Random Violence: Can It Be Stopped?

Earlier this week, a milkman named Charles Carl Roberts IV walked into a schoolhouse in Amish Pennsylvania and shot 10 young girls, killing five of them. Roberts's wife was shocked by his behavior and told police she had no idea her husband was troubled until she discovered a suicide note that morning. Co-workers were equally stunned, although some told police they noticed Roberts had recently stopped chatting and joking, becoming quiet and sullen. Would anyone have been able been able to foresee Roberts's explosive behavior? NEWSWEEK's Julie Scelfo spoke with Dr. Jeffrey Lieberman, chairman of the department of psychiatry at Columbia University's College of Physicians and Surgeons, to find out. Excerpts:

NEWSWEEK: Is there any way to tell beforehand that someone is going to commit a violent act?

Jeffrey Lieberman: Usually with violent crime, there's a certain motive or rationale—crimes of passion, crimes of envy or revenge—related to some set of circumstances that are understandable. But when crimes are committed by people like Andrea Yates [who drowned her children] or Colin Ferguson who killed people randomly on the Long Island Rail Road in New York, it's done without any discernable predictability. That's because what compels people to do these things are internal aberrations in mental states—delusions, hallucinations, gross disturbances in mood regulation. And these are not fathomable to external observers, which is why it's so alarming and so unforeseeable.

So family members can only tell there's a serious problem after something happens?

It's hard to recognize mental illness when it's mild. People who suffer from mental illness very often don't think they have mental illness. They can't distinguish internal reality from external reality. We in our society have a value system which places a premium on personal rights, individual expression, so we are a highly tolerant society which resists the idea of expecting people to conform to any narrowly defined range of behavioral conventions, much less evaluate them if there is a slight aberration. The way our values are constructed and the way our criminal-justice and hospital systems are constituted, somebody has to cross the line of acceptable and legal behavior before anything can be done.

Does that mean we should be changing the lines?

Certainly when it comes to people who have mental illness, we should do all we can to ensure that they're treated and they stay in treatment. For people who are suspected of having mental illness, we should do all we can to help them get evaluated and provided with the best options for treatment before it gets too severe, before something bad happens and their condition becomes too severe or results in destructive or adverse consequences … [Those who commit violent acts are] mainly people who are not just mentally ill but untreated, have active and extreme symptoms, and their symptoms are not just any symptoms but of a nature that are compelling them to commit violent acts such as hearing voices saying "kill that person" or "destroy that individual." Or they may have delusions that other people are the devil and they need to protect themselves.

Could somebody commit an act like this if they are not mentally ill?

Here we get into an analysis of human behavior. [It's possible that in] somebody who is a pillar of society—looks like they are leading a normal, productive life, enjoys the respect of peers—there's something's going on in [their inner life]. There's a [Henry David] Thoreau quote about people leading quiet, desperate lives. There's a capacity for compartmentalization that exists in human behavior, human psychology. People can carry with them very troubling conflicts, memories, that are in and of themselves incredibly powerful, but they are able to contain it. And it doesn't influence their behavior generally such that there are any outward indications of mental illness like bizarre behavior [or] lack of attention to normal bodily grooming, just for example. Some people have very deep-seated or powerful conflicts or traumas that are compartmentalized. In this particular case, one would have to look at the shooter's history to try to understand what could have inspired this kind of behavior. Random, horrific acts like this just don't appear spontaneously without any underlying cause.

What are the outward signs of mental illness that people should know about?

There are pretty consistent sets of signs and behaviors that signal something may be going on associated with mental illness. One common one is sleep disturbance, erratic sleep. One is change in appetite or change in weight. Third is change in their level of function, meaning they were a good student, competent in job performance, have a certain level of success in social life, engage in various forms of recreational activities and there's some apparently abrupt change in that. This is a very common sign. And very grossly, if there are abnormalities in someone's behavior—they become severely moody, act different, show preoccupation or interests in an overinvolved, overvalued or obsessive way in certain things. There are also extreme forms where someone is outwardly behaving in a bizarre fashion. Another factor can be substance abuse.

What do you do if you see a loved one suffering and you're not sure if they have a problem?

You attempt to approach them and try to find out more about what's affecting or causing the behavior you're worried about and try to elicit as much information as you can. Absent that, an approach is to speak to other family members to see if your observation is consistent with theirs. If there is a consensus or agreement that this person may be having problems, try to encourage them to seek evaluation and possible treatment. If there's any uncertainty to how to go about doing that or if the person is resistant to doing that, then I would speak to your medical professional, your primary-care doctor, your internist, and seek their advice about how to get that person evaluated. If in that process you think they may be inclined to hurt themselves or they go out and purchase a weapon or talk about killing a boss who has disrespected them or demoted them, then I would consider going to the police. [B]e on the side of being overcautious—meaning overly involved—rather than pass it off as a mood swing or transient change. It's better to be safe and wrong than to dismiss it and have some terrible irreversible consequence occur. Whether you're concerned about a neighbor, family member, colleague or friend, the principle is yes, you need to be your brother's keeper.