Psychiatry & Psychotherapy Podcast - Mass Shootings: An Interview with Criminologists Drs. Jillian Peterson and James Densley, the Argument for Data-Driven Nuance, and Steps for Prevention

Episode Date: September 7, 2021

A 2019 poll reported that one-third of adults say they feel they "cannot go anywhere without worrying about being a victim of mass shooting" and "more than half of American teenagers worry about a shooting at their school." A mass shooting is generally defined as the murder of at least four people at one time. Why do mass shootings take place? Are there any commonalities between the perpetrators? Could these shootings have been stopped before they started? By listening to this episode, you can earn 1.5 Psychiatry CME Credits. Link to blog. Link to YouTube video.

Hello and welcome to the Psychiatry and Psychotherapy Podcast. I'm here to talk about getting rid of burnout, increasing job satisfaction, and feeling like an expert in what you do. One thing that created a lot of burnout and angst for me was trying to get continued medical education right at the last minute. So why not join the CME membership and do CMEE while listening to this podcast? Go to Psychiatrypodcast.com, sign up, sign in, take the test, and the certification is email to you in seconds. I'm very excited to announce an episode on a very heavy topic. Jillian Peterson, PhD, James Densley, PhD, come on to the podcast. They are PhDs in criminology and have spent years creating theviolenceproject.org, which is the largest database of mass

shooters. It dates back around 40 years, pre-social media. And throughout this episode, we talk about their new book. It's called The Violence Project. How to stop a mass shooting epidemic. And Dr. Peterson and Dr. Densley share their expertise of mass shooting. They were able to look at and create this very detailed database, along with speaking with a lot of survivors, a lot of heroes, a lot of families. And they personally interviewed five of the survivors who did not commit suicide after after they committed this atrocity.

I think in this episode, you'll be surprised. It's like we all have opinions, we all have thoughts, we have ideas on what's caused this. You know, if you're in one political persuasion, you may have been saturated with a certain message, a certain narrative. And interestingly, I think that regardless of where you're coming from, you will learn something in this episode,

will challenge you in some way. It will also give you a different picture. I have had a couple shifts in my thinking, one of which is kind of moving away from like this is a very different type of homicide. There's a large component of suicide in this. I see these events largely as kind of like homicide that also is planned with a suicide at the end. And there's something about that as you'll hear this episode, as you read the book, as you look at the data, that kind of shifts your mindset on this type of person. It's a very different type of person than, you know, the psychopathy episodes that I've had in the past or Ted Bundy episode I had in the past. So this book is literally releasing the day that this episode is being released. I did that on purpose.

I'm hoping that people buy the book, you know, gives them a little boost. This is an important topic and I think they are the most databaseed, sort of thoughtful thinkers on this topic that I've heard. So check out the article that I've written with this episode in Psychiatrypodcast.com. I have included a large summary of the database in tables, so it's easy to digest. And I think it'll be a great addition to listening to this, and both of which I think will inspire you to check out their book and check out their full database. I'll leave it there. I'm excited to have you guys on. So welcome to the show. Thank you. Thanks for

having us. Yes, thank you. I actually looked at your database years ago. And so when I got contacted by your publisher to have you guys on, I was like really excited. Like, oh my gosh. So you guys have studied in particular, it looked like the database was 180, but the book covers about 172. Is that correct? Yeah, that's right. So, So the database is now in its fourth iteration. So we have, we released the original database in about November of 2019. And based on users like yourself who've downloaded the database and have interacted with it, we've made updates since then. And then in addition to that, there's also been more mass shootings in the time since that original database was released.

And so we've added new cases, unfortunately, when they've occurred. So now the database has about 180 people in it. But when we were analyzing the data to write the book, you know, obviously with publisher deadlines and stuff, we tried to make it as an evolving and moving project as we could. But at times we, you know, we were unable to kind of keep pace with the actual shootings that were occurring in the community, which is how sad this work really is. And so, yeah, the analysis in the book is based on that original kind of data set as we move through it. And you define mass shooting as four or more deaths.

And then what you did, that was I found really interesting, is you interviewed five people in detail who were still alive, who hadn't committed suicide during the mass shooting. Was that correct five people in depth? And in particular, the shooters. And then you interviewed, like, hundreds of people surrounding the events. Is that saying more about that? We sent letters to every perpetrator we could find who was incarcerated, who had killed four more people. And, like you said, the majority die in the act. So there was actually, of the 172 cases, I think we sent 32 or 33 letters.

We got seven back to people who said no. We also heard from a few lawyers and different people who said they can't participate, but we had five perpetrators write us back and say that they wanted to be involved with this study, which we were really shocked by. And we made sure they knew that they were not getting compensated in any way, that we weren't going to use their names. So they weren't going to get fame or notoriety from the process, that this was really about understanding their pathway to violence. And it was going to be really focused. Interviews and conversations were going to be focused on their life history rather than on. their crime itself. And so we did have five individuals who agreed to sort of do that process with us. Yeah. So I think that gives my audience a kind of a picture of who you guys are, what you guys have been up to. Just to give you guys some my thoughts, reflections coming into this, I actually was working in Loma Linda at the time of the San Bernardino shooting. So there was a couple patients that I saw at Loma Linda Hospital right after the shooting, I was on covering for CNL, constantly and psychiatry. And then I had some patients subsequently in my IOP and outpatient

psychiatry practice that I saw, people who were survivors who had had serious injuries, horrific stories. So this was very real to me in that sort of like situation. I think a lot of our listeners have had a lot of media input that they've seen of mass shooters. So yeah, it was hard to read this in part because of that. Like I had to like stop sometimes. I was like, okay, I got to like take a walk or something because you tell a lot of the stories which are horrific. And I think for us doing the research, that was probably one of the most powerful things of doing it, which was the time that we spent with the victim's families, with the perpetrator's families, who themselves are trying to process, you know, can we grieve? How do we make sense of what

our son has done? But particularly with the survivors of the shootings or with those families who've lost loved ones, the trauma that they've endured was just at times overwhelming. And, you know, there were cases where we would spend an entire weekend with a family. So it wasn't just that we'd sort of dip in, do a quick one-hour interview and dip out again. You know, we'd have breakfast in the home. They'd show us family photographs. We would get that whole immersion in their lives. And I think it was the weight of carrying around those stories where Jill and I really decided we need to write a book here because this can't just be something that we kind of archive, you know, in a peer-reviewed article that no one

would read, we felt this sort of great obligation to sort of share those stories. And the other thing that was really powerful about this is the way in which those families, and we write about this, particularly in the last chapter of the book, are forever kind of connected to each other. They don't want to be. But as those who've lost love, loved ones, the only people that are even close to appreciating and understanding what they've gone through are others who've gone through those same mass shooting tragedies themselves. And so they find themselves at times connected to one another in these very strange ways. So yeah, those stories were really, really powerful.

And I think they'll stay with us forever because I feel like they have fundamentally changed who we are as well, having kind of lived vicariously through that project over the last three or four years. Yeah, that was something I was actually going to ask you about, like, how do you guys, like, cope with your own internal, like, angst? I mean, you are hearing trauma, right? You're hearing trauma. You're not trained therapists.

