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The role of masculinity and mental illness in rampage shootings
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As rampage shootings dominate media coverage and fuel the national debate over gun accessibility, mental illness has been broadly branded as the cause for these tragedies. Sociologists who study shootings say it's much more complicated. - photo by Chandra Johnson
Editor's Note: As the nation deals with its 355th mass shooting of 2015, this three-part series explores potential responses and solutions to this all-too-common public safety crisis, including the role of the media, mental illness and gun accessibility.

Prior to July 20, 2012, James Holmes may have seemed unlikely to carry out a rampage shooting.

An excellent student all the way through high school, Holmes was poised to follow in his fathers footsteps with a career as a scientist. Holmes later graduated with a degree in neuroscience from the University of California Riverside, where a chancellor once described him as the top of the top in academic performance and kind of quirky, just the way you expect smart people to be.

But in 2011, Holmes began to struggle.

Holmes performed badly on an oral exam while attending University of Colorados Ph.D. program perhaps an unsurprising setback for someone who had difficulty making conversation and was described by friends and teachers as quiet and shy.

He issued a letter withdrawing from the university just three days later and posted a rsum on Monster.com to try and find work as a lab technician arguably a big step down for someone who once mapped the neurons of zebra finches and studied hummingbird flight muscles as an undergraduate.

Holmes relationship with his on-again, off-again girlfriend was also on the rocks at the time. During the trial, Holmes ex-girlfriend Gargi Datta, whom prosecutors called Holmