shared by millions and millions of people who will never shoot anybody,” Dvoskin says. “Much more valuable are actual threats. I think it’s important for us to begin to make clear the difference between warning signs and threat assessment.”

Each state has different case law and statutory law to define when a healthcare worker has the duty to break confidentiality and report a patient’s potential for violence. However, if evidence demonstrates that a person poses an imminent threat of danger to self or others, in all states, there is a process to notify law enforcement for civil commitment to a psychiatric hospital, he says.

In the case of the Parkland shooting, Dvoskin underscores the well documented fact that serious mental illness has very little relationship to gun homicide.

“What is much more useful in preventing gun deaths is a recognition of emotional crises, fueled by despair, rage, and often, alcohol or drugs,” he says. “These crises can result in interpersonal violence, suicide, and a host of other bad outcomes. In my opinion, it is imperative that we restore funding for the public mental health system’s ability to respond to emotional crises born of despair and rage.”