Armchair diagnosis and attributing violence to mental illness

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Photos of the 6 victims of Elliot Rodger's shooting

You’ve probably seen stuff about the Isla Vista shooting everywhere (I’ll have links to good resources at the bottom of the post). Still, I thought it was worth addressing whether or not Elliot Rodger had a mental illness or not. Here’s a Facebook post by Maddox that has 14,034 likes at the time of writing:

100% of gun massacres occur by people with mental illness. If you disagree with that statement, be prepared to make the case that there are some rational, cool-headed people who, after thinking clearly and weighing the pros and cons, decide to commit mass killings. There aren’t. Rather than focusing our efforts on demonizing society, guns, gender or family, we should focus our efforts on getting people with mental illness the help they need. The fact that there’s stigma associated with receiving mental health care is a problem. If you know someone in need, reach out and try to get them help. Trying to rationalize an irrational act is futile. Rational people don’t go on shooting rampages.

There’s no time to dissect the whole thing but the bit on “demonising gender” is worthy of a PhD.

Here’s the deal. You should not be a psychiatry or psychology denialist. That would be anti-science. Yes, these fields deal with very complex phenomena and many of their conclusions are more tentative than the conclusions of (say) basic physics. Still, psychology and psychiatry are a thing; an actual field of study filled by smart experts.

If these are fields of expertise, they have terms that mean specific things that experts know about. Mental illness is one such term, tied to a specific diagnosis (often as per the DSM), and requiring a trained professional to be applied correctly. What’s missing from here is the intellectual right of the general public — that’s us! — to take upon ourselves the SUPERBRAVE task of making diagnoses about people in the news based on our understanding of “mental illness” as a colloquial concept.

The lay concept is quite different to the experts’ concept. The public seems to be ok with a general “mental illness” that people can have (and thereby become “mentally ill”) that’s defined based on our whim and not even tied to the diagnosis of a condition. For Maddox , mental illness is the opposite of being rational and thinking clearly. I’m sure you can think of some problems with DEFINING irrational acts as being the result of mental illness. But note that he also uses the colloquial sense of rationality, which seems to be “whatever seems ordinary and non-extreme to him”. A more useful definition BTW, is “a set of algorithms that maximises the chances of a desired outcome occurring”. When you mix a bad definition of rationality with a bad definition of mental illness, you can then label all murderers as mentally ill. Who needs experts to actually tell us what mental illness is, right? BTW, it’s perfectly consistent with maximising your desires to execute a plan if you believe the things Rodger did — things believed by hundreds of millions.

There are bigger problems with the unscientific definition of mental illness that we hold as a society. It actively harms. Mental illness stigma is very real, and by playing fast and loose with what a mental illness is we’ve accepted the “collateral damage” that people will experience. People with a mental illness are generally not more violent than the general population, by the way — but 2.5 times more likely to experience violence with stigma playing a key role. You just can’t diagnose someone like Elliot Rodger with a real definition of mental illness and if you’re using the lay definition you’re basically substituting folksy wisdom for the deliberation of experts.

The other really important thing about diagnosis is the extent to which it’s historically been used against the powerless. Exhibit 1: Drapetomania, the mental illness that causes slaves to run away from their masters. I’m sure psychiatry has diagnoses that would seem just as ludicrous to people from the future cough sex addiction cough. Still, the experts are MUCH better about it than the general public. For example, many have pointed out that the mentally ill folk label tends to be applied to men read as white. We would be hard-pressed to label all members of all terrorist groups as mentally ill and divorce their violence from ideology. To be more extreme, should we believe all perpetrators of the Rwanda genocide (of which there were tens to hundreds of thousands) were mentally ill? To think that Rodger’s difference is that he acted alone is to deliberately downplay the social aspect and the pervasiveness of his ideology.

The hard truth is that the content of beliefs can influence people without a specific mental condition to kill, rape or torture — up to and including a majority of a population. Scary but true. Presuming to attribute mental illness to the causes doesn’t give extra explanatory power, is specifically harmful to people with mental illness and also contributes to an anti-science, anti-expert attitude.

Some useful articles about the shooting: