Dec 21, 2012

What I am doing to respond to Sandy Hook

When Pete Earley asked what we were doing to respond to Sandy Hook, this is what I wrote.
Over the course of the past week, I have written several blog posts about preventing violence of this kind on my blog http://redesigningmentalillnes.... I usually write about mental health recovery, but I know a lot about the connection between mental health and violence. I have designed curricula for NAMI and I have taught crisis de-escalation in courts and jails in Ohio and Kentucky. I have been writing about research connecting violence and mental illness for quite a while. I don't subscribe to the views of either of the policy camps. The TAC offers bad policy, the mental health community wants anti-stigma more than they want to express precision about risk.

There is a realistic way to approach this. The key is that these very hard incidents look just like suicides as they roll out. You don't have to have a "by the book" case of diagnosable whatever in order to have a breakdown or become suicidal. The DSM is just a catalog, after all, and even psychiatric pros will change their mind and argue about what kind of disorder is what. For ordinary people who are not clinicians, the kind of trouble a person has is not material. It's the pattern of the breakdown in thinking that matters, and this can be interrupted. People interrupt suicides every day.A tiny fragment of these people in trouble end up attacking others.

We can interrupt these incidents if ordinary people were better at spotting suicide risk, and learned to have a serious talk or even a simple four-question script. I wrote about the parallels between the Portland shooter and Wade Page, the Sikh Temple shooter one week ago, and laid out the crisis/suicide prevention technique I published in my book Defying  Mental Illness.


A final note: In the NY Times yesterday there was an article about suicide bombers and rampage killers. Adam Lankford, an academic researcher has a book coming out connecting both with motivation to suicide. The article's author and I both agree that the clues and motivations of potential suicide risk are often common denominator in murder-suicides, and ordinary people really do have the best opportunity to prevent all this senseless death.

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