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Mass Violence Facts from the National Council on Behavioral Health

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you're listening to the site. Central podcast guest experts in the fields of psychology and Mental Health Chatelet provoking information using plain everyday language. Here's your host yet. You tallaght in welcome to this week's episode of the site central podcast calling into the show today. We have Dr Joe Parks. Who is the medical director for for the National Council for Behavioral Health Dr Parks Welcome to the show? Hey glad to be here well before we get started into our topic. Many people aren't familiar. Oh you're with the National Council for Behavioral Health. You kind of give us a fifty cent tour of that sure. The National Council represents about three thousand three hundred organizations nations nationwide that provide treatment for either addiction or for mental illness. And we Do Policy Work in Washington. We advocate for or People to get high quality treatment and to have prompt access to it and we help our members with technical assistance and training. Now many of your listeners may know about one of our national programs mental health first aid. We've trained over two million people To give mental health first-aid when they run into somebody in their community or their family that is in distress from a mental illness. Earn addiction is a great training mental health. First Aid is an excellent program. I am an instructor so I I. I really believe in the program enough to teach and for longtime listeners. We did a previous show on what is mental health first aid so you have to go back and check that out if you want more more information. Great all right today. We're going to discuss mass violent and its relationship to mental illness now given the high profile instances of mass violence in this country. Many people people mistakenly believed that we don't necessarily have a mass violence issue but we have a mental illness issue. What are your thoughts on that? Well you know I think they need to take look at the data and the studies around it and You know we're GonNa have a great conversation today but if your listeners want to learn more they should go to the National Council Council website the National Council Behavioral Health Mass Violence. If you put those search words in your browser you'll get our report and There'll be a lot more information and then we'll have time to go over today. That said there are really two separate problems. There is some overlap but if you eliminated mental illness so you would not be eliminating violence. I think that many people believe that in order to commit mass violence. You must therefore be insane insane to use layman's terms. People have trouble wrapping their head around any sort of violence on that scale. Not being mental illness this I really don't understand that way of thinking. I don't see how it how it's more sane to kill an individual to kill your spouse to kill your brother. What what is it about it being multiple people that seem that makes it aprio rory as a fact mental illness and it also depends what you mean by mental illness? You know one of the things we found reviewing all the studies on this is the amount of mental illness. Involved depends on how the researcher defined mental illness and there is not a standard definition agreed to among researchers or a federal definition. That's been worked out by the Department of Justice or the Centers for Disease Control as to what we're going to call mental illness. In the context of mass violence the definitions go from everything to mental. Distress to the clinician would call a mental illness. And things like schizophrenia. Major depression bipolar disorder. If you look just at the mental illnesses on that list you would only account for four point. Seven percent of people that are perpetrated mass violence if you go with mental distress well that's about seventy percent of anybody at any given time. I think this is what confuses people of course because I think that people believe that you are either perfectly healthy. You have perfect mental health or you have mental illness your crazy or insane and they don't understand this concept of everybody has mental health and while most people have a good mental health. Most of the time you can still have what you referred to as distress or a crisis point or a mental health issue. And that's where we have to start discussing it because if anybody can have a mental health crisis then we can start to do things to prevent that and really start to look into controlling and preventing mass violence in this country. Why I think you made an excellent point mental health and mental illness or not all or nothing? It's just like physical health you can. You may not have cancer and you may not but have quadriplegia and be paralyzed but you can still be very physically unhealthy the same thing with mental health. You may not have schizophrenia bipolar disorder. But you may still have distress and have trouble getting through your day and interacting with others comfortably. Let's talk about mass shooters because that's kind of one of the most common come in once. Let's get that out of the way quickly. Are there any common characteristics that all mass shooter seemed to have well here. You've you've come across the other another another big problem. We found looking at the research. There is no settled definition of what is meant generally by mass violence. And now you've used the term mass shooters news which is a subset of mass violence. There are people that kill large numbers by running a vehicle through a crowd or by stabbing now. It appears that that over ninety percent ninety five percent in the United States is due to shooting that is the large majority also. There's no standard definition of what the word mass ask means. Some studies use three or more some use for more some exclude when it involves family members some exclude when it's done as part of a Crime I'm an attempted theft so another place we need help. We need really the government get active is we need again. A standard definition of what we mean by. I math violence or mass shooting the number of and the types of deaths we're going to include. Then you have the problem. What do you do by about near misses We looked at one case of a person who had fired over forty rounds at a crowd only hit one person. She was a lousy shot. 