I don't think, right? No. You guys are, like, PhD-level, you know, researchers in this field. This is heavy stuff to deal with. I mean, we go through years of training in therapy to kind of, like, sit with these stories. I mean, you guys have gone through the horrors of this for years. I'm just wondering, like, how are you guys doing? You know, like, do you see a therapist?

Does it wait? Do you lose sleep over this? It's a good question. Before I was an academic, I was actually an investigator. And I worked for the New York Capitol Defender's Office, which is the public defender's office that works. on exclusively cases in New York. And I was what's called a mitigation specialist. So I developed the psychosocial life histories of these individuals who were facing the death penalty. So it was

spending a lot of times on Rikers Island, a lot of times with families, a lot of times in the courtroom, also just trying to kind of keep their mental health stabilized and try to understand sort of how you get to the point of committing this heinous murder, which was used in their sentencing hearings. And I was, what, 23 when I was doing that work. I think it was kind of, and I would say I wasn't great at coping back then, right? It was really, it was overwhelming to sit with that every day and to be immersed in that world. I did have some really good mentors in that space and people who had been doing the work a long time and taught me a lot about sort of self-care and taking breaks and compartmentalizing and sort of knowing when you need to step away. So I think

that training and mentorship was really important. for me. Yeah, mentorship key there. Yes, absolutely. And people who are able to sustain this work for a long time, I feel like, have learned how to take care of themselves through the process, for sure. Yeah. And I think for me, there were times writing the book when you were diving into the story and you kind of, you put the outline together and you've got the data in front of you and you write it and you've been sat at the computer all day and you finally take that break and you go outside or you just realize that you're in a really bad mood. And you're like, and you just realize that,

and it's not just the typical bad mood of I've been sat at the desk all day riding. It was, oh, actually, these stories might be having an impact on me. And it was like, okay, time to, you know, take a break, take the dog for a walk, take a deep breath, go outside in the sunshine, and try and recalibrate for a minute. And so there certainly were those moments where you're like, well, this is heavy. And even in the book, you know, there are chapters which deal with trauma and there are some pretty horrific stories in there. And I think we know that even for readers reading the book, there's a few moments in the book which perhaps are going to be a little heavy to read. And, you know, it's not the light beach read that people are going to pick up for that reason.

But at the same time, only when you understand those stories, can you really start to appreciate where people are at? And then you can move toward prevention. And that's the goal. I think the other piece of this is that these, you know, the world's messy and ugly and these things are happening. And I think when we just see them on television or we see them for a minute or the way that we consume these stories usually, I think in some ways is harder. Like it's just, it's so awful and there's just nothing you can do and you're not really diving deep and then you move on and the next day you're at the next story that I think, for me, it is heavy and it's ugly and it's horrific, but it's real and it's happening and the honor

of being able to hear these real stories and carry these real stories and tell these real stories. To me, it is heavy, but it was also hopeful at the same time. Yeah, you guys have, and we'll get to kind of like some of your strategies, some of your plan, and I think it's well thought through. I mean, a lot of people have a lot of ideas on what's going to work, right? you guys have, especially in your last chapter, kind of like a cohesive, okay, here are the multiple domains that we can make some changes, systemically, individually, what we can do as individuals to help this. And I want to say one more thing about the San Bernardino shooting. I remember

afterwards going out in public and positioning myself with the thought, like, okay, if a shooter comes through this door, like, I can take this table, I can like turn it up, I can charge them with the table or like, okay, I have my family here. I can, you know, position them. And I think a lot of people who watch media are sort of, like, despite this being a super rare event, right? I mean, 330 million people in the U.S., and this is like influencing a very small population, but because of the way that the media portrays it, we think a lot about the shooter, we think a lot about their story. And these stories are so impactful into our psyche. And you gave some statistics about like, you know, one-third of adults feel that cannot go anywhere without worrying about

being a victim of mass shooting. More than half of American teenagers worry about a shooting at their school. These are very high numbers of, like, global fear because of these incidents. Do you have an idea on, like, what you would say to me? I remember at the time thinking about getting a concealed carry. Like I looked at the laws. California is horrible for that. So I don't know. I lost steam with that.

But a bunch of my colleagues got concealed carries. There was a nurse that worked in the psychiatric hospital that had one. There was a, you know, a bunch of my friends. So I feel like there's like this kind of response that we have that, I don't know, have you thought about that? Or like, what would you say to me in the midst of this? No, absolutely. I mean, there's two things about this, right? So on the one hand, you have, there's the fear and the kind of fascination with mass shooters

that we have across the media is one contributing factor. And it's one of the things we do write about in the book with the sort of contagion of mass shootings, which is that you do have some mass shooters who are studying the past history of mass shootings and they receive inspiration from that because they're seeing the amount of media coverage and the attention and what can be achieved, if that makes sense, through the shootings. On the other side, you have the fear of the general public, which in turn drives things like gun sales. It's one of the things you mentioned, which we know is not a good solution to the more guns is not the solution to a problem with gun violence, but that's one of the ways

in which people, I think, try and exercise a degree of control over that situation. But then the The other thing is the reactive policies and processes that come after these shootings. So we have an entire billion, multi-billion dollar industry in the United States around school safety, school security, workplace violence prevention. A lot of it is focused on kind of reaction. So it's, you know, we are going to drill ourselves, train ourselves in our response. going to run, hide, fight if this ever happens in our building. In turn, I think that also contributes to more fear, which is this idea that this is a proximate threat that could happen. And there's nothing we can do about it except for run, hide, fight. And one of the things we

tried to do in the book is like change that narrative a little bit, is to sort of say, well, if we're making decisions based purely on fear, that's never a good place to be when we're trying to really exercise good public policy. So what if we take a step back and try and make those decisions more based on data and more based on what we know about the life histories of these individuals? And that moves as a little bit away from reaction and more toward prevention. There's still a role, necessary role. If a shooting were to occur in a building, you'd need to react.

But we want to try and ensure that it doesn't occur in the first place. So I think you're on to something quite right here, which is the initial reaction to shootings for a number of years has just been to sort of mitigate casualties and react to the event. And a lot of that has been driven by the fear that these horrific shootings create in our communities across the board. Yeah. It's like we have fear and we're like, okay, if this situation happened, what would we do? Whereas what I like about some of your perspective?

is because there's decades before this person is sort of cooked into this outcome, which is the horrific outcome of the mass shooting. Because there's decades before, it's like how do we kind of intervene or how do we put our energy into that? And as a mental health audience, I'm hoping this gives some meaning to people in the trenches as well

that, hey, the work that you're doing is very important. And we need to expand it we need to advocate for it because we're not, we don't have enough, right? We don't have enough mental health counselors in the schools. That's one thing you guys talk about. It's like one counselor per like 1,500 or something where it's like we need really one per 250. Is that kind of your thought in general?

Yeah. That was something that was striking is how many of these perpetrators, they had early childhood trauma, really significant childhood trauma. They had ongoing mental health concerns. They were hitting this crisis point. And a lot of it was happening when they were young. And they weren't from families that were well-resourced to get them connected to community mental health services. But school is the one place that they were every day. And school is the place that people were seeing them and noticing things. But if the resources just aren't there, then there's nothing the schools can do. I think so many of these individuals would have so benefited from school-based mental health and somebody sort of seeing what was going on and stepping in early, early on, elementary, junior, and even high school.

But that sort of early elementary school intervention would have been so key. And you're right. We just are so understaffed. And those students across the country are just so underserved. Yeah. I think one of the things that you kind of do in the book is you move. from calling them monsters in the first chapter, which it was a little bit almost abrasive to me

when I was like, monsters, monsters, you know? And then you kind of make a switch to like humanizing them. And I think about, Jillian, for you, like when you were on death row, seeing those people, writing their histories, when you're talking to these five people in detail, it's like, how do you do that without humanizing them? And without seeing kind of like,

okay, this is the whole arc of their life. And a lot of these people, one of the quotes you had, Jill, is the worst, the crime, the worst, the story. And it seemed like there was this kind of pattern of chaos and horror that a lot of these people were born into. And like I said, it's going to be hard for you guys when you get the book to read some of these stories. They're horrible stories. I think there's this balance that maybe I'd like you to speak to. Like, how do you, like, do you see them as victims and perpetrator? or do you see them as mostly victims?

Like, what responsibility do they have versus, you know, this sort of like they, you know, have been through horrible things in their childhood? You know, how do you sort of rectify these two sort of dichotomies? I don't know if it's human nature or something that we have to be able to put people in the sort of, you're a good guy or a bad guy box, right? Like, I need you to fit into one of these things. And I think in doing this work, and working on death row, sometimes I think there's this false sense that if you humanize someone

who's done something horrible, that you're somehow taking away from the horrible thing that they've done, or you're hurting the victims more in some way, or you're not having them take responsibility for it. And I think we were really cognizant of that during this, that in telling these stories, we are not trying to say that what they did wasn't horrific, that they don't deserve to be in whatever way they're being punished, that they didn't hurt all these people. I think they, someone can do something horrific and you still need to understand that human story that got that person to that place. And it's not to say it is their fault or wasn't their fault. It's just, we have to understand the pathways that get people to this point. And for me, especially,

I noticed this working on death row, people would say, isn't that horrible, isn't that, you know, depressing. And I would say, no, it's not because these are the people who have done the worst, worst things you could ever imagine. And they are still human beings and they still could have been stopped. And to me, that was so powerful. I didn't meet any monsters. I meant humans who had done monstrous things. But they were still humans. And in understanding those stories, I think that's the only way we're going to get anywhere moving forward. And I just would add that the labels are powerful, right? So when we call mass shooters monsters or madmen or they're evil, all that does is explain away the phenomena.

It doesn't actually explain it. And I think that's something that we were very cognizant of in this work, which is, okay, so you're going to say that this is the act of pure evil. But how does that get as any close to stop? the next mass shooting, and it doesn't. So as Jill said, it was a real balance of like, we're not trying to explain away what they did, and we're not trying to absolve them of their crime either. Like, they have to be held responsible. What they did was horrific. But if we're, if we're going to try and stop the next mass shooting, we've got to get deeper than just putting someone in a box and saying, well, they did this because they were, they were crazy or they were evil.

we know, particularly in mental health, those labels really matter, right? Because they contribute to the stigma around mental illness. They contribute to the way in which we criminalize kind of everyday behaviors of people in our communities. And so there's a broader connection to that work that we also try and tap into as we kind of work through the process. Yeah, I would say the, you know, I usually don't talk about politics on my podcast. So we can kind of abstain from, largely talking about politics. That seems like a wise choice. But in general, the right says mental health, which, you know, of homicides, at least there's

some data to say like about 5% of homicides are committed by people who have like a psychiatric diagnosis who are acting because of the psychiatric diagnosis. So in general, people with schizophrenia initially in their first psychotic break are more violent but then over the course of their life are not that much more violent than the average citizen although like we have this like stigma of like oh someone with psychosis they're very violent and the uh the left of course says guns guns guns right and like take you know we need more gun laws assault weapon ban where in reading your data it's only like a fraction of the people are using assault weapons most are using handguns so are we going to take away all guns or

Are we taking away guns from? How do we better identify the people we need to take away guns from? You guys touch on these things, but you're a lot more nuanced, which I appreciate. I appreciate that kind of nuance of like there's actually more sophisticated solutions that we can think about. Yeah, any reflections on what I just said are kind of like where you guys find yourself. Because I imagine people who bring you on news shows, they want you to present a specific message that kind of like reaffirmed their preconceived ideas. So I imagine you're not going to have friends on either side, really, because your message is like, or maybe we have friends on both.

And that's another way of looking at it. But you're absolutely right. And here's the other thing. You could say that the nuance is strategic to avoid the political divisions that we have. But actually, the nuance is just data-driven. And that's what we always try and come back to. We just come back to what does the evidence tell us about these things. And what we've done is we've dichotomized this, as you said, the right has gone mental health,

the left has gone guns. And really our argument is can't it be both and also can't it be a whole host of other things too that in a comprehensive package moves closer to prevention? And I think that is what has got missed in this whole debate the whole time, is that we've tried to shoehorn things into one side or the other, but it's actually not getting us any closer to that prevention goal. And so there's absolutely stuff we can do on guns, but it doesn't have to be some of the things which are particularly, you know, frowned upon on the right. And there's also stuff we need to do on mental health. Like we were just talking about, you know, how is not recruiting more

counselors for schools a good idea? Like, I mean, I mean, I can't understand why there would be any opposition to that, to that, you know, how is dealing with early childhood trauma controversial, so to speak. So there's absolutely space for both these things to coexist. And I think that's what we've tried to do. And when we look at solutions to mass shootings, we've kind of layered them. So we've said there are things that can be done on the individual level, which are things that we as citizens of this country can do tomorrow to try and stop a mass shooting. And that might just be more aware of our friends and neighbors and our colleagues at work that if we're worried about somebody reaching out, connecting with them, it could be something as

simple as that. Then there are things we can do on the institutional level in our schools, in our workplaces, in our communities, things like crisis intervention training to ensure that we can de-esculate when somebody is struggling in life. And then, of course, there are the big picture kind of societal macro solutions, which might take an act of Congress or the legislature in your state to move something forward. But I think too often we've said, unless the legislature does something, then we can only do nothing. And what we, what we're trying to say where the book is, actually, there's loads of things we can do that don't need an act of Congress, but an act of Congress might be nice in some areas, too.

Yeah. Yeah, I specifically, going back to this, school counselors, you talk about if trauma screens were done on everyone, we'd find in low SCS places, around 20 to 25 percent of the kids have been through some trauma, which having treated teachers in the trenches right now in those places, like I would say 100%, maybe even higher than that. I mean, 100% I agree with you. I think that the percentage probably is higher because the kids are just really, really raw. It's very difficult for teachers at this point, period, in inner city scenarios. So school counselors, I think, are just, like, so needed.

And I think beyond that, a good partial day treatment program for these kids to be referred to is, like, 100% essential. Like, as a mental health professional, the biggest change I can do is to get someone in these, like, daily groups with other people who are lonely and isolated. And one of the problems is insurance, honestly. I don't know if you guys knew this, but in the last 20 years, reimbursement has decreased, like, 22% for doctors. If you look at, like, CPI data, it's consumer price index. That's how the government measures inflation. But the CPI data is probably underreported, is what a lot of economists report. It's because they move how they measure things around.

