In the aftermath of the assassination attempt on Donald Trump and the tragic death of Corey Comperatore, we have watched and rewatched the videos taken by every cell phone camera that day. We’ve heard analyses from experts and novices accompanied by a plethora of conspiracy theories all concentrated on the Secret Service, local police, and the last five minutes before the shots were fired. But they are all ignoring a critical point.
We know very little about the alleged gunman, Thomas Matthew Crooks, but what has been reported brings up a pattern familiar with other mass casualty cases. (READ MORE: What Would Have Happened If Crooks Hadn’t Missed?)
This did not start on a slanted roof in Butler, Pennsylvania. It started years before, and it continues to fester in communities across the nation. The assassination attempt is the latest example of the colossal failure of psychiatric treatment in our country. We have seen this before and we will see it again unless government and scientific leadership take meaningful steps to reform our weak mental health “system” and make the tough but necessary choices to build a network of effective evidence-based care. We are a long way from doing it and currently do not have a congressional and cabinet leadership committed to fixing this continuing catastrophe.
According to a recent analysis from the Secret Service National Threat Assessment Center (NTAC), there is no single pattern that fits every perpetrator. However, almost all are male, tend to be in their teen and young adult years, half the attackers are “motivated by grievances and were retaliating for perceived wrongs,” a quarter of the attackers “subscribed to a belief system involving conspiracies or hateful ideologies,” the attacker’s behavior elicited concerns to family and friends, many experienced stressful or traumatic events, and over half had mental health symptoms such as depression, psychosis, and suicidal thoughts.
A 2021 study of mass shooters showed nearly 50 percent had schizophrenia, a severe delusional disorder that can lead to violence if untreated. Many perpetrators researched violent subjects about other mass attacks and made careful plans. There are always some behavioral indicators that something is awry, although the signs may be missed or dismissed by co-workers, classmates, schools, and families. (READ MORE: A Worthless Search for Trump Shooter’s Motive)
Early information about Crooks is still an enigma of contradictions. High school classmates described Crooks as quiet, intelligent, a loner, not involved in school clubs. Reports from other students say he was bullied and appeared “a little weird.” His school said it has no records he was bullied, however, it is not uncommon that fellow students will report observations that differ from those of teachers and administrators. An FBI review of his phone record showed he researched former President Trump and his Butler rally, President Joe Biden, the Democratic National Convention, Catherine Princess of Wales, making explosive devices, and the Oxford High School shooting. Crooks had a picture of the shooter on his cell phone. He was a registered Republican but also donated to a liberal organization.
Like many shooters, we do not know if he had a diagnosed mental illness or was involved in any treatment. However, he allegedly did an internet search for information about major depressive disorder, a path many will take to self-diagnose their condition. His parents reportedly contacted police the morning of the shooting expressing concern about him not responding to their attempts to contact him.
Students with problems are often identified by school officials and referred for treatment. When a student is bullied, one would hope their school intervenes, but HIPAA regulations often block a school’s ability to discuss concerns with parents. Regular access to a caring adult is an important factor associated with a reduced likelihood of engaging in violence. Yet, schools may prioritize their safety efforts by purchasing much-needed hard security equipment. There may be no line item in their budget to have caring adults engage with students. Once out of school, there is no obligation to follow up to see how they are faring. There is no warm hand-off to external counselors to continue care.
Many attackers are lonely, isolated, troubled young men, who can develop a fascination for violence and seek revenge or recognition. In other cases, such as with schizophrenia, or psychosis disorders, the attacker may be suffering from a severe mental disorder, characterized by fixed false beliefs; believing their actions will be considered heroic. These actions typically appear unexpectedly in many men around age 20.
Do we have a system in place to help identify, monitor, and stay engaged with persons of concern? No. Not on the federal, state, county, or local level. There is no safety net of care.
The key federal agency, the Substance Abuse and Mental Health Services Administration, tasked with coordinating treatment efforts for the mentally ill has all but abandoned care for the most serious subset of individuals diagnosed with a Serious Mental Illness (SMI).
In the wake of the Sandy Hook elementary school shooting in December of 2012, I led a multi-year investigation into our mental health system. As Chairman of the Subcommittee on Oversight and Investigation in the Committee on Energy and Commerce, we discovered a hodgepodge of disconnected federal programs, scattered across multiple federal agencies, spending $130 billion on general “mental health” programs, not SMI. SAMSHA’s efforts were more involved with “feel-good” stress-relieving interventions for mild mental illness and ignored SMIs of psychosis and schizophrenia. Their anti-psychiatry policies prioritized advocating for patients’ rights to refuse treatment rather than rights to treatment.
In response, I introduced major mental health reform legislation, to improve access to evidence-based care for mental illness, including SMI conditions.
We eventually passed the bill, the Helping Families in Mental Health Crisis Act, with near-unanimous bipartisan support (422-2) in the House, although key aspects were removed which significantly weakened reforms and access to care for the SMI population.
With the creation of the position of Assistant Secretary of Mental Health as the head of SAMSHA, the bill required greater accountability, evidence-based programs, and cooperation between federal agencies. Initially, care for SMI returned, but the current administration is not treating it as a priority. With some exceptions, mental health care in the U.S. is often disastrous with a massive loss in lives and dollars.
A comprehensive death count associated with mental illness is not tracked by any federal agency. However, total deaths from suicide, substance misuse, early death associated with mental illness (non-suicide), homelessness, and homicide, in the past 20 years likely exceed the total military deaths in all U.S. wars since the American Revolution.
The White House estimated the annual cost for mental illness at $280 billion. The actual cost, however, may be four times higher when adding suicide, depression, schizophrenia, and substance misuse, plus many other unknown costs for common psychiatric problems such as anxiety, attention deficit, and personality disorders. The total annual cost of mental illness easily exceeds the Pentagon’s annual budget. We are losing the war against mental illness.
One in five persons has symptoms of mental illness right now, and about half of adolescents and young adults. We have a shortage of clinical mental health providers and few of them have experience working with violence risk or SMI.
We have a critical shortage of dedicated acute-care psychiatric hospital beds. Those with untreated SMI are more likely to be homeless or in jail and often encounter police. Community problems associated with untreated SMI contribute to ongoing stigma and fear of people with SMI. Many are so impaired by their illness they are unable to seek or accept help. HIPPA laws prevent families from being able to communicate with doctors, and most communities do not have easily accessible and supportive care. Courts, communities, civic organizations, schools, and churches do not work together to create a safe network of continuous care.
No single profile predicts a person’s propensity towards a mass attack. Rather than focus on a profile, we need a wider and more comprehensive approach. The public is desperately searching for leadership who will address this growing problem with the gravity it demands. A recent survey found that 7 out of 10 voters are more likely to support a candidate who prioritizes mental health care.
What we need are leaders at SAMHSA, other federal departments, and Congress who are energized and committed to fixing the problems. This will require throwing some elbows, demanding important changes, and holding states and counties accountable. While Congress has hearings, it must also investigate why we still have major gaps in care. Our next president should appoint people who are tough enough to challenge the ineffective status quo. Too many lives are at stake.
Tim Murphy, Ph.D., is a psychologist specializing in trauma recovery and the author of three books, including The Christ Cure: 10 Biblical Ways to Heal from Trauma, Tragedy and PTSD (2023). He served as a psychologist in the U.S. Navy Medical Service Corps, was elected eight times to the U.S. House of Representatives, and authored major mental health reform legislation receiving wide bipartisan support. DrTimMurphy.com and LinkedIn
The post Before the Bullet: Was Crooks a Victim of America’s Mental Health Crisis? appeared first on The American Spectator | USA News and Politics.