'cause she only killed one one person. Does that make that. How's that different from somebody that had hit five or eight? Is the difference between a mass killer in singer killer. How good a shot? They are so the listeners. Need to be aware that if you re different studies you get different answers because they use different definitions of all these very important factors that said the most common characteristics is almost all her men very few women. The second is almost all are using guns. They're much more effective at killing people than than other means especially in in large numbers. Almost all of them are angry and resentful. They feel the world has has been injustice either to them personally or to some other group that they identify strongly with almost all of them are more isolated on average than other people. They you have fewer social relationships family relationships Many of them have had a a recent disappointment. Either with a relationship with with a partner or with family or the job but it is resentment anger and isolation that are actually much more common factors than the presence of a mental wellness. If you look at what is usually meant when you see a psychiatrist or psychologist or therapist in clinic mental illness. Things like schizophrenia. A AH recurrent major depression bipolar disorder. It appears that about twenty five percent maybe of people when perpetrating mass violence silence had recently or at the time they did the act had a mental illness but at any given time about nineteen percent of everybody in the nation has a mental illness. So it's not much different. The other problem you get into is assuming that the mental illness caused the violence. You can certainly have something and not have it causes ause you to take a particular action now in some cases with mental illness. It's pretty clear that there's a cause. A few cases people had command hallucinations heard voices telling him to kill much. More commonly people had problem with depression or anxiety. It's unclear how being depressed or anxious makes you wanNA kill somebody so assumption of causation is another air. But in general about one in four people that have perpetrated mass violence by the best evidence available bowl which is pretty spotty at times had a mental illness. That a clinician would call it mental illness at the time they did the act compared to about nineteen nineteen percent of people with a mental illness for the general population. Let's talk about the research for a moment because you you've laid out that we don't have good standards for this and your research. Research is only as good as your data. That's a well accepted. The scientific method. Is there for a reason. And it doesn't seem like the federal government is looking to close these loopholes. So I I guess that's my first question. Why doesn't the federal government want to get a good study on this so that we can get a handle on it? I know you're not the policy. Director turbot the National Council does do policy advocacy. Did they have any thoughts on this. I mean we have specific recommendations on our report that that I'd I would urge all of your listeners to talk to their elective representatives about If you think about airline crashes another horrible in rare cause of of Math Steph. We have the National Transportation Safety Board. Who keeps say staff of investigators who has a standardized system of investigating every crash Josh and there's mandated reporting and their standardized data and it goes into databases and they use it to improve the engines? They use it to improve pilot training. They use it to improve airport airport design. Why don't we have something like that with mass violence? If we're going to make the problem better we need to have that serious systematic investigation set of standard Definitions and data basing and mandated reporting instead of a lot of one off studies and just feeling bad about it. Second is there's not decent federal funding to look at the causes of violence either related to mental illness. If you're worried about that almost all the studies are retrospective studies. Eddie's the last major prospective study done was done about twenty five years ago it was mostly funded by a private foundation the Macarthur Foundation by the way that study study found that people with with serious mental illness are no more likely than the general population to be violent unless they also have a substance use disorder so no perspective studies studies and look at all the restrictions on Violence with guns. There's very little funding and there's a lot of restrictions on what you can study so if you have mass violence where ninety five percents guns but you have us as a nation. It's not just our elective representatives. We decided this as a group saying that. We don't want to seriously study this stuff for whatever reason. Listen why should we expect anything to get better now just to take us out for a moment. Many of our listeners are familiar with prospective studies. Retrospective Studies. Can you explain that for us. Real quick wacoal. I'm sorry yeah. A retrospective study is where I take information. That's been gathered for other purposes. So I look at everybody after the shootings as of occurred I look at them as a group afterwards and try and find out if there was a violence related to mental illness. A prospective study would be where I look at thousands or tens of two thousand people with mental illness before any violence has occurred and I follow them over ten or twenty years. It's a much stronger study methodology. Because you're not it just looking at the subsection and missing all the people that haven't been violent yet. Thank you so much for explaining that now. One of the reasons that we want to do these studies reason why the National Council advocates. These studies is because in doing so we can prevent violence potentially because we can do things like threat assessments now we have have threat assessments. Now what are those in. What are they based on? If the studies are so wonky well again it depends on what you mean by threat assessment. What we are referred to in the report is threat? Assessment is a multidisciplinary team and this was a process that has been developed over time by the FBI. I That is not just all clinicians. That does an ongoing investigation of someone. Were there's concerns that they could be dangerous