They undermeasure some things. So the CPI data is probably undermeasured. And so the decline is probably more than 22%. So because of that, physicians see more patients per hour. Therapists are driven to see more clients where maybe it's just, you know, a full schedule is probably around 30 to 20 for them. But if they have to see more than that, it's just like it's very fatiguing. And so this drives them to cash pay away from the low SES groups. And it's, it can be very frustrating to treat low SES groups with insurance that is, miserable and the prior authorizations and I could go through all the like the just the daily stresses

we face but then also on top of that mental health counselors seem to the people in the school school psychologists they tell me that there's just mounds of paperwork and they're doing more paperwork than seeing kids I don't know if you guys have seen that as well well I can relate on one level which is in a previous life I was a special education teacher I taught in New York City public schools before I became a professor. And as a special ed coordinator, I was doing students' IEPs in a lot of those meetings. And yeah, the paperwork was, you know, the bureaucracy was overwhelming. And that was just in that role. So as I imagine as a school council, a school psychologist, then I remember those office visits and the mountain of paperwork that they were buried under.

And I also just say that some of the things you're speaking to, in the book we have a chapter, It's titled America, which is a very broad topic, if you will, to try and tackle. But some of the things that we want to highlight in that chapter are these structural problems, which are quite unique to the American experience. And one of the quintessential things that is unique to the American experience is the way in which we have tied health care to employment. And as we've seen during a global pandemic, there are major barriers to getting good, affordable, accessible healthcare. And there is this kind of division between the habs and the haves-nots-notts. You know, you can get extremely good health care in the United States if you can afford it and if you can get access to it.

But if you don't have a great health care plan, if you're not employed and so on and so forth, that can be a massive barrier. So you scale that up to what we're talking about, violence prevention, early intervention, and the barriers to getting that, this is a structural problem that runs really deep, as you mentioned. So it goes back to sort of, okay, we've got those things we can do as individuals, we've got those things we can do as institutions, but there is some things which we need to move mountains. And you look at other comparable nations across the world, no one else tied. health care to employment. There's no other Western democracy, wealthy nation that does that.

And universal health care is a right in most countries. It's very different to the United States. It's weird to be talking about that when we're writing a book about mass shootings. And you probably think, like, well, how are those two things connected? But that was really one of the goals of the research, which was to try and flag that actually these things are connected. You know, maybe if we had paid maternity leave and maybe if we had universal health care, maybe if we had counselors in schools and these other things, we could eat away at this phenomena without just having to focus on what appears to be the proximate issues,

which are firearms and other factors as well. Yeah. I just wanted to touch on the counselors in schools, because I think another thing that I learned and that we saw doing this research is, on the one hand, we have the severe shortage of counselors and we do need mental health professionals and we need community resources and we need day treatment and we need people who are licensed in the schools. But I think then there's also this tendency to think that kind of mental health and wellness in a school happens in this counselor's office, right? Whereas there are things that we can do throughout a school building, whether that means we're teaching social emotional learning curriculums at young ages, whether we are carving out spaces for teachers to check in with students that they're worried about because they have small enough classes to notice that or they have time in their day to be able to have those conversations. So there are things, I think the culture of the school, the relationships that students have with

adults if they feel like they're trusted and can disclose problems or not disclose problems. A lot of that stuff happens outside of the counselor's office. It's like we need those counselors, but then we also need these spaces that are kind of these warm, welcoming environments that are really pushing mental health and wellness throughout. Yeah. Yeah, I think that's good. I think teachers can learn to be lay therapists. And they are. A lot of them are, you know, they're on the front line. interacting with people. Interestingly, you talk about how a lot of these shooters,

some of them, or at least some of them, it's like everyone knew who it was going to be in the last decade of this school. It's like, oh, it was that person. It's like people knew who was going to be before they heard the person's name. Was that common to kind of like, how common was that that this person was identified

as someone in crisis at one point at least and it kind of slipped through the cracks. Very common. So I think it was just data-wise, 82% of people in our database were in crisis in the days or weeks leading up to the shooting. And we defined that as a marked change in behavior from baseline. So things like changes in isolating or abusive behavior or paranoia.

But there is a marked change in their behavior and the people around. them were noticing it and picking up on it. But no one knew quite what to make of it. And I would say for school shootings in particular, I can't think of a case where the people in the school building couldn't believe that it was that student. It seemed to be that the pattern was that when it happened and people said it was this student, everyone was like, I figured it was that student. You know, that that student had been on people's radar, that they had made threats previously, that they were known to be depressed or suicidal, that they had had previous sort of punishments or exclusions from the school, that these were kids that people knew were in trouble and that just

hadn't had the intervention that they needed. In many cases, the intervention was exclusionary. So it's criminal charges or its expulsion or its suspension, but that doesn't address the problem. And in many ways, it only exacerbates their grievance with the school. Yeah. And there are also barriers to reporting that as well. So you see that some people, they kind of have a gut feeling. Some of our interviewees, they call it teacher gut. You know, if you work with teachers, they kind of have this feeling or a sense. But at the same time, they felt like, who could I really go to to report this to ensure that it wasn't a punitive intervention, that it actually was a more supportive and caring intervention. And that was a barrier. And then you also had peers of those students. in the schools who also were a little bit concerned about behaviors, but at the same time, they didn't want to be seen as a snitch. And then you have, on top of that, parents and adults in a community who also just kind of would blow these things off as saying, you know, well,

boys will be boys. And, you know, we don't think he's really that much of a problem. And I think there's two ways of looking at that. Number one is we need good reporting mechanisms. But number two, we need alternatives in terms of what is the intervention? Because at the moment, law enforcement are the de facto responders to any and all problems in society. And as we've seen playing out across the country, that's not really the best solution to many of these things. So you can't have a parent or a teacher or a colleague at work or a peer at school,

say, well, the one and only option is dial 911. the police will come, kick in that kid's door and arrest them. That's only going to make matters worse. So we've got to look at what are the alternatives here to get people connected to the services they need if they don't need an immediate law enforcement intervention? And that's one of the big challenges we've got to try and remedy now across the board. Yeah, 100%. I think in reading this book, my image of the typical perpetrator change. changed. And I think this is worth talking about and thinking about. And I hope my audience kind of has this shift as well. I've done episodes on like Ted Bundy. I've had about three episodes on

the podcast on psychopathy. And this seemed different than psychopathy. I think there were a couple that in reading the news articles and something, you know, like there was one guy in particular that I read. And I was like, this sounds more like psychopathy. But in general, it seems like, well, I'd be curious, like, did you think about like the psychopathy checklist? Have you been trained in that at all? Or like, did that come in your mind when you were talking to these people and like, yeah, I can see you guys smiling already. Go ahead. Yeah, I am trained in the psychopathy checklist. And it's certainly something we thought about. I would say for the vast majority, and like you said, there may be one or two where that really does fit. That description fits more. But the vast majority,

it really didn't. Maybe some of the factor two stuff in terms of the more sort of impulsive behavioral stuff, but the factor one kind of personality stuff, the sort of callousness, the manipulation, the sort of not feeling too much in one direction, I feel like these guys were the opposite of that. They were not charming or glib or manipulative or emotionally flat. They were actually quite emotional. They were very anxious, they were depressed, they were suicidal, they were hopeless, they were desperately seeking somebody to give them some sort of approval. It just felt so different than that psychopathy checklist. I think I was surprised by that too. These are individuals that are just kind of much messier.

