What Role Does Mental Health Have in Mass Violence?

Trigger warning: this post mentions loss of life involved with incidents of mass violence.

Six people killed – including three children – at a Nashville school by a former student. Ten people killed at a Boulder grocery store, the perpetrator of which is still waiting for “competency to proceed” with the trial. At an Orlando nightclub, 49 people killed and another 50 injured in one of the deadliest mass shootings in the country’s history. There are so many others that the locations have taken on a sort of painful familiarity – Uvalde, Monterey Park, Sandy Hook, Las Vegas, Aurora Theater, El Paso, Virginia Tech, Columbine.

In all, 2,842 people have lost their lives in 546 mass killings since 2006.

These events have become so unforgivably common that we all know the responses by heart, as if they were lines in a play:

There are too many guns in this country – we need more gun control.

No, the perpetrator was mentally ill – we need more mental health services.

While we at WellPower aren’t gun policy experts (although we are strong proponents of the public health approach to this and other deadly problems), we do know a thing or two about mental health. So, what role does mental health have in mass violence?

Note: there isn’t enough room here to fully explore this complex and important topic, so we invite you to look at some of the resources linked throughout for more information and analysis.

First, what is mental health? And how does it relate to mental illness?

Mental Health vs Mental Illness: What’s the Difference?

We all have mental health. Some of us live with mental illness.

The World Health Organization defines mental health as a “state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community.” It affects how we interact with others, manage stress, approach challenges, learn and even sleep. Basically, it’s how we see and feel about ourselves and move through the world around us.

Mental illness, on the other hand, is a specific condition involving changes in emotion, thinking and/or behavior. Conditions like bipolar, schizophrenia, major depression, obsessive-compulsive disorder and others might come to mind. Mental health professionals use criteria to diagnose and treat these and other mental illnesses.

So, you might think of mental illness as one part of some people’s overall mental health, but not everyone who has mental health (we all do) also has a diagnosable mental illness.

How Does Mental Health Relate to Mass Violence?

You probably already know that people who live with mental illness are statistically no more prone to violence than anyone else. And in fact, people with mental illness are actually much more likely than the general public – up to 10x more likely – to be on the receiving end of violence.

When those who do commit an act of mass violence are later found to have a mental illness – an estimated 11% of perpetrators (compared to around 20% of the general public experiencing a mental illness at any given time) – there is usually another factor that has triggered the violent action such as a specific incident or situation.

Crises like being laid off, experiencing workplace conflict or losing a relationship are difficult for everyone. For a small subset of people who are particularly angry, aggrieved, emotionally unstable and socially isolated with limited support, these situations can feel insurmountable. In very rare cases (although still far too common), those with a reduced ability to handle emotionally challenging events may be more prone to acting out in revenge or retribution for real or perceived wrongs by specific people or groups.

This is not to say that anyone who feels angry or socially isolated is at risk of perpetrating mass violence; many people struggle with these same circumstances and will never act violently in response.

It’s clear that we as a society need to do more to extend access to mental health support, particularly for those who currently have the lowest ability to get help when they need it – whether due to ongoing stigma, shortage of providers, cost, difficulty navigating the system and even self-imposed barriers like not feeling “sick enough” to reach out. This goes not just for the very small number of people who might act violently, but for all of us – our families, friends, neighbors, coworkers and ourselves.

What is WellPower – Denver’s Mental Health Center – Doing?

As the community mental health center (CMHC) for the people of Denver, WellPower works with a range of partners and community groups to increase access to mental health support. While other entities might focus on one or two of these areas, being able to connect them all together in-house is one unique strength of the CMHC model.

Crisis response. We work with law enforcement and the justice system to reach people living with circumstances that put them at higher risk of committing legal violations. In addition to our crisis response team, we partner with Denver Police through the Co-Responder program and with Denver Health through the STAR program to send the right response to people in crisis. We respond to emergencies to offer support for people impacted.

Prevention. We work in communities to help people address their social determinants of health. We innovate – relentlessly – to develop new and better ways of extending access to care for everyone who needs it, such as through our online, on-demand, no-cost TherapyDirect program.

Services in schools. WellPower’s school-based therapists provide individualized, strength-based, trauma-informed and culturally relevant mental health treatment services to students within Denver Public Schools. Therapists collaborate with parents, guardians, school personnel and community organizations. Given the inequities in supportive services and health care, our school-based program focuses on communities of color and other diverse student populations. Providing therapeutic services within the school setting increases the ease of access while decreasing barriers to treatment.

Policy work. We continue to work with our community partners and elected leaders to develop policies that improve safety and increase access to behavioral health support.

Addressing mental health will not be enough to end mass violence (again, as community health organization, we advocate for a public health approach to this and other challenges). Still, we must continue to fight for access to care for everyone in Denver, in Colorado, in the United States. We won’t stop until every single person has the support they need to live their best life.

How to Get Help

Anyone in Colorado can access 24/7/365 support through Colorado Crisis Services:

– Call 1-844-493-TALK (8255),
– Text TALK to 38255, or
– Visit a 24/7 Walk-In Center. (In Denver: 4353 E. Colfax Avenue).

For support outside of Colorado, call 988 to be connected to local support based on your phone number’s area code.