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A TRAINED EYE

Tragedy Can Be Averted

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By Patricia Dalton
Special to The Washington Post
Tuesday, August 19, 2008

It had all the hallmarks of a catastrophe in the making: a stash of guns and explosives; a map of Camp David marked with a presidential motorcade route; a list of home addresses for teachers at St. John's College High School, from which Collin McKenzie-Gude had just graduated.

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The 18-year-old former Junior ROTC member is now in jail on a $750,000 bond, facing charges of weapons violations, possession of explosives and attempted carjacking. Prosecutors say they do not yet know what, if anything, he planned to do with his arsenal. His lawyer says McKenzie-Gude had "none, zero" intention of harming anyone. We may never know whether a tragedy was averted by a tip called in to the police.

But that tip signals at least one person's worry that all was not okay in the McKenzie-Gude household, that a young man who was stockpiling arms and ammunition and exploding pipe bombs could be preparing to do damage. What might it have all led to?

It's a relief to be asking ourselves that question, instead of engaging in the soul-searching that so often follows a tragedy. After 32 students were slaughtered at Virginia Tech, five were shot dead at Northern Illinois University and three Montgomery County children were drowned in a bathtub, we all wondered what signs of impending violence were missed. What could we have done?

In each of those cases, many people looked to the mental health professions for the answer: By identifying and treating potential perpetrators, couldn't psychologists and psychiatrists prevent other senseless murders? But as anyone in the mental health field will tell you, our specialties are blunt instruments when it comes to forecasting behavior. Forensic psychologists remind us that predicting dangerousness is a complex undertaking. Actually preventing carnage is even harder, and there are limits that a free society with due process places on constraining individuals who have not committed a crime.

What's more, mental illness is not as strongly associated with violent behavior as is often assumed. Using data from their 1998 MacArthur Violence Risk Assessment Study, John Monahan, a professor of law and psychiatry at the University of Virginia, and Henry Steadman, president of a firm that focuses on mental health services, report that substance abusers are much more likely to commit violent crimes than the mentally ill. Although substance abuse and mental illness form a risky combination, research shows that as adherence to mental health treatment increases, violence decreases.

That said, there is an axiom that every graduate student in psychology can recite by heart: Past behavior is the best predictor of future behavior. A good illustration is personal honesty. A person caught embezzling money is likely to embezzle again. Given the opportunity, murderers can and do commit murder again. I've seen repetitive patterns play out among patients I have treated, including violent ones. I once saw a burly, agitated man with a history of violent behavior who was threatening to kill his estranged wife. He agreed to a voluntary psychiatric hospitalization, primarily because he was afraid of losing a long-term job he took pride in. I warned his wife while he was hospitalized that I believed he represented a danger to her. After he was released, she reconciled with him -- and he later stabbed her (though not lethally).

None of this would have helped in the case of McKenzie-Gude, who, from what we know so far, has no history of violent behavior. He is described in newspaper reports as a polite, cooperative student with no record of disciplinary problems. His one alleged act of violence -- an attempted carjacking, during which he is accused of knocking down a 78-year-old man -- occurred shortly before police searched his home.

Going Through the Motions

Seung-Hui Cho, the shooter at Virginia Tech, also had no history of violence. But he did have a record of mental illness. He frightened people, including his teachers. His behavior worried his roommates enough that they contacted school officials, who arranged a psychological evaluation for him. He was briefly hospitalized, and outpatient mental health treatment was recommended but not required. His parents were never informed. And, as is so often the case, he never followed through in getting help.

There is a big problem with mandated treatment: Experienced therapists have found that treatment is likely to have little effect unless the patient decides that he or she is in need of help. Some go through the motions but don't (or can't) face the true nature of their problem.

There are many, many people like Cho, whose bizarre behavior alarms people, but they never go on to commit murder or suicide. I can think of a paranoid schizophrenic father of two I once worked with who was convinced that his community was being poisoned by radioactive material; he wore a gas mask outside. His family admitted to being scared, but he never became violent.

Then there is Mark Castillo, the father held in connection with the drowning deaths of his three young children. According to newspaper accounts, Castillo, who denies he killed them, signaled intent to do harm in ways Cho did not. He had psychological problems serious enough to worry his ex-wife, who begged the court not to let him see their three children. He was not working, had been hospitalized for depression and suicidal threats, and refused medication and further treatment. Most important, Amy Castillo reported that her husband had told her, "The worst thing he could do to me would be to kill the children and not me."

But the case that truly confounded prediction was the shooter at Northern Illinois University, Stephen Kazmierczak, who, like Cho, killed himself. He was described by former professors as having been an exemplary student. His live-in girlfriend of two years said that he always treated her well. It was reported at the time of the shooting that Kazmierczak had sought treatment for depression and had gone off his medication. Those who knew him were stunned. My colleagues and I had the same reaction: How could this kind of person commit a crime of this magnitude?

We were right to ask that question. A detailed portrait of Kazmierczak in the August issue of Esquire magazine paints a much darker picture of a tormented young man who collected weapons, exploded homemade bombs and had made many suicide attempts. It was a history he had concealed from almost everyone he knew.

Reducing the Risks

There are steps both individuals and society can take to lessen the danger some people represent. Studies show that untreated or under-treated mood disorders account for an estimated 80 percent of suicides. People need to understand that there are solid data showing that a gun in the home is far more likely to be used for a suicide or to kill a family member than for shooting an intruder.

In the case of contentious divorce and custody situations like that of Mark Castillo, the safety and well-being of children -- not the rights of parents -- should be paramount. Supervised visitation that assures the children's protection should be ordered when there is any margin of doubt.

And we need to be aware, as Monahan points out, of the potential for violence in a small segment of our society: those who are male and young and have problems controlling their temper.

But most of all, we need to realize that when it comes to creating a safe society, more can be done by private citizens than by members of the mental health professions. The woman who called the police about McKenzie-Gude must have realized that. She had the courage to act on her conviction. People like her provide one clear answer to the "What could we have done?" question.

Critically important in preventing tragedies is to limit the availability of guns, the source of the power that turns murderous impulses into actual murder. McKenzie-Gude had amassed weaponry that could have turned any argument or simmering resentment into a lethal assault.

I do have hope regarding gun control. Here's why: Remember when it was common for people to smoke wherever they pleased, and to be indignant if their right to smoke were curtailed? Remember when people who had had too much to drink routinely drove cars? In both instances, it was public opinion that eventually drove changes in behavior and ordinances, not vice versa. I believe that the same tipping point can come with guns. The city of Richmond has lowered its murder rate after introducing a policy to prosecute even minor gun violations aggressively -- a policy both the National Rifle Association and the Brady Campaign to Prevent Gun Violence support.

We need to foil the plans of unpredictably violent people in every way we can. Preventing violence is a shared responsibility.

Patricia Dalton is a clinical psychologist in private practice in Washington. Comments:health@washpost.com.


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