We always want the quick fix, the simple solution..........and so often, those are untenable.

Thank you for telling us all this detail. It really helps.

that this is a hard, hard issue with no even somewhat easy answers.

who are not medical professionals. It's way too glib to blame mass shootings on "mental illness," especially when it's been determined that most mass shooters do not suffer from the kind of mental illnesses that cause delusional or paranoid ideation, e.g. schizophrenia. Likewise, the insanity defense is almost never successful, or even attempted, in cases where the shooter survives and is prosecuted. A legal defense based on mental illness requires the defendant to show that he is not responsible for his due to an episodic or persistent psychiatric disease at the time of the act, that prevented him from controlling his actions, or in the case of the old M'Naghten rule, that he did not know his act was wrong or he didn't understand the nature of his act. That threshold is very high, and unless the defendant is diagnosed as suffering from a severe mental illness that causes delusional thought, it won't be met. Sufferers from an Axis II disorder are not likely to be eligible for an insanity defense (some jurisdictions allow for a verdict of "guilty but insane" ).

On the other hand, it's reasonable to say that a person who goes out and murders a bunch of strangers at a mall or a night club or a school is not normal, even if they are not diagnosed with a specific mental illness. Some of them, e.g., Adam Lanza (Sandy Hook), probably the Dayton shooter, possibly the Las Vegas shooter, and the Parkland shooter, have been described as "troubled," and their families, classmates and acquaintances have described them after the fact as odd, unsociable and even scary. Were they mentally ill? Suffering from a personality disorder but not delusional? What about people like the El Paso shooter, Dylan Roof, and Anders Breivik, who are unrepentant white supremacists who evidently don't regret their actions at all? They are clearly rational, and are delusional only in the sense of their own grandiosity and the perverse nature of their beliefs. Can we call them mentally ill, or are they just evil?

I've been around a bit of rehab and addiction and addicts. Normal is a pretty amorphous concept, and that makes things like mental health difficult to define, too, because there really isn't a standard to compare it too. It's the Catch-22 affect. If you're crazy you can't see how crazy you are.

Everybody has their story and my headache will always hurt more than your broken leg-insert your own allegory. I guess the thing we need much more of is empathy. Mental pathology always seems to include an unhealthy lack of that.

We won’t agree on what that response is, but when we see someone who seems in danger of harming self or others the FIRST course of action is to try to get them to remove access to means of doing so.

After spending 8 months in a mental health center she was placed in a group home for the mentally ill. She was doing very well and was allowed to work for a temp agency, but when they dropped her off on Monday she went in but did not work and walked away. Since she is on a court ordered Chapter 51 hold the police were immediately called. She is in a city she does not know and doesn't know anyone there and has no money and hasn't had her meds in 2 days now. There's been no sign of her and since she is 5'10" redhead, she's not exactly another face in the crowd. She is now on the national missing persons database.
I'm worried and scared and feel helpless and am constantly on the edge of crying.

Being on the national missing persons database, in any law enforcement anywhere picks her up as soon as they enter her name they will know she is missing. The thing is, she is afraid of the police because too often when she has had contact with her they have hurt her (broke her arm in 2 places).
I was sure they would find her in a few hours, not days. I'm trying to keep myself distracted by posting online.

I wish I could help. I hope she makes herself known in some non-harmful way and is gotten back into a safe place. Please keep us posted.

but one of its side effects is psychosis, exactly what she doesn't need. Until these past 2 days she has taken her prescribed meds everyday for nearly 10 months. She is subject to breakthrough symptoms though.

in a small city 20 miles from where she had been last seen. After 2 days off her meds she was psychotic and was yelling at people in a Burger King. The police were called and she threatened them with a lighter and when she approached them they tased her. She broke her arm near her elbow when she fell.

She was lucky because I bet had she been a black male they would have just shot her.
She is recovering at a Mayo behavioral heath unit. Previous to the 2 days when she was missing she had taken her meds everyday for nearly 10 months. Just last week her pdoc put her on Ritalin and that may have caused the problem. But she was having trouble with auditory hallucinations telling her to do things.

I hope they rethink that Ritalin and get her back in a stable state. She is lucky in some ways, I guess, but I feel for you both. Hang in. I imagine you’re on quite a roller coaster.

The term "mental health" when used by lay people is often meant as a way to signify that "something is abnormal" about the person's behavior. It is also used, along with "crazy" "criminal" and other terms to differentiate between "them" and "us".

As you said in your last paragraph, it can happen to anyone of us. The good thing is that it doesn't, and if it does, it is usually not severe enough to lead to the commission of significantly violent acts.

People often need a shorthand way of saying things because of the complexities of human behavior. Therapists do not treat a label. They do not treat Depression, or Schizophrenia. Therapist help people to improve their lives by understanding some of the causes of distress and problematic behavior, by providing them with coping mechanisms and helping them to create a path toward health as they understand it and which makes sense to them.

We need a much more nuanced understanding and discussion about how we deal with stress, grief, the biochemical factors that influence our behaviors, and how we can insulate ourselves from the most extreme levels of behavior.

as you said, any 1 measure will be imperfect, but together will cumulatively reduce the damage done with firearms.

The Gilroy shooter bought a gun 3 weeks before killing. Without it, maybe he stabs people instead. That's preferable to me as the odds of surviving are higher.

Better that he had to wait 3 months, 6 months, a year to take possession. Remove the ability to manifest the impulse.

Exactly. We can neither "cure" nor even readily identify all the various stripes and permutations of things we bundle together as "mental health." Nor have we ever been more than even moderately successful in identifying those who might be a danger. Which should not at all be taken as a discouragement in our efforts toward steering people toward help .. or support and encouragement for people (and families) that are facing problems. We need to do a lot more rather than less. But the idea that "mental health" is going to serve as any magical elixir (or even a functional component) in our efforts to combat mass shootings and gun deaths .. is pure fantasy. We don't have the tools .. and we don't even have a good target.

Too many politicians are looking for a simplistic quick fix that they can use to prove that they are "doing something" while preserving their NRA ratings.

You are correct that there will be no one solution to this problem and that it will be a process. I sincerely hope that we can make meaningful progress to change the status quo.

mental health and criminal behavior. So did people like the late master therapist and author Jay Haley. Mental illness is no excuse for committing crimes. If you commit a crime, you owe a debt to society. Period. Mental illness/mental health issues exist separately, as they should be. "Not guilty by reason of insanity" is a forensic argument that nonetheless should imply that the defendant cannot be re-integrated into society without rigorous examination, pleas for forgiveness, remorse, and compensation to victims. Even at this juncture in our understanding of human behavior, mental health determinations are not reliable predictors of future behavior. But past behavior is.

I'm posting this as someone, now retired, who entered into the professional field of psychology in the early 1970s, and I've done work with sociopaths/psychopaths in a state prison, with families riddled with incest, probation/parole clients, and all manner of people with criminal backgrounds. "Mental illness" cannot be, IMO, a reason to mitigate criminal prosecution. It should be an afterthought.

There are real victims of crimes who suffer, some for the remainder of their lives. That a convicted defendant engages in pleas for forgiveness, compensation, remorse, and examination, and does so with congruency and sincerity is a symptom of mental health, AFTER the fact of the commission of a crime. (Pleas for forgiveness do NOT imply that victims accept the forgiveness plea; only that the defendant makes the plea. Being coerced into accepting forgiveness from the defendant can re-traumatize victims.)

I don’t agree that one size fits all. The fact you worked with people convicted and imprisoned shows the filter. I’m sure you understand that there are many, many sets of circumstances that can lead to the same end and should not be lumped together. I worked in a children’s prison for a while and there were some deeply damaged kids there. Some I had hope for. Some I didn’t, not so much because of them but because the milieu they came from and would return to was incapable of helping them succeed.

Sometimes a plea for forgiveness is a sign of health and sometimes it’s a manipulation.

But this conversation itself shows how many ways we can see things, even within the profession.