And the fact that so many of them, most of them plan to die in the act, I think makes it really different too, right? These are individuals going into this thinking, this is my final act. Either I'm going to kill myself or I'm going to be killed, this is it. That's a really different mentality going in to commit a crime is expecting to die when you do it. Yeah. One of the things in your database, I counted, 116 had an ongoing stressor, recent or ongoing stress, or 115, this is out of 200, had increased agitation. 51 losing touch with reality 42 paranoia 69 at isolation so they had that and then they had this increased trauma beforehand so they kind of had like the kind of had like the kind of like

kind of like this like really I just want to curse horrible childhood a lot of them and then they had this kind of like acute ongoing stressor and it seemed like for a lot of them this was like a suicidal event and that was kind of a shift in my mind on honestly, when I read this book. So I'm glad I did this episode after I read the book, but then before I read the book, because I probably would have said, probably would have focused in on a couple of cases that seemed like psychopathy or like, you know, focused on other things that weren't reality-based, data-based.

It seemed like this was kind of like a last-stand suicidal event that is more common in America because largely they have access to guns and they have this media that has taught them over the course of their lives. This is a pathway some people can go on. And I want to emphasize that you guys talk a lot about how the media should talk about this or shouldn't talk about this. And I'm not using any of their names in particular because of the way you guys talk about this. And this was actually, I think, really helpful. And I think, I don't know if we should, you know, like you guys talk about, like, should Facebook or Google just censor and not anything with their name on it doesn't get published, right?

The problem with that is people go to Rumble, people go to these other alternative media sources to watch this. So I think it's more of like everyone needs to come to this like group cohesive agreement as a society that we're going to talk about these things in a certain way to not create more and more of these things, right? Yeah, I think so there's two things I want to pick up on what you've just said, which are really important. So the first is this overlap between suicide and homicide. And if you think about mass shootings as suicides, it changes the way you approach prevention of them, both in terms of how you reach out to people, connect with services, and deal with the underlying grief and the underlying grievance that might be motivating that particular act. So you're absolutely right, that the mass shootings are intended to be a final act. And if we think of them that

way, it kind of recalibrates the way we think about deterrents, particularly, right? So putting an armed guard on the door of a school might not be a deterrent if your goal is to die. Because in some ways, that might actually be more of an incentive to go and attack that particular location. Now, secondly, as you mentioned before, you've got this media connection. to this. And that also folds into what you just talked about with the suicide piece, which is we have learned through copycat suicides that we need to be very careful about how we talk about suicide in the media space and in our world. To the extent now where usually there will be in a media story about suicide, a connection to the National Suicide Prevention Hotline. There will not be a

focus on the means and the methods of the suicide. There'll be much more talk about support for the family and the way in which the community is grieving this particular suicide. If you apply those same principles to how we would talk about mass shootings in the media, there's also a lot of traction there for trying to break that cycle of the routine of mass shootings, which is that People look at the media cycle and think, well, this is a way to become an overnight celebrity. This is something that just people do in our society. We can flip that script. And so there is two components to what you're talking about.

And then that last piece, of course, is social media is we ourselves as consumers of that media and as users of those platforms, whether it's Facebook or Twitter or even the more obscure sites that are out there, we have to kind of do that gut check as well. And so like, what am I liking? What am I sharing? What am I promoting here on this platform? Am I actually contributing to the problem? Because my sort of like ill-informed opinion is now out there in the public space or because I accidentally shared a site that is perhaps part of the problem and not part of the solution. And so that goes back to that point before about there were things we can do as individuals to stop mass shootings. And sometimes it might just be, don't retweet that because that might be part of the

problem. Or I would even say, like, if you hate someone's tweet, like if I hate someone's tweet, I don't comment because I know that will increase the algorithm. You know, it's like very counterintuitive. Like, you don't like that TikTok video. Okay, don't post a comment. Keep scrolling, scroll as fast as you can, because then you won't be bombarded by that. You won't end up on that side of TikTok, right? You're starving them of the oxygen of publicity, right? That's what you're doing with that. So, yeah, I think that's a great way to think about it.

There is a desire to be famous, which I think is uniquely American. We have a fame culture. We have this kind of archetypal fascination with the famous. You think about, like, who do people give attention to? it's like not really the heroes of our society right i was thinking about like how many heroes are there in these mass shootings and how do we draw our collective attention to that i know that it's like there's so many podcasts on like mash you know like this kind of idea of like understanding the murderer understanding you know this like serial killer and like there's this like almost like

it's almost like pornography it's like so addicting, you know? It's like the dopamine surges you get from learning about this stuff. How do we move that to these heroes? There are heroes. There are heroes who stop mass shootings, you know, who prevent these things from happening at all. Like, how do we draw attention to those people? Yeah. I think it's, it's so important to think about this because, you know, we said mass shootings are suicides, but they're suicides meant to make headlines, essentially, right? So they're suicides meant to advertise their grievance to the world so that after they die, that their name and their image will live on and people will know who they are. And the reason they think that that's

going to happen is because it does happen, right? And we've watched it happen and they've seen it happened so many times that they want their name to be on that list of those people that we know, you know, right? And so A, we have to stop putting people on that list as people, we know, right? Like, it needs to, we need to that idea of not sharing names and not sharing images is to break that script. This is not a way that you get known in infamy, right? But at the same time, this idea of who can we celebrate then, I think is really important. Like, who are the people who should be making national headlines, whose faces we should see? And whether that's the victims, who have had remarkable lives, whether that is the teachers or in one case we studied it,

a janitor who talked a school shooter down and stopped a school shooting, right, whether that is the HR professional who caught it before it happened. I think there are these stories. We did try to put them in the book as much as we could to really celebrate some of the lives of some of the victims and some of the heroes, but these are not names that we know and these are not stories that we know, I think, and that's a really important piece of this, is who are we celebrating and who are we remembering. Yeah, so it's almost like if the, you know, there's a saying, we worship that which we fear. So if we have this incredible fear towards these events and like 50% of high school students

are worried about a shooting on the campus, I think our brains just naturally have evolved to want to know and be curious about that which we fear, right? It's like the ape that sits there and watches the snake, you know? there was one other kind of just big meta thought that I had in reading this, which was like, overall homicide in the U.S. has gone down, yet mass shootings have gone up, which is an interesting sort of like, like it's hard. We don't think in statistics. Largely most people don't.

I think my audience probably does more because I talk a lot about statistics. But I don't think in my head, oh, homicides have gone down overall in the U.S., like in the last, 40 years. Like 4.5 per 100,000, like in the big picture is like, I mean, it's not as good as Europe, but it's pretty small, right? Like in the middle ages, it was probably around 100. And 10,000 years ago, there's some research that shows like 50% of men may be killed by other men. And if we look at like ape communities, I was watching this documentary Jane, which, if you haven't seen that guys, watch Jane. Have you seen that? I'm familiar with it.

