51˶

Tracing a Killer's Path to Mass Shooting

— Mental health system reform is one tool in a broader playbook against gun violence

MedpageToday
A photo of the Indianapolis FedEx shooter, Brandon Scott Hole.

Investigative reporters recently of the events that led to the April 2021 mass shooting at the FedEx facility in Indianapolis. The shooter killed eight people and injured five others before ending his own life.

I had the opportunity to personally review the shooter's records. Analyzing and deconstructing a killer's path to violence is fundamentally important in preventing future events. Unfortunately, in-depth analyses do not occur with sufficient frequency to produce a satisfactory level of prevention. Too little is known about the complex circumstances surrounding many of these incidents. Thanks to the work of these investigative reporters, a more complete picture has emerged.

The Case

We learned that the shooter suffered from mental health problems that started long before the attack -- like , including a student , who killed four and injured seven at Oxford High School earlier this week. This is consistent with that show a majority (approximately 60%) of mass violence perpetrators have a history of mental health issues. It is important to note that even when mental illness is present, prior research indicates that cannot reliably predict targeted violence or violence in general.

In grade school, the shooter was diagnosed with a variety of mental health disorders, including obsessive-compulsive disorder, disruptive behavior disorder, and others. He also struggled with aggression, disrespect of authority, and self-harm. Medication was prescribed, with limited effectiveness.

As he grew older, he became more violent. When he was 11 years old, he physically assaulted and stabbed his mother. He was arrested and later placed on probation. Subsequent treatment occurred sporadically.

During high school, there was little to no improvement. Like others who have committed public mass shootings, the perpetrator was overtly depressed, threatening suicide, and isolative. He also purchased a weapon and became fascinated with things related to the military. These two characteristics have proven to be important warning indicators for committing acts of mass violence.

The shooter's mother tried valiantly to get help for her son. When that didn't succeed, she turned to the authorities. She did what we ask the public to do: If you see something, say something. She saw something and she reported it to the authorities. She told them how he purchased a weapon, his suicidal ideation, and his history of mental health problems and violence. She did everything possible given the resources available to her and the surrounding circumstances.

After the mother reported her son, the police confiscated his weapon and took him to the hospital. But he was released after only 2 hours. No diagnosis. No medication. Seemingly no aftercare plan.

The failsafe in these circumstances is designed to be the red flag laws, but for a variety of reasons, to bring the shooter's case before a judge. Thus, a dangerous, evidently suicidal, and homicidal man was set free. During the next few months, he legally bought the weapons eventually used to kill eight innocent people.

Strengthening the System

This case highlights the within our systems and the helplessness that many families in similar circumstances face. While not all people who commit gun violence suffer from mental health issues and addressing systemic issues is far from the only thing that can prevent mass shootings, mental health system reforms serve as an important tool in the broader arsenal against gun violence.

In this case, the mother begged for help. Little help was offered, even though an FBI agent told the mother that her son "hit predicting a mass shooter," according to an interview with her local Fox station. Neither the mental health nor the legal system could effectively intervene.

Sheila Hole, the shooter's mother, is speaking out in hopes of making a change:

"I just want people to know, if there is something wrong, I wish I could tell them who to call... and I would try to help them...maybe I didn't do it for my son, but I will for you." She , "I cannot accept what he has done...Had I thought for one minute he was going to hurt innocent people...I would have had to hurt him."

Few people in her circumstances have been as open, particularly because for their son's actions.

Our legal and mental health systems are both ill-equipped to handle these types of situations. Strict inpatient commitment laws in many states make it very difficult for people to be held against their will. Even when an individual is involuntarily committed, the stay is not of sufficient length to prevent suicide, homicide, or both.

Our current system of laws and policies -- in terms of both access to guns and mental health care -- is insufficient and unable to prevent these tragedies. It must not be this difficult to get help. We must do better.

is an associate professor of social work and criminology at Chatham University in Pittsburgh.