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Undiagnosed and Untreated Mental Illness Pulled the Trigger in Aurora

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James Holmes resized
James Holmes

By Bob Cesca: When an event like the theater massacre in Aurora occurs, it's always a challenge to know how exactly to discuss the story from a political point of view.

For what it's worth, I would like to extend my condolences to the families of the victims of this latest gun-related tragedy.

What follows isn't intended to trivialize their deaths or to somehow ameliorate the loss and pain the survivors are surely experiencing today. But whenever a senseless act of terrorism occurs, it's critical that we examine what, if any, systemic and societal factors might have contributed to such a disaster. If we can open a dialogue about such topics, it makes the next event slightly less inevitable -- even if by a hair.

Anyone who knows me and my work is aware of the fact that I believe down to the core of my being that video games or comic books or Heath Ledger characters or comic books had nothing to do with this tragedy. Not in the slightest. If you think they're to blame, you're just as ignorant as some of the zealots who blamed the theater-goers for not shooting back.

Uncharacteristically, however, and with some level of potential controversy, I'd like to suggest that this wasn't just about James Holmes' ridiculously easy access to guns or gun-related paraphernalia, either. Yes, firearms were the weapon of choice, and, yes, the efforts of misanthropic gun lobbyists and the politicians they control absolutely contributed to the ability for Holmes to attain an arsenal of weapons and armor. And, had that access been severely restricted, the attack may never had occurred.

But what exactly prompted Holmes to acquire those weapons and plan the massacre in the first place? The root -- the "patient zero" cause of the attack on those people in Aurora was undiagnosed and untreated mental illness. It's the catalyst for everything. Clearly, it was untreated mental illness triggered Holmes' plot from start to finish -- from the acquisition of weapons to the choice of venue to whatever pop culture references he may have employed in the aftermath, severe unmitigated mental illness was the reason it happened and specifically what we ought to blame.

His mother knew it right away, but why wasn't it caught and treated sooner? We may never know exactly, but we will always know the upshot.

One in four Americans suffer from some form of mental illness. This frustratingly complicated and poorly recognized disease is more prevalent here than cancer and heart disease. From a CDC study:

According to a rigorous health survey conducted by the CDC in 2004, an estimated 25 percent of adults in the U.S. reported having a mental illness in the previous year. Lifetime prevalence rates of mental illness in the U.S. were around 50 percent when measured back in 2004. That means in a family of four, one of you likely has a mental illness.

That's not to say someone in your home or immediate family is plotting to murder a dozen movie-goers. Obviously, there's a spectrum of mental illness that ranges from the innocuous to the severe.

But what we know is that Virginia Tech and Aurora and Columbine were all carried out by insane people who were motivated by serious diseases that infected and destroyed their ability to distinguish right from wrong -- perhaps not to the extent of total incompetence, though such a judicial outcome is in the hands of a jury -- rather, we can only conclude that the decision to mass-murder other human beings emerges from a place of severe psychological abnormality. Just as we diagnose heart, lymph node, breast and testicular abnormalities, so should we diagnose mental illness, especially when it's as far gone as Holmes' diseased brain. And especially so before they're allowed to purchase deadly weapons.

Instead and despite its reach, mental illness continues to be misunderstood.

Until as recently as late 2008, mental health wasn't required to be covered in employer-based health insurance plans. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 was the first successful piece of congressional legislation that forced health insurers to cover mental health, and it was clandestinely smuggled into law as an amendment to the bailout signed by President Bush while the economy was collapsing. Most of our traditional health insurance policies still, to this day, don't cover mental health medications and therapy.

As a society, we just don't regard mental illness with the same level of importance as other more "visible" diseases because, until someone totally snaps, mental illness boils under the surface behind eyes that seem perfectly lucid, while sufferers, in some cases, don't even recognize their own disease. If mental illness generated a visible tumor or bloody discharge as an early symptom, theater-goers in Aurora might have lived happily to see another film. But because it lurks deep in the brains of its sufferers, it's too often brushed under the rug and ignored.

Give a person with an untreated and severe mental illness a handgun and a target, and another movie theater massacre waits in the wings. Take away the handgun, and it'd be homemade explosives. Take those away and it'd be poison in the cafeteria food (beyond the legal poisons already mixed in). What else can be taken away? Basic freedoms and liberties, maybe? Video games? Mental illness with homicidal tendencies will find a way to manifest itself -- guns laws or not.

The sooner we target mental illness the better; the sooner our healthcare system and, more critically, our society as a whole takes it more seriously, diagnoses it and resolves it with urgent therapy or medication or, in some cases, with confinement, the sooner we'll prevent more senseless murders before they happen. Otherwise we have no other choice but to accept the brutal consequences of our healthcare blindness, while laying the blame on guns or movies or heavy metal lyrics.

James Holmes is insane. A system better prepared to diagnose and treat Holmes might have prevented the massacre. Sadly, that system doesn't completely exist yet.

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