Someone recently suggested to me that diagnosis is necessary because of violent individuals like James Holmes, perpetrator of the recent shooting in Aurora, CO. This person said, "We must be able to define abnormal behavior which monumentally affects the individual and poses a threat to society... [James Holmes] clearly is mentally ill and probably has an identifiable psychological disorder." This person is making the assumption that (1) James Holmes was not diagnosed and did not receive treatment prior to the shooting and (2) if only he had been diagnosed, he would have received treatment that (a) helped him and (b) would have prevented the shooting. The person is also conflating mental illness and violence. While I agree that it is part of the role of mental health counselors to address and prevent violence, I think we are treading on dangerous territory and promoting stigma when we are not careful to differentiate mental illness from violence. See my earlier post, America's Gun Problem is Not About Mental Illness.
James Holmes saw at least three mental health professionals before his crime. Unfortunately, the right steps were not taken to help this man or prevent his crimes. I do not know whether he was taking psychiatric medications, but there is also the issue of akathisia, a side effect of some psychiatric medications that has been linked to violence and suicide by a number of professionals, including psychiatrist Peter Breggin, author of (among other things) Medication madness: The role of psychiatric drugs in cases of violence, suicide and crime. James Holmes told a classmate four months in advance that he wanted to kill people. I do not know what, if any, label James Holmes received from the mental health professionals he saw, but for me his case is not a question of his diagnosis. My question is, how can we educate society so that people such as his classmate, who knew of Holmes' plans months in advance, know what to do with such information? And much more importantly, how could the mental health system have better engaged Holmes when he was at the door, finding ways to heal him so that he could feel at peace, for his own good and that of all the lives later lost in Aurora? I don't know the answer, but I do know that it does not lie in the DSM.