Santa Monica shooting raises specter of mental health, again

The mental health of John Zawahri, accused of fatally shooting five people in Santa Monica, Calif., Friday before being killed by law enforcement, is increasingly becoming a focal point in the search for larger lessons behind yet another mass shooting.

Law-enforcement officials are refusing to speak on the record about Mr. Zawahri's mental health, citing privacy laws. But CNN has reported that Zawahri was hospitalized for mental-health treatment a few years ago, and neighbors and acquaintances have said that Zawahri was troubled by his parents' divorce and point to a history of angry outbursts and a “fascination with guns,” according to the Los Angeles Times.

Given that three young men accused of being mass shooters in recent years – Adam Lanza in Newtown, Conn., James Holmes in Aurora, Colo., and Jared Loughner in Tucson, Ariz. – all struggled with mental-health issues, the questions about Zawahri are multiplying.

Mental-health professionals bristle at the assertion that those diagnosed with mental illness are more prone to violence. But some 60 percent of the mass shootings during the past three decades involve an individual with mental-health issues, says John Matthews, a 30-year law-enforcement veteran from Dallas who has studied 60 mass shootings in the US and written "Mass Shootings: Six Steps to Survival."

“These shootings are a serious mental-health issue for our country,” he says. “The de-institutionalization of the entire mental-health system has led us to where we are now,” he adds, referring to the decades-long practice of “mainstreaming,” rather than institutionalizing mental patients.  

Troubled young adults more often than not cannot be relied upon to either take prescribed medication or follow through with counseling, says Mr. Matthews, who now travels the country, training school administrators in response and evacuation procedures. But "individuals are seen or held briefly in the system, then released on their own."

“We need to completely overhaul our laws with respect to privacy and the way we administer mental-health services,” he adds.

Daunting as that may be, others suggest the challenge is even larger.

“This is not just a mental-health problem, it’s a public health issue,” says Thomas Esposito, head of trauma at Loyola University Health System in Chicago. 

Society first has to decide on its acceptable level of gun violence, he says. Then, small steps on several different fronts will begin to change the larger culture in much the same way long-term strategies on many fronts have changed attitudes toward smoking.

“Who would have thought even 10 years ago that it would be illegal to smoke in restaurants and bars all over the country, or that smokers would be pariahs at parties?” he says.

Among the issues that need to be tackled, Dr. Esposito says are better gun technology, such as safer trigger locks; education, such as the best practices training programs conducted by the National Rifle Association; enactment and enforcement of laws; and “sin taxes” – like those on tobacco and alcohol – on guns and ammunition.

The notion of raising taxes on arms protected by the Second Amendment would be controversial, particularly in red states. But one step that can be taken immediately, say others, is greater honesty among parents and sometimes even pediatricians. They are too often in denial about red flags in children's behavior, says Los Angeles psychiatrist Carole Lieberman. 

“This is because parents don't want to admit that their parenting could have been less than perfect, and because they don't want to face having a child with mental problems,” she says via e-mail. But “it is always better to err on the side of caution, and take a child for a psychological evaluation, than to keep pretending it's 'just a phase' they'll outgrow.”