Yeah, yeah, yeah. One of the best documentaries I've seen. It categorizes Jane, an early woman who went and lived with apes, which was amazing because females weren't doing that kind of stuff. She, like, had the gumption to do it. It tells her story. But at one point, the tribe, the group of apes that she had watched for years and years and years splits into two tribes.

And then, like, a time period later, one group completely annihilated. and killed the other group. And she had this fantasy of this, like, animal utopia, where in reality, like, this is like you had one group that, one clan that just literally murdered the other clan. So I think in the large trajectory of humanity, like we are living in a very unique time. Like, I would not prefer to live in the Middle Ages right now

if I was a man or 10,000 years ago, much less. How do you, like, rectify the time scale and, like, the overall homicides declining with the rise of this kind of like homicidal suicidal event that we had become captivated with. Yeah, this was actually a question that we saw as a puzzle, actually, a puzzle to be solved, perhaps, when we approached the research originally. There was ways you can kind of get at that puzzle. So on the one hand, you can compare the United States to other countries where you, you

can see the ebbs and flows of homicide over time and see what makes the United States different from those countries. And that's one of the things we try to do in that chapter in the book about America. And then the other thing you can do is you can think, okay, if there are some things that mass shooters tend to have in common, so if it is early childhood trauma, if it's the fact that they reach an identifiable crisis in their lives, if it's the way in which the shooting has been scripted over time, and if it's access to firearms, you then have ask yourself, okay, which of those has changed in recent years? And you could make a case to say, well, there's kind of always been early childhood trauma and there's kind of always been

stresses in life that can maybe bring you to some sort of breaking points. Now, perhaps they've been exacerbated by certain things in society. But some things that have absolutely 100% changed that we know are consumption and access to media and social media. So we know that that has had a role in so many different aspects of our society. So we can see the polarized debates that play out on social media, the way in which social media can anger us, can incite us to action. We saw that with an insurrection on the capital this year. We've seen that with other things in the world where people have been mobilized to action because of groups that they've become affiliated with on the internet. So I think that's a contributing factor.

And then there is access to firearms. We have greater access to firearms today than we have in a long time. You know, we had record gun cells last year, for instance. So we know that that proximity to a weapon is important. Oh, you can't buy a gun. There are shelves that are empty. It's like hard to get bullets. Bullets are like five times the expense of what they were before. It is, I mean, the sales went through the roof, right? In the last few years. And but what for us, one of the ones, which was interesting with this is a lot of people who are buying those firearms are first time gun owners. They're not necessarily competent without firearm. That feeds into where that gun's being stored. One of the things that we found in our data was for school shooters,

eight out of ten school shooters are getting their firearms from their family members. They're getting it from their parents or they're getting it from their grandparents. How are they getting those guns? They're just taking them. They're not locked up in a way that would protect the kids. There it is. That's a very simple law. Very simple.

It's very simple move. You can either do it as a law. It could be a policy or it's just something we can all start doing tomorrow. We can make a pledge right here on the podcast and say, if I'm a firearm owner, I'm going to store it safely. And so what is that statistic again? 80%. 80% of school shooters. So if you're a mental health professional and you're listening to this, when you ask the question, do you have guns at home, you should inevitably ask, are they locked up? Are you the only one that has access to them? Like who has access to them? The guns should not just be laying around. You know, I mean, this is like, this is this is something that we can do absolutely that and that and so to answer that bigger question of like what's changed i think in some ways like the way in which we access firearms has changed over the years like

they're more readily accessible and they're perhaps not being stored as safely the more people who have them the less likely it is that they're being stored safely and then i think as well you've got that kind of media and social media cycle that's feeding into people's anxieties it's feeding into people's anger and it's perhaps mobilizing people to action. And so that's, that's a change. I want to, I want to dispel one of the myths as well that you talk about. It's not, it's not video games. Oh, no. That's interesting to me. So, so understand this. Video games have changed. They're more violent than ever. Media like TV shows more violent than ever. You know, it doesn't seem to be that. No. The one thing that I would just add about this sort of bigger picture thing is,

While we've seen homicide rates drop, we've seen deaths of despair increasing, right? So we've seen things like suicide. Suicide has increased. Yes. All of those things are increasing. Especially for the adolescents. Yep. Yes.

And so we think mass shooting actually better fits at that death of despair category than in the homicide category if you look at the trajectories over time. And right, we're not seeing that media, violent video games. We looked at it specifically when violent video games were getting a lot of attention and conversation in their connection. We went through and we really coded exactly what each perpetrator had in their background and it just wasn't a factor. Interesting. I think about there's other myths that you guys dispelled for me, one of which is like the angry white male myth. It's like I, if you were to ask me before reading this book, how many of the perpetrators are white, I probably would have said maybe like 80, 90 percent. it turns out to be like 50, which is lower than the national average.

So, well, but then I looked and there was like this one New York Times article that was like, yeah, every person that we've talked about on here is white. And they even comment about themselves and that sort of narrative that kind of gets into our mind, you know? So it doesn't seem to be, I don't know, to me it doesn't seem to be a racial issue per se. because then you have you have a lot of countries like Hispanic countries which are very violent, high homicide rate,

but then there's less Hispanic shooters than there are other nationalities. So it's not a, it's like that's interesting to me too, this dichotomy of like, okay, they're in other countries like the homicide rate can be quite a bit more than the US.

They come to the US and there's actually less than the national average of mass shooters. There's a lot of myth. there's a lot of myth about what motivates people to, like you said, violent video games and things. I mean, violent video games were the driving factor behind mass shootings. You'd have mass shootings every day in Japan, and we don't. So, so.

Right? Yeah. Where they paid a lot of money for it. There's an entire industry around video games, and obviously that's not the case. And as you mentioned before with race, I think that is one of the big myths around this, is that all mass shooters are And of course, it's how you define a mass shooter. It's how you slice that data. But a lot of it, I think, is also part of the biases that we see of how people approach the data,

is that sometimes people go into it expecting to see the things and they can kind of slice it the way that they need to slice it. We do see, for instance, like school shooters, for instance, do tend to be white males more often than not. But when you start to include workplace shooters into the equation, those statistics, change very, very quickly. And so a lot of it is driven by age. A lot of it's driven by location. These are perhaps more predictive than something like race. And yeah, that was one of the things that, again, you go into the data, you see what it shows you, and that can dispel a lot of the myths around these crimes. And that's one of the goals of the book, is to try and arm everybody with the information that they need to make informed decisions for policy and for practice and to hopefully

try and put to rest some of these myths so they don't get peddled out the next time we see a mass shooting because that's the other thing that we always see the talking heads show up on on the news media and they're all talking about violin video games and and you think how is this still a thing it's but but it is and that's just the world we live in jillian any comments you have on this And obviously you guys in the book detail the race thing a lot more. You add a lot of other things that we could go into. And are there any other myths that jump to your mind? Well, I think one thing we noticed, like James said, that school shooters tend to be white males.