so people are brought to the attention of this team and maybe somebody that has become more solid at work has started muttering that he's GonNa take it anymore and somebody's gotta pay and someone got worried and called up and it came to the team's attention how the team in the case of workplace would consist probably if somebody from HR somebody from the local police because has it is potential for a crime a lawyer that's knowledgeable about rights because we want to protect the person's civil rights also and behavioral health professional in case there is a mental mental illness related to it and they they gather information around the person before they talk to the person then they decide who talks to the person about what and and it's an ongoing process. It's not a clinician alone in a room talking just about medical symptoms. We'll be right back after these messages. Want real no boundaries. Talk about mental health issues from those who live at listen to the not crazy. PODCAST CO hosted by a lady with depression and a guy with bipolar visit psych central dot com slash. Not Crazy or. Subscribe to not crazy on your favorite podcast player. This episode Sodas sponsored by better help dot com secure convenient and affordable online counseling all counsellors are licensed accredited professionals. Anything you share is confidential schedule schedule secure video or phone sessions plus chat and text with your therapist whenever you feel. It's needed a month of online therapy. Often cost less than a single traditional face to face session go to better help dot com forward slash psych central and experienced seven days of free therapy to see if online counseling is right for you better help dot com forward slash psych central. We're back discussing mass violence with Dr Joe Parks from the National Council for Behavioral Health. Dr Park what motivates mass violence. You no I don't have a good answer for that. I can give some theories but boy. I'm not certain there right. A lot of this is connected to people feeling more hopeless is angry and treated unjustly and a lot of it is also A loss of connection and it appears to me and I think many of your listeners who look around the people are less connected to the and then they weren't each other and that people are much anger and feel more resentful that their life is not fair to them. You know another good question question is why is this such a huge problem in the United States and not in other countries. You know we don't have near the rates of other citizens of other countries shooting large numbers the people because they're angry resentful. Let's talk about that for a moment first off facebook and facebook memes are terrible terrible terrible place to get any sort of data or information about well anything but I see a lot of stuff on facebook especially doing my research for this episode where somebody will say that you know. Other countries don't have large amounts of mass violence surrounding guns. And then somebody will post after it will. Yes but they have large amounts the violence with driving cars into people and and you know stabbing and other forms is that true or do they have lower rates of mass violence. It's hard stop. Oh No no you know. One of the points of data shows in our report. If people WANNA take a look at it shows the data on assaults else we actually have fewer assaults than many countries is just in the US when we assault each other. Were much more likely to kill each other. They're just much more deadly so this this is on page twenty one of our report if people Wanna going downloaded has the percentage of population assaulted annually by nation. And they're the top of all all places as Belgium around six and a half percent and the US is about Oh fifteen twenty countries down the list at about one and a half percent but if you look at the death rates from suicide and homicide by nation we're at about nine deaths per hundred thousand. We're by far number one and and we're over double the next country which is fine linen so we are much less likely to assault each other but when we salt each other were much more likely to kill that. What is that is incredibly interesting? And I can't imagine that you have an answer to this next question but why do you think that is I think we're less likely. I believe he used cars or knives. there are mass assaults with knives that usually don't result in large numbers of death they result in large numbers of wounds We're simply using more effective. Means when we do an assault would be my guess but this is where we need more research if we wanted to know we would fund serious research. I think it's incredibly credibly interesting. That all of America is aware of this issue. I think that you would be very hard pressed to find somebody. That is not aware of mass violence and concerned by amass violence and it really does impact our day to day lives. We teach our children not to talk to strangers. We go through metal detectors to go to sporting events and concerts we. We are just really worried and concerned about mass violence yet. You're telling me that the federal government is doing not very much about it They studied the individual cases. They don't have a large systematic method like the national transportation. Safety Board does with airplanes and even though ninety five five percent of the mass violence are shootings there's very little or no federal funding for research around violence and guns and there are restriction attached to it. That's just incredible and again. I WanNa make the point that this isn't political. Nobody is taking a partisan side on this issue. Just simply stated Americans are concerned about out mass violence. But we don't seem to be doing much about it now. The National Council has some opinions on what we can do to stop the trend of violence. Yes and and we we recommend the first of all there should be some national definitions and some real research and A Standard Board that looks at the shootings after the fact like big national transportation safety and try to figure out what can be done before we think there should be more threat assessment teams that States in the feds should make funding available in the threat. Assessment team should be available in every school district and in all the large workplaces and in most communities so when community members are worried. There is a team that can look into it and take action. We think everybody