When a mass shooting happens, the conversation inevitably shifts to the mental health of the person behind the gun.
How could the mental health system have intervened before tragedy struck? What signs were missed? How was someone so troubled able to get a gun? But experts say stopping mass shootings will take a lot more than a couple of tweaks to the mental health system.
ABC15 spoke to experts in Arizona mental health treatment and law for their perspective on the mental health system’s role in curbing this type of violence.
“I think that a lot of these shootings are perpetrated by people that have mental health conditions,” said mental health attorney Josh Mozell. He represents providers and families who are fighting to get help for loved ones.
Mozell said many of the people who commit these acts don’t have a clinical diagnosis, which is one of the requirements for gun rights to be restricted. And if someone is not willing to voluntarily submit to an evaluation, he said the process is incredibly difficult to get through.
“A large part of my job is dealing with families who have gone to start that process and have failed with their kids concerning behavior seven times, 10 times before they get to me,” he said.
For someone 18 or older, there is a three-step process for involuntary evaluation.
Arizona law allows “any responsible individual” to begin the process by filing an application for court-ordered evaluation for a person that, because of an alleged mental disorder, is a “danger to self or to others” or is a “person with a persistent or acute disability and is who unwilling or unable to undergo voluntary evaluation.”
“That agency completes a screening. If they believe the person needs to be picked up, they issue a pickup order that person is brought in,” Mozell said.
While getting that accomplished sounds simple, Mozell said, ”there's a bunch of steps that have to be met, there's a lot of pressures outside of whether or not a person clinically meets the standard.”
Meeting the standard is important because if the concerning behavior doesn’t rise to the required level, the mental health system is no longer required to be involved.
“They're released back into the community... as if that never happened,” Mozell said. “That's what happens most of the time, for people going through that process, is that they don't make it to the judge.”
But if a person does meet the standard, they are referred to one of three behavioral health hospitals run by Valleywise Health.
“They get seen by two psychiatrists and a social worker,” said Dr. Carol Olson, who is a medical doctor that specializes in forensic psychiatry. She is Chair of Psychiatry for Valleywise Health System which does all evaluations for involuntary commitment in Maricopa County.
“About a week later, the person has a court hearing before a judge. At that time, there have to be two witnesses show up in court, to this person making these violent statements, and having signs of a mental illness,” she said.
If two witnesses don’t show up, the case must be dismissed, which she says happens often.
"They're scared of the person, and they maybe don't testify very strongly because they're scared the person is going to blame them for testifying in court against them,” she said.
If everyone does show and the judge decides in favor of court-ordered treatment, then — and only then — can a person be legally banned from purchasing a gun and placed on a prohibited possessor list.
Still, Dr. Olson said the mental health system is not capable of being a failsafe for violence in general and mass shootings in particular.
“Even people who, say, are paranoid and angry, and irritable. Most of those people don't go on to be violent. So it's, it's just difficult to make those predictions,” she said.
But she does think improvements can be made like raising the age of when guns can be legally accessed.
“There is science behind the fact that people's brains don't fully develop until they're in their early to mid-20s. And that many of these incidents seem to happen with people who are highly impulsive with poor judgment, and not really able--not having very good coping skills,” she said.
She said red flag laws are another potential improvement.
“They don't require that a mental illness be identified. They just require that there be evidence of the person being a potential violent person due to their statements or behavior,” she said.
Mozell said he is pessimistic about finding a solution within the current system.
“There's no panacea. If we really wanted to solve the problem, we back up look at the state of our mental health in our country and try to start providing interventions earlier on.”
Because he said with a country with nearly 400 million guns and a second amendment that allows them, no one change in law is going to make it any easier to identify the next person ready to commit a mass shooting.
“How do we pick out the person who's gonna go and commit a mass shooting? It's a needle in a haystack,” he said.
Families looking for help can visit this website for mental health resources for loved ones.