Violence is not out-of-blue

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As much as we are always taken aback by the report of a person on a killing rampage, the facts always slowly emerge. Certainly in the case of James Holmes, former graduate student in neuroscience, who allegedly left 12 dead and 58 wounded in Aurora, Colorado at the midnight opening of “The Dark Knight Rises” we’ve come to hear about his mental health history and a more disturbing, but clearer picture is emerging. Mr. Holmes appears to have been struggling with a severe mental illness for quite some time. He was noted to be non-communicative by his fellow graduate students and at other times a whimsical personality would emerge. As he spiraled downward into his mental illness he became increasingly remote and withdrew from his school program. In early June he reached out to another graduate student via a text message and asked her if she had heard of “dysphoric mania”, a psychiatric condition which is a form of bipolar disorder with mania and agitation accompanied by dark thoughts and delusions. Two weeks later he stepped into the public eye with his horrific act. He shared his inner most thoughts but unfortunately he had already withdrawn from school and was advancing his plan. His notebook, which he mailed to Dr. Fenton, remains secured by the courts and leaves a gap in furthering our understanding of his planning and perhaps into his mind. To read the New York Times story “click here”

http://www.nytimes.com/2012/08/27/us/before-gunfire-in-colorado-theater-hints-of-bad-news-about-james-holmes.html?_r=1&emc=na

In the course of the next few weeks of this summer we have come to know Wade Page who opened fire at a Sikh temple in Wisconsin and killed six people. We have learned that Mr. Page was well known for white supremacist activities which may have begun while he was in the Army and his public displays of his personal philosophy of hatred through his music and Facebook page. Mr. Page did little to conceal his thoughts and feelings and was on a “watch list” as a potentially dangerous person. His life ended at his killing spree, but we don’t yet understand what was going on in his mind that allowed him to kill peaceful people in their place or worship.

And, now we meet Jeffrey Johnson, 58, a former graphic designer who killed a former co-worker who he held responsible for his job loss. Mr. Johnson showed up at his former place of work at the Empire State Building in New York City and opened fire killing Steve Ercolino, who he blamed for his job loss and faced the police in a gun battle on crowded streets which resulted in his death and others wounded by police bullets. Yesterday, the New York Times published an interview with Mr. Johnson’s mother who referred to a near-fatal accident he had in sixth grade as a pedestrian hit by a car which in his mother’s words: “left him near death”. She related a story about his reaction to the euthanasia of his cat following a long illness and his wish to exchange to trade places with his cat if he could.

Did Jeffrey Johnson experience a brain injury which accounted for his reclusiveness, paranoia and odd behaviors? As the story emerges his mental health problems become more apparent and we are getting insight into his planning the event to include his own death. How come no one else knew about him?

These three latest events are set against a backdrop of many others involving university students. The Tucson, Arizona shooting of Representative Gabrielle Giffords by Jared Lee Loughner, a disaffected Community College student resulted in 19 shot and 6 deaths. Gang Lu in 1991 was a university student who killed 5, wounded two and turned his gun on himself. Frederick Davidson in 1996 killed three professors in the midst of defending his doctoral thesis. James Kelly in 2000 murdered his professor then killed himself. Peter Odighizwa in 2002 killed 3 at his law school. In 2002 Robert Flores, a Gulf War vet who returned to school, went on a shooting spree and killed himself. Seung Hui Cho, a Virginia Tech student, in 2007 killed 32 and wounded 17 before taking his own life.

Two Colorado high school students, Eric Harris and Dylan Klebold, were responsible for the April 1999 massacre at their high school which resulted in the death of 12 students and a teacher and left 24 others injured. Harris and Klebold committed suicide in what we’ve come to understand as a pact between these two young men. Harris’ blog which he began in 1996 contained threats, plans for violence and a “hit list”. Complaints were made to the Sherriff’s department expressing concern with Harris’ well-articulated threats. He openly talked about a display of violence bigger than the Oklahoma City bombing. He had gotten into legal trouble and was under psychiatric care and was prescribed Zoloft due to depression and suicidal thoughts. Not much is known of Klebold’s mental health status, other than he was a follower.

Last year in Norway, Anders Breivik a 32-year old right wing extremist took the lives of 77 people in two separate attacks, the last being on an island campsite. Mr. Breivik’s planning was traced back to 2002 and he maintained a long chronicle of his hatred for minority groups and immigrants. During his attack he phoned the police twice and attempted to surrender, but his call for help was ignored and the killings continued as the police were disorganized and delayed in their response. In the court mental health examination Mr. Breivik was founds to be a paranoid schizophrenic. He was sentenced recently to 21 years in prison, the maximum allowed by Norway. However, he could be held an additional 5 years if he continues to be “deemed dangerous”.

In 1966 on the campus of Texas A&M University, a military veteran and graduate student climbed to the top of the water tower and gunned down 14 people after having killed his wife and mother the prior day. Charles Whitman turned his gun on himself after the melee. In his communications a note was found in which he was questioning the personality changes which had overcome him over the past year and he requested that an autopsy be conducted upon his death. He had sought help from doctors, but to no avail. His autopsy revealed a large brain tumor.

With each event we gain some insight into the person responsible for the violent act. It never can justify the horrific display of violence and the needless loss of life, but it does help us understand the person and begin to unravel the confusing journey which brought them to violence. If the issue lies in a psychiatric disorder, could timely and effective help make a difference. Why didn’t people react if the potential for violence was known? If it was a brain injury like in the case of Jeffrey Johnson or Sgt. Bales, could recognition of the psychological and behavioral changes have prevented the violent act?

With most of these events there were indicators or signs of problems. Even in cases were reports were filed, there is no evidence which suggests that actions to prevent the attempt were made. We could blame society for the access to weapons or we could look at the facts which emerge from each event as ask ourselves why action was not taken to prevent the violence? Could the courts have stepped in? Or, could aggressive mental health screenings have identified at-risk individuals? Could we require mental health screenings for gun purchases? Sometimes we know more about the perpetrators than we care to admit. Unfortunately, the cost of maintaining silence is high.

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