Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states ...Read More
Recently, another person used a gun to kill 12 people before he himself was shot to death. This is what happened in the Navy Yard in Washington D.C. As a result, many people in the media are asking why this man, who was evidently descending into a psychotic mental illness, was not noticed and referred for psychiatric treatment? The question presumes that modern psychiatry could have predicted and prevented the violent attack. In looking back in time, in what is referred to as “hindsight” it seems as though the entire episode could have been avoided. Is this true?
While psychology and psychology do try to predict human behavior, they often fail because human nature is complex and largely unpredictable. It does happen that a psychiatric emergency room deems a psychiatric person in the throes of a crisis to be of no threat to others and are then discharged with a referral to a mental health clinic. Sometimes they are administered a psychiatric medication along with the referral. Then, tragedy strikes and the patient either commits suicide or hurts another person. It doesn’t happen often but it does happen. In other words, even the best medical experts in psychiatry cannot always prevent tragedy.
The media is making much of the fact that, Aaron Alexis, the shooter, was hearing voices, reported them but in the hotel he was at but nothing was done. Does this mean that, if a psychiatrist knew he was hearing voices the tragedy could have been averted? Maybe, with the administration of anti psychotic medications. However, there is a problem with this.
I learned in my years as a social worker in psychiatry that hearing voices is not at all an indication of potential violence. It is a common symptom for those with schizophrenia to hear voices yet never act on them and never commit violence. In other words, the fact that voices are being heard does not mean that violence will occur.
The real tragedy in this story is that, this man who had a history of trouble while in the Navy and elsewhere was able to walk into a store and purchase a powerful weapon. A background check might have stopped the store owner from selling the weapon and prevented the tragedy from happening. Without taking guns away from responsible people, we need background checks in order that these weapons do not fall into the hands of people who have a history of unstable behavior and of mental illness.
There is one more point I wish to make. It is that 13 people were killed that day if Mr. Alexis is included. While it is true that his actions resulted in the deaths of 12 innocent people, his life was also a tragedy because of the ways in which his mind was tormented. Evidently, he experienced a gradual decline into acute mental illness for which he was never helped. He too was a victim and I point that out knowing full well that the acts he committed were unforgivable.
Allan N. Schwartz, PhD