Aaron Alexis -- another improperly treated, mentally ill man becomes a mass killer

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Another mass shooting has been perpetrated by another mentally ill man who, every shred of my 20 years of experience as a forensic psychiatrist, tells me was under-treated or improperly treated.

And, now, those who wish to waste our time on irrelevant arguments about gun control will argue we should focus on the weapon the man used, rather than the man himself.

Such people are dangerous because they distract us from the real issue at hand: Our broken mental health care system and the folly of military psychiatry that focuses on making soldiers “resilient,” rather than keeping them safe from psychosis and suicide and homicide.


Aaron Alexis, the 34-year-old shooter who killed 12 people yesterday at the Washington Navy Yard, has a long history of mental illness, stretching back, it seems, to symptoms of post-traumatic stress disorder related to 9/11, a history of shooting out a person’s tires and a history of shooting a bullet into an apartment above his own.

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He was also reportedly addicted to a drug—violent video games (which are no different than heroin or cocaine, but potentially more of a public health threat). Recently, according to credible reports, he was under psychiatric care for paranoia and hearing voices.

This reportedly psychotic man with a history of PTSD and weapons charges in the past was apparently not hospitalized.

I will bet you anything he was not given a battery of psychological tests that had a chance to determine whether he was harboring violent thoughts.

I will bet you that he was placed on oral medication (if at all), rather than the available monthly injection of medicine that might have kept his paranoia and those voices at bay, much more reliably.

And, I will bet you that if he had expressed homicidal ideation that someone somewhere in the system asked him to “contract for safety” and promise he wouldn’t shoot anyone and then sent him away. Because, my friends, that is the way our sorry, shattered excuse for a mental health care system functions.

The shootings at Columbine and Aurora and near Tucson and in Newtown and now in Washington were all avoidable.

We have all the tools we need.

Psychiatry, properly focused and deployed, and properly linked to the judicial system and deployed in our V.A. hospitals, is a miraculously effective safety net for those at risk for violence toward self or others.

But we seem hell bent on not focusing this healing, helping art and not deploying it.

It’s a true shame, because we could do so economically and humanely and prevent these tragedies.  It would not be hard.  It would be easy.

Right now, there are two main hurdles to doing so:

1) The political will in Washington to take on the task.
2) And those liars and fools in Washington and elsewhere who state or actually think that guns are the problem.

Here in Boston, where I live, I will remind you, 3 people died and 264 lost limbs or were otherwise injured by bombs at the Boston Marathon made of pressure cookers and nails.

On August 4, 2013 a man was killed in L.A., and 11 people were seriously injured when another man drove his car into a crowd.

And, we shall not forget, on September 11, 2001, almost 3,000 people died when planes, commandeered with box cutters, took down the World Trade Center and slammed into the Pentagon and a field in Pennsylvania. No gun was used in any of those tragedies.

Aaron Alexis would have used a bomb or a car or fire or poison to kill people, had he not used a gun. He wasn’t without the means or the imagination.

We need to fight terrorism and we need to fight mental illness.  
Supremely talented people are needed for both efforts.  Distracting them with political posturing about guns is shameful.