9:21 AM EST, December 2, 2013
The recent report issued by Danbury State's Attorney Stephen J. Sedensky III may not be the definitive account of the Newtown shootings of nearly one year ago, but the 48-page document is worth reading. Perhaps not so much for what it finds as it what it doesn't — a clear motive to explain what caused 20-year-old Adam Lanza to kill his mother and take the lives of 26 others, including 20 children at Sandy Hook Elementary.
The circumstances of the killer's life are chilling yet oddly familiar, as if copied from similar tragedies of the recent past. He had a fascination with Columbine, death and violent first-person shooter video games, his collection of which included "School Shooting." He was isolated, had a "history of significant mental health issues" and owned a variety of firearms including the Bushmaster rifle he used to kill his victims before shooting himself with a Glock pistol.
In retrospect, the signs of a damaged mind seem inescapable. His bedroom windows were taped over with plastic garbage bags. He communicated with his mother only by email even though they lived in the same house. He tracked mass murderers by spreadsheet. He had images of himself holding a gun to his head and pictures of dead bodies.
The report notes that Nancy Lanza had privately expressed concerns about her son's mental state and planned to sell their home and move elsewhere so that he might enroll in a special school or find meaningful work. Socially awkward and possibly bullied as a child (witness accounts are contradictory on this point), he was described by classmates as a loner who made few friends growing up. He had stopped communicating with his divorced, remarried father.
The only reference to mental health treatment is to note that he was diagnosed with Asperger's syndrome in 2005, suffered from anxiety, obsessive compulsive disorder and did not have empathy and followed a "rigid" thought process. The report makes reference to mental health providers and "evaluations" over the years and claims he refused therapies and medications.
Mr. Sedensky concludes that whatever mental health problems Mr. Lanza may have experienced, he had failed to seek appropriate treatment for them. "As an adult he did not recognize or help himself deal with those issues," the prosecutor writes. "What contribution this made to the shootings, if any, is unknown…"
Implicit in this observation is the inference that Mr. Lanza had access to appropriate care, that he was capable of recognizing his ailments for what they represented and seek treatment, and that those around him, his mother included, had acted responsibly. In this, Mr. Sedensky reveals a prosecutor's bias — the desire to strip the perpetrator of any possible defenses that might lessen his guilt. But that doesn't address the larger question of how such incidents might be prevented from happening in the first place — how best to protect society.
Not every person with a mental disorder has access to appropriate mental health care, nor is every person suffering from a serious illness capable of recognizing that fact. That is like expecting a person with a broken leg to walk to the hospital. It is the injury that prevents it. One may as well punish Alzheimer's patients for forgetfulness as expect those who hear voices in their heads to recognize they are imagined.
Much progress has been made for mental health "parity" in recent months, including through the minimum standards of health insurance required by the Affordable Care Act. But there are clearly still holes in the safety net. In Virginia last month, a 55-year-old state senator was stabbed multiple times by his troubled 24-year-old son who then shot himself. The young man had undergone a psychiatric evaluation but was not admitted — allegedly because a psychiatric room wasn't available in their rural part of the state.
Most people with a mental illness do not stab their fathers or walk into elementary schools with an arsenal of weapons. They are not likely to be violent, and when they are, they more likely to hurt themselves than others. But not having access to appropriate mental health care? That happens every day. Studies show access to mental health care in this country is worse than any other medical specialty. Nearly 90 million Americans live in federally-designated Mental Health Professional Shortage Areas. And an even bigger barrier is often societal attitudes toward mental health problems — that these are issues that shouldn't require the help of others.
Mental health care in this country is too costly and too difficult to obtain. That families and friends of those who suffer mental disorders are ill-prepared to act should come as no surprise, given the stigma and misconceptions that surround these illnesses. The exact motivations behind the Newtown shooting may never be known, but our failure to recognize disorders and provide appropriate medical care for individuals like Adam Lanza is clear enough.
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