should be trained in mental health. First Aid for that subgroup or twenty five percent where mental illness may be a factor actor so it can be identified early before. They're so distressed that there that angry We also think that extreme risk protection orders also known as red flag flag laws should be more widely adopted. These are available in about seventeen states. Now how easy. The law is to use various by states. But this is where someone can go to the court your local court and say your honor. I'm worried about Janis. Saying he's not GONNA put up with it anymore and I know he's got a bunch of guns and he's talking about somebody's gotTa to pay and I'm just scared and the judge can say well let's have. The police removed. John's guns temporarily while the threat assessment team talks to him and it's so it's due process. It's with a court. John gets his guns back after the issues settled down and cleared up and this has been in place for domestic violence nationally for many any years. You know if you threaten to shoot your partner or spouse with a gun Every state has a way to remove that until you work it out if you threaten to shoot up the church up the street only seventeen states have a way to remove your gun until that gets worked up. It's fascinating to think about the idea that were debating whether or not it's okay to leave weapons in the hands of somebody who has publicly threatened to use them for their intended purpose on innocent sent people when we all know how we react once that happens. Yes it's We're Kinda conflicted. You know the other major recommendation indication. We have in terms of the smaller subset of people were mental. Illness may be a factor is. I'm sure all your listeners are aware of the difficulty not out there in accessing treatment for mental illness and addiction promptly. People don't know where to go in the study By the Coen Veterans Network Foundation Nation of over half. The people said they would know where to go to get help for mental illness if they needed to find it for themselves or a friend when they do find it they often have to be on a wait list for weeks weeks or months. Well the solution to that has been implemented in eight states now gets called certified community behavioral health centers. This is a treatment organization that treats both addiction and mental illness that has federal requirements for getting people in promptly having laid hours having weekend hours having being a mobile crisis team. That will go out and help people that are crisis. Twenty four hours a day seven days a week has a full range of services. It's not go one in place for your residential. Go someplace for your outpatient. Go someplace else for your meds and we. We believe that that needs to be continued and expanded. It's called certified community behavioral Liberal Health Centers. It was put in place by the Excellence Act and people should say that they wanted in their community so they can get treatment when they need it in your advocacy work. Do you think that the federal government government is responding to you see things improving. Are things getting better. What's the reaction from the capital? We are making some steady progress on certified community behavioral health centers and. We're making steady progress on mental health. First Aid We're we're not seeing real. Progress is on a standardized definition Asian and data gathering around mass violence and on some serious research into it and we haven't seen progress yet on resources for threat assessment went and management teams. So it's mixed it's mixed but you're out there working and hopefully making it better you know and if people take a look at our report there's something in that report any of them could weigh in and make a difference on. We have very specific actionable organizations on what you can do as a community entity member or what you can do if you work in an organization that does health care and there's legislative recommendations and you can certainly let your elected officials know some of these very very specific ideas if there was you agree about but you won't know until you look at our report if you agree or not and can you give us the name on location of the report. One more time please is to make it easier for the listeners. To Find Yeah Putting Your Browser National Council for Behavioral Health and then put it in the words mass violence in America. And it'll pop right up. Excellent Dr Parks. Thank you so much for being on the show. I have one last question before we part mental illness and mass violence are they correlated or not correlated. They they are not particularly correllated. You know again. There's about twenty five percent of people that mass violence perpetrators that had a mental illness about nineteen nineteen percent in the general population. There are certainly some people that perpetrate mass violence that have mental illness. There is a small subset of cases where it appears to to be causal in the majority of cases. Mental illness was not a cause of the mass violence and again with the caveat. That studies are hard to come by. Ainley really need to do a better job to make life better for all Americans. Yup serious study is better than random speculation. We need to stop speculating and start gathering information. Dr Parks I really appreciate you being here and I appreciate all the work that the National Council for Behavioral Health Does thank you. Thank you appreciate the discussion. Thank you Dr Parks for agreeing to be on the show and I hope everybody will read it and talk to their legislator because no matter what side of the aisle you're on. I think that we can all agree that we WANNA see less violence in our country. Thanks everybody for tuning in and remember you can get one week of free convenient affordable private online counseling anytime anywhere are simply by visiting better health dot com slash psych central. We'll see everyone next week. You you've been listening to the song central Kost want your audience danced to be wound at your next event featuring appearance and live recording of the psych central podcast. Right from your stage email us at show and signed central Dot Com for the details. Previous episodes can be found at psych central dot com slash. Show on your favorite podcasts player. Psych central is the Internet's oldest and largest independent mental health website. 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