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<div class="at-above-post-homepage addthis_tool" data-url="https://blog.lareviewofbooks.org/essays/mental-illness-school-shootings/"></div>In the aftermath of yet another school shooting we have seen the same debate about gun control and mental health playing itself out that we do each time such a disaster occurs. As usual, the gun control folks have called out mental health as a red-herring designed to distract from the issue of guns, while the pro-gun folks try to lay all of the blame on mental illness, claiming that only a <a href="https://www.cnn.com/2018/02/22/health/trump-mental-illness-comments-bn/index.html">“savage sicko,”</a> as the president put it, would use a gun to shoot up a school. When even the valiant efforts of Parkland students to use activism to make meaning of their horrifying experiences are met with intense backlash, it is difficult not to feel like we are caught on a kind of sick hamster wheel, futilely running in place while someone, somewhere is nursing the desire to commit the next mass atrocity.
That’s why for some of us, there remains what feels like an urgent question about what motivates such violence and destruction, and why the pace and deadliness of such events seems to have increased so dramatically in recent years. The answers may lie somewhere between the issues of gun control and mental health, in the space where individual and collective problems converge.
As a psychological and medical anthropologist at Northwestern University, I study how people’s social and cultural backgrounds affect the way they think about and experience mental illness. Such knowledge is crucial to understanding not only what is motivating these mass shootings, but also why we are so locked into a futile debate concerning what to do about them.
As Americans, we tend to think of mental illness as an individual phenomenon. The causes of mental illness, we believe, are located inside of individual people, in their genes or their upbringing. But evidence from historical and cross-cultural studies shows that people’s expressions of social or emotional distress and the form these expressions take differ across time and place because they are closely tied to their social and cultural contexts. Such expressions, rather than being universal manifestations of organic pathology, are locally meaningful expressions of locally generated distress. In this sense, what we call mental illness is not an individual phenomenon, but a highly social one.
Thus, every behavior or characteristic linked to distress — including both mass shootings and everyday gun violence — has a crucial social and cultural dimension that needs to be understood.
Research shows that even disorders that have become familiar and taken for granted in the US, like Anorexia Nervosa and <a href="https://press.princeton.edu/titles/5802.html">Post Traumatic Stress Disorder</a> (PTSD), have very specific historical and social contexts. Though forms of self-starvation can be found in other contexts, Anorexia as we know it has historically been predominantly a disorder of Western Industrialized countries, suggesting that this expression of distress is linked to aspects of our social and cultural context. Research suggests, for example, that anorexia is an expression of self-hatred that grows out of cultural messages disvaluing femininity and female bodies, and prizing self-control and self-discipline. Expressions of distress such as this are thus intelligible only when understood in context.
This is also an example of an expression of distress that results in self-harm. Yet this self-harm has a highly communicative function: it sends messages to family, friends, and the broader society about the struggles many young women experience in the face of pervasive cultural devaluation of femininity and everything associated with it.
Suicide similarly expresses distress in the form of self-harm — <a href="https://www.amazon.com/Suicide-Emile-Durkheim/dp/1607966425">Durkheim</a> famously referred to it as violence turned inward. Research shows that suicide is not always connected to mental illness but instead may be motivated by social factors. Cross-cultural studies in particular underscore the ways in which suicide may function to communicate distress, alienation, shame, despair, or rage associated with a person’s social circumstances in ways that are culturally meaningful, rather than merely representing evidence of individual psychopathology.
Mass shootings are clearly a case of violence turned outward. But like suicide, this violence is profoundly communicative, and it says something important about our society. For the expression of distress to take the form of such large-scale destruction is not somehow anomalous or aberrant, but a direct product of our particular cultural moment. In this sense, what made Nikolas Cruz pick up that gun is not the question we should be asking. The question is, what is it about our current social, cultural, and political climate that is driving some men to express their distress, rage, and alienation in such an explosive and public way? Focusing only on the individual factors that led <a href="https://www.cnn.com/2018/02/26/us/nikolas-cruz-neighbor/index.html">Nikolas Cruz</a>, or <a href="https://www.cnn.com/2017/10/24/us/sandy-hook-adam-lanza-unsealed-docs/index.html">Adam Lanza</a>, or <a href="https://www.theguardian.com/us-news/2018/jan/20/las-vegas-shooting-police-report-gunman-motive-mystery-stephen-paddock">Stephen Paddock</a> to their actions distracts from the systemic factors contributing to the social disconnection, estrangement, and profound anger these men experienced, and keeps us from recognizing the elements of our cultural and social context that link the causes of their distress to this particular form of expression.
These kinds of factors include the emphasis on, and even glorification of, power and aggression in our society broadly; how common it is for people to be lonely and isolated in our current social configurations; how easy it is to access groups that promote violence and violent imagery through social media; exposure via the media to the model of other mass shootings and the intense attention that such shootings and shooters receive (this may appeal to someone who is isolated and unable to communicate his distress to others effectively); and of course, access to deadly weapons. Together, these factors have created the possibility of mass shootings, and the existence of this possibility in our collective consciousness has made it a meaningful way to express distress. 
<a href="http://www.latimes.com/science/sciencenow/la-sci-sn-florida-shooter-psychology-20180226-htmlstory.html">As others have observed</a>, our focus on individual level causes is not only distracting but also damaging — not to mention completely useless in terms of making meaningful progress toward preventing future shootings. Linking mass violence to mental illness <a href="http://abcnews.go.com/Health/florida-shooting-raises-awareness-stigma-attached-mental-illness/story?id=53128272">increases stigma</a> by equating mental illness with both danger and individual responsibility. The <a href="https://www.ncbi.nlm.nih.gov/pubmed/12866388">perception of danger and individual responsibility</a> has been shown to profoundly increase peoples’ blaming attitudes toward the mentally ill, and decrease their desire to help. 
A key function of such stigma is to frame those who suffer from particular conditions as “other,” so that the rest of us can feel secure that whatever their problems are, are not our problems too, and we are not implicated. By reframing mental illness as a social phenomenon rather than an individual one, we acknowledge that such distress, in all of its expressions, is a collective problem best dealt with collectively. This requires us to stop seeing the perpetrators of such violent acts as radically other from us, and recognize that they are monsters of our own creation.
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<h6>Image: By Hermann Rorschach (died 1922) [Public domain], via Wikimedia Commons</h6>
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Mental Illness and School Shootings

Rebecca Seligman, Ph.D., is an associate professor of Anthropology and Global Health at Northwestern University, a faculty fellow at Institute for Policy Research, and a Public Voices Fellow.