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Jared Loughner may be mentally ill. But does that matter?

Jared Loughner’s YouTube videos, his online writings and even his reading list suggest that the 22-year-old accused of six deaths and 14 injuries in this weekend’s shooting rampage in Arizona was mentally disturbed. But in searching for clues to explain Loughner’s alleged actions, how much does that matter?

Without interviewing Loughner or reviewing his past, several clinical psychiatrists have acknowledged in interviews that the college dropout’s strange behavior in the last several years suggests that he may have suffered from what mental health professionals call “severe mental illness,” such as schizophrenia or bipolar disorder. For example, Loughner was entranced by nonsensical syllogisms — about currency and “mind control” — and obsessed with a philosophy of “nihilism.”

Photo: Flickr/Dan Tidswell

As Daniel Lende, a medical anthropologist at the University of Notre Dame, has noted, Loughner became isolated from “guiding social institutions” like family and school. He described himself as a “conscience dreamer” who, friends said, became more interested in his delusions than his waking life. Even his reading list — including titles like “We the Living” by Ayn Rand and George Orwell’s “1984” and “Animal Farm” — suggests a fixation with the idea of the state persecuting the individual, as Mark Potok of the Southern Poverty Law Center wrote this week.

Observers have sifted through these clues in an effort to reconstruct Loughner’s mental state at the time of the attacks, and determine if a mental disorder drove him to shoot Rep. Gabrielle Giffords and 20 others in the parking lot of a Tucson supermarket, as police say he did. But research on the connection between severe mental illness and violent crime suggests that they may be missing the point. The search for an amateur diagnosis of Loughner’s mental state, experts say, may be at best a futile task and at worst a dangerous misunderstanding of what motivates people to be violent.

Schizophrenia, it turns out, has very little do with it. Certainly there are those infamous assassins and serial killers — Mark Chapman and David Berkowitz among them — who claimed to be listening to voices when they carried out their crimes. But those notable cases are rare, and as outliers they don’t tell us much about why people actually commit violent acts. But because they are burned into the public consciousness, people often mistakenly interpret those crimes as evidence of a connection between mental illness and violence.

“This is wrong,” Lende wrote for the Public Library of Sciences this week. “It is wrong scientifically, where excellent research shows that the link between mental illness and violence is minimal, and it is wrong socially, where naming a person as mentally ill then closes off a deeper explanation of what happened and why.”

In the case of Loughner, that deeper explanation is what we should be looking for, Lende and others say. Every day, more clues about Loughner’s behavior emerge, as investigators scour his background and interview his friends. If we want a richer understanding of why someone like Jared Loughner — a 22-year-old music lover with no record of violence — would do what he is accused of doing, we should use those clues with firsthand interviews to reconstruct a history of Loughner’s behavior, his thinking and his gradual detachment from the world around him, psychiatrists and other experts said.

Dr. Seena Fazel, a clinical psychiatrist at Oxford University, has produced the seminal research on this topic. He pooled studies of nearly 20,000 individuals on the link between mental illness and violent crime, and found that diagnoses like schizophrenia only minimally increase the chances that a person might be violent. Fazel’s research suggests that it isn’t the schizophrenia per se that motivates violence, but certain underlying “risk factors,” like a family history of violence or aggression. Those clues may be more complex and harder to detect, but they tell us much more about a person’s violent impulses than a simple diagnosis of mental illness.

Foremost among those “risk factors,” Fazel found, is substance abuse. While people with schizophrenia or bipolar disorder are only marginally more likely to be violent, those who abuse drugs and alcohol are substantially more likely to commit violent crimes, according to Fazel’s research. Like anyone else, a person with schizophrenia might become violent and might require special care. But as a warning sign for violence, Fazel said in an interview, mental illness “doesn’t actually make a large contribution compared to something like drug and alcohol problems.”

That’s important, experts say, both for understanding why people commit violent acts like the shootings in Arizona and for preventing such crimes in the future. “If I was worried about someone, I would be looking at risk factors,” Fazel said. And in the conclusion to one of his reports on violence and mental illness, he wrote that “violence reduction strategies that focus on preventing substance abuse among both the general population and among people with psychoses might be more successful than strategies that solely target people with mental illnesses.”

Loughner might well have been one of those people. He might have suffered from delusions of persecution; his thoughts might have been obsessive and disorganized. All of these clues might tell us something about his mental state. But if they do, that will be only a small, perhaps even insignificant part of the story. If we really want to understand what happened on Saturday morning in Tucson, we might instead ask ourselves what signs we could have looked for in this troubled 22-year-old’s progression from quiet teenager to suspect in that horrific attack.