And I think a lot of that is because Columbine became sort of the blueprint for what a school shooting is. And so most school shooting perpetrators study Columbine. They read all of the things they left behind and the basement tapes and the documentaries. And there's so much mythology and information around Columbine that other young white men feeling vulnerable and isolated and suicidal and hopeless find themselves in these Columbine shooters. And so you see this kind of profile emerge there. And the same thing is true actually for university shooters. The vast majority of them are not whites. and it's actually majority Asian.

And if you think about that Virginia Tech shooting, that really was the one that put university shootings on the map. And so other people that see themselves in that shooting. And so you see the way the media kind of perpetrates or sort of perpetuates that cycle. But then workplace shooters, it's about 50-50, and black shooters are overrepresented amongst workplace shootings. And these tend to be sort of blue-collar workplaces in the south. And so it's nuanced, right?

I think that's the biggest thing. You can't just say it's all white males. There is this nuance when you look deeper into the data. Yeah. And you, of course, told this horrific story of, like, true racism that preceded one shooting in particular. How many of the African-American shooters, did you have evidence of true, like, racism, like, overt racism? Like, the example in the book was someone put like a new silver. his locker or something like that, which I would consider that's like an egregious racist act, right?

Yeah, it's interesting because there's two ways of seeing it. On the one hand, you have shooters whose crime is motivated by racism. So we have a chapter in the book on hate, for instance, where they tend to be white perpetrators. It's white supremacy that's driving a lot of that. And then they are targeted shootings in places like churches and in community, sort of censors, which are very much hate-driven. Then you have the perpetrators who themselves have experienced racism, and that that may be a contributing factor to the crisis in life that they're going through, which then motivates them to take revenge for that reason. And that did seem to be more common in the workplace. And partly because I think the workplace is kind of a

microcosm of unmet goals. And it is representative of those frustrations and strains that we feel, which we may interpret through that sort of principal modality of race, where we think, am I not getting the promotion, or am I not getting the respect that I'm due, or am I not getting the opportunities that I feel like I deserve because of racism in the workplace? And so it's both real and perceived. But that, turn can drive people to take revenge on that workplace. And so we did have some examples, as you mentioned, where that seemed to be a contributing factor. I don't know if it was the only factor. I think there's a lot going on in people's lives that get them to that point of

perpetrating a mass shooting. But it certainly was there and present in some of those cases. Yeah. One thing you talk about is like individualism. And I think that when I read it as as a psychiatrist, I think of like healthy individualism and what I would consider like unhealthy individualism. So healthy individualism I would define as like high internal motivation. So high conscientiousness, maybe high achievements driving, like both of you. I would put you both on that scale. Highly organized, right? Which you can't do this type of stuff without having that. Or I assume that both of you are high conscientiousness. Looking at your CVs, high achievements driving. there's no way you're not. And then I would also put it as like internal locus of control.

So like although it's beneficial to understand like, okay, we're product of our genes, our environment, it seems like mental health-wise it's best if someone has like a higher internal locus of control, a higher ability to think that they can actually act. Like I wouldn't want anyone to leave this talk thinking like, I am helpless. I'm hopeless. These things are just going to continue. there's nothing I can do about it, right? So high internal locus of control, I would say, is healthy. And then they found in a lot of studies a higher belief in free will or this ability to move forward to affect change.

That's linked to all sorts of positive mental health outcomes. And in contrast, I would say there's that, like, that toxic part of maybe, like, individualism that you kind of describe of isolation of grandiosity. I did this all myself. No gratitude, right? know a lack of kind of abstract thinking, more concrete thinking. Do you guys differentiate these two things? Because in the book, it sounds like you kind of lump, or maybe I'm defining things differently.

I'm not defining it in a colloquial term of like individualism, like in the way that the research presents it the way that you guys think about it. I don't know. Do you have any thoughts on that? Yeah, I would say the way that you just described individuals. And I'm not quite sure I would use the word. individualism for that. But it actually, it just made me think I was like, locus of control is a perfect concept that I kind of wish we had put in the book now, because it's the idea that these individuals

truly do have this external locus of control, right? There's this, I think we talk about individualism just in terms of generally in America, this idea that if everybody works hard and you do what you're supposed to do, you should be able to make it. Right. And so just more of the sort of societal belief in that, rather than the individual attributes. But these individuals, they don't make it, right? They're not making it. It's not going how they wanted it to. And then the response is, whose fault is it?

Right. And they figure out who they want to point to and they pick someone who they blame for that. Right. And there's this intense anger. And then their mass shooting always targets the person or the group or the thing that they blame. That's their external, a locus of control for why they can't, why they're not being able. to do it, right? I was working at a college as a school psychiatrist there. And if you were to ask me,

out of all the people I've ever treated, who would be a mass shooter? I can pinpoint this one person. And he blamed everyone for everything bad that was happening. He was an attractive, six-foot something guy. I don't want to describe him too well. He couldn't get a girlfriend. He would get into arguments with teachers. He blamed his teachers. He blamed. Yeah, it's like everything was, but it was almost like a psychotic level of like there was no arguing with him. Like some people, you can, they kind of like have some doubt that it's other people are to blame. You know what I mean? It's like, but there's some people that like it's so concretely, rigidly, structured in their psyche as such a defense against their inadequacy and all of the sort of

underlying failures that they're feeling so intensely. And that's something that you kind of picked up, would you say, in your research? Or is that, you know, you're following my kind of like the concrete sort of like fixed rigidity versus like I can sort of put these thoughts on trial. I don't want to put words in your mouth. So disagree with me if you want. I think in some, I think in some cases, and they often tend to be quite high profile cases, actually, that what you have described is accurate. You know, there is this sense that everybody else is to blame, and therefore I'm motivated to kind of take action against that. And so I do think that rigid thinking is something that we saw in some of the cases. I don't know if I would say it was across the board, but I think that in

turn speaks to that there is diversity within the mass shooting population and that there are different trajectories that people take. It's why one of the frustrating things is people are looking for like the profile of the mass shooter, right? So it's like if you have these five things, we check them off and you say, okay, that's it. We know who we're dealing with. And what our research is saying is there's not really a profile, but there are pathways. And I do think that for individuals, as you've just described, we would see that in the data. There are examples of that, but there might be other contributing factors that are also feeding into it. I think that's right. I think I would say the thing that comes first more often is the shame, the hopelessness,

the isolation, the depression, and then the thing that seems to come second is the whose fault is, right? And whether that is because they're getting radicalized in online groups, whether that's finding a different perpetrator that they feel affiliation with, whether, you know, however that radicalization process. And then the thinking can become very, very rigid. But I think its roots are in that sort of shame, hopelessness crisis. I should be doing better than I am. Yeah, I think that's a, when I think about like why violent video games don't cause it, but why maybe some of these online communities where you have kind of this echo chamber of vitriol could potentially cause something like this.

