Newtown shootings underscore how confused we are about mental illness and violence

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There are substantially more questions than answers about what led to the horrific events that unfolded in Newtown, Conn., last week.

But one thing seems clear: There is much misunderstanding about the connection between mental illness and violence.

Social networks are brimming with speculation about the type of mental illness the perpetrator, Adam Lanza, had been diagnosed with, as if that would help to explain his actions.

Many media outlets have been featuring medical experts offering uninformed opinions on Lanza's psychological state and how similar events can be prevented.

Countless people have read and shared a blog post titled "I Am Adam Lanza's Mother," in which a woman compares her 13-year-old son, whom she describes as aggressive and threatening, to Lanza, despite knowing next to nothing about his upbringing, background or behaviour.

The truth is that we simply do not know enough about Lanza. And even if his complete medical history was made public, it may not bring us any closer to understanding how he could kill so many people – or how to prevent it from happening in the future.

That is because mental illness does not predict violent behaviour, nor does it explain why an individual would commit such acts.

"The issue of violence is very, very complex," said Peter Szatmari, head of the department of child and adolescent psychiatry at McMaster Children's Hospital in Hamilton. "The vast majority of people that have mental-health challenges are not violent, so it's really important to separate those two as quite different phenomena."

In response to the 2011 shooting in Tucson, Ariz., involving former congresswoman Gabrielle Giffords, Thomas Insel, the director of the U.S. National Institute of Mental Health, wrote a blog post stating the majority of people with serious mental illnesses, such as schizophrenia, are not violent and that they are actually more likely to be victims than perpetrators.

He added that when violence does come into the equation, individuals with mental illness are far more likely to harm themselves than others.

Marjory Phillips, clinical director of Integra, a children's mental-health centre in Toronto, warns against the temptation to blame mental illness for the events in Newton. "When a tragedy like this happens, people … try to find answers," she said. "I think it's overinterpreting and oversimplifying a very complex [issue] without the knowledge."

There can be a relationship between mental illness and violence, but it is much more limited than most people realize. According to the Mental Health Commission of Canada, people with severe, untreated symptoms of serious illnesses such as schizophrenia with psychosis or major depression may have an increased rate of violence toward themselves or others. But, with intervention and treatment, these individuals "are no more dangerous than the general population," according to the commission's website.

While many details of the Newtown case may remain a mystery indefinitely, several experts in the field say it may be a good time to talk about how to improve access to mental-health supports and services.

For instance, decades ago, the solution to aggressive children was to lock them away, said David Wolfe, director of the Centre for Prevention Science at the Centre for Addiction and Mental Health in Toronto. That "was not a proper resolution by any means" and now there are new treatments and therapies to help those, including children, who may be dealing with aggression or violence as a result of mental illness.

But there are simply too many gaps in the system and it is ill equipped to deliver the type of preventive care that could help individuals before they reach a breaking point. "Our system in mental health is designed to respond at the very last minute," Wolfe said.

For parents who may be worried about whether their child may be dealing with a mental illness, or how to know when to seek care, experts such as Wolfe offer several pieces of advice. They emphasize the importance of reaching out to others and not keeping the problems hidden. There are support groups parents can attend, for instance.

Szatmari noted that early intervention can help children and adolescents get treatment to manage their condition.

The mental-health system should also be easier for families and patients to navigate and more supports should be available in the community, Wolfe said.

"If we work together as a community and as a province, we can make a difference," Szatmari said. "We should have that as our motivating cry and not be paralyzed by the enormous sadness and tragedy of the event."