As humans, we're uniquely pulled into ideas and frameworks of thinking and ways to make sense of things. And also camaraderie. Like if you are completely disenfranchised, I've had a number of patients who, I feel like isolation and being sort of alone, it's kind of a final common pathway of mental health. It's like as mental health worsens, people become more isolated. And then in the midst of that isolation, like, how can I find some community to connect with? And so you talk about, I don't know, how many actually you had links to off the top of my head,

but there was some number, it wasn't more than 50%, but there was some people, that had this kind of fringe online community that you found that they were linked to? Yeah, and it's a relatively new phenomenon, of course, because it trends with the development of the Internet and social media. And so we've got mass shooters in our database that go all the way back to 1966, but it's only in the last 20 years where we've seen this component of social media come into play. And of course, that correlates. I'm not saying it's causal, but it certainly correlates with a rise in mass shootings and a rise of mass shooters who have started to post on social media before they go ahead and perpetrate their crime. Not just posting everyday life, like we all do. We all have social media that we post to, but actually directly in reference to I'm contemplating becoming a school shooter or I am kind of tumbling down the rabbit hole and getting a.

involved in this world. And so this was a relatively new kind of development in recent years. I think it feeds into two things. One is people are searching for answers. When you are isolated and when you are struggling and in crisis and suicidal and some of the other things we've talked about today, you're looking for others who are like you and for models of behavior. and the internet is that readily available service to provide that. And then in turn, just like, you know, if you've got a headache, you Google it. And Google will tell you it's usually cancer because that's what it always does, right? It gives you the whole laundry list of all the nasty things that it could be.

And nine times out of ten, it's just a headache, right? That's all it is. But it could be all these one of the things. People are doing the same thing. They're Googling it. They're going online. and they're getting really bad advice when they go online. They're going into chat rooms with other people who expressing same views that they are,

whether they're racist ideologies or hateful ideas and other things. And it's not necessarily the ideology that gives meaning to the shooting, but it's something that they can connect to to think, I'm part of something bigger. And that might just be the straw that breaks the camel's back in some cases to mobilize them into action. Yeah. Yeah.

And I think with that, we have to be careful as a society to have, to look at groups and to not lump people in groups and kind of escalate the amount of disgust towards groups because that, that, you know, something Hitler did actually. You know, he like had this group of people

and over the course of time, he created a lot of propaganda to create disgust. towards this group. And so to some degree, like, there's not one group that we can look at from your data and we can pinpoint this person and say, that's the person we should hate. You know, you talk about the four Ds and how do we identify someone that needs help, right? That needs therapy.

That needs something other than the cold, you know, isolation, lonely reality that they're facing. We talk about disruptive behavior, distress behavior, disregulated behavior, dangerous behavior. That's kind of a screening tool. I think it's good. I'd like to kind of bring this to a close, but also kind of emphasize some of the key things that I think you guys have brought to this field. The screening, having resources for these people, having both people in the trenches, plus how do we get more resources to be in the trenches at earlier stages, kind of thinking through what we've talked about, what are some of the things that you would like to leave the audience with, an audience of largely mental health professionals, things that they could do? I think when we asked the five perpetrators we interviewed, is there anything or anyone that could have stopped you?

The answer was yes every time, right? And so I think we think about how complicated this is and how deep it is and how far it goes back. but I think what you said about the last step seems to be this just complete isolation. And we saw that again and again. And someone reaching out and genuinely asking how they're doing and connecting with them, it's like they're these balloons ready to pop and just somebody letting a little bit of air out of that balloon, which could be a mental health professional or a teacher or a neighbor or someone. But I think that to me is hopeful. Like, yes, most of that. these individuals do need intensive therapy over a long period of time and serious treatment. But at the same time, when you're close on this pathway to violence and you're getting to this

crisis point and you're really isolated and you're suicidal, we all have the power to reach out and connect with someone and ask questions and be unafraid to ask hard questions and be willing to actually just listen to someone and take it in, which is why I've been adamant about sort of crisis intervention skills, just being really important skills that we all have and are all using, especially as we're coming out of this pandemic, maybe, in sort of reentering spaces, that that becomes really key. It's going to be a rough, it's going to be a rough couple years. I just, I just foresee it. There's so many, so many people reaching out to me in so many different ways telling me,

like I had a primary care physician to see other day to say, like 70% of what I'm seeing is mental health. Yeah. And there's just a huge amount of isolation that's baked in to the pandemic, right? Yeah. So and fear. So, yeah, I really appreciate that answer and I appreciate your guys' guys' work here. I think it's refreshing, it's motivating. I hope it's meaningful for my audience to hear this to realize, like, I don't think mental health professionals think about this every day that they go to work.

and they really should. There's probably someone who's going to not do a mass shooting because of the work that you're doing. Right? Or like a teacher. Like if a teacher's listening to this, it's like you're seeing that super lonely kid and becoming friends with them. You may be that one person in their life, which it's hard to be that one person. I have some patients who it's like, these are sometimes difficult conversations to have, right? But it's important.

So yeah, thank you for that. James, anything that's jumping off the top of your head is like, really want people to know this, really want people to walk away from this? I mean, we've covered a lot of ground in the conversation and we're very grateful that you've given us the time and the space to be able to do this. And I think just for your listeners is we've really tried to be intentional with the book to not just tell the stories, but also translate those stories into actionable steps. And so we see the book as being a kind of blueprint for what can we all do, whether you are a mental health professional or whether you're a parent, whether you're a schoolteacher, whether you're a member of Congress, this stuff we can all be

doing. And so for me, really, it's just a case of not feeling hopeless with this. Because whenever we see a mass shooting on the news, it feels like, oh, no, not again, the standard kind of routine that then follows with this. And we have to break that cycle. And we hope that the book provides kind of inspiration to do so and a little bit of hope that it can be done. It can be done. And we can break that cycle. But it just takes, it takes all of us kind of being on the same page with how that that goes forward. But again, I'm just grateful for the conversation and thanks to your listeners for tuning in.

Yeah, so once again, the book is called The Violence Project. How to Stop a Mass Shooting Epidemic by Gillian Peterson, James Densley. And I would also say, check out their website, theviolenceproject.org. You can get their full database. If you are a researcher, if you're a PhD student, and you want to have a database that's already there that you can do research off of,

it's there. And it's really well done. I actually appreciate how organized it is, your high conscientiousness coming through there. It is, everything is hyperlinked to the actual articles. So if you have like a question of like, where do they get this data that this person has been through this horrific trauma? It's like, boom, right there. So I hope that my audience will appreciate that.

I really appreciate your guys' time today. And yeah, so yeah, any final thoughts before we sign off? No. Thanks so much for having us. Yeah, thank you. All right. Thank you, guys. All right.

Well, I hope that you enjoyed that episode. I know that it was just amazing to listen to them, to hear their stories, both in the book and in person. It's just surreal that I get the chance to be able to interview people like this. and, you know, go to theviolenceproject.org, check out their work there, go on Amazon or wherever you buy a book, and, you know, look up the violence project, how to stop a mass shooting epidemic. I will put this article up on my website, psychiatrypodcast.com. You can get it in the resource library. I have tons of tables which will, I think, kind of give you the hard data. so that you can digest and sort of see this problem for what it is.

I think there are things that we can do. I really do. I hope that this is a hopeful message. I think that you as mental health professionals may not fully realize the ripple of good that happens from seeing clients day by day. And a lot of the times we don't really know, but I bet you, I bet you that every single person who has lived a full life as a psychiatrist or a therapist seeing clients has prevented either a mass shooting or definitely suicides.

And so I think that if you can kind of see that meaning in your day-to-day work, the importance of the work that you do, I hope that you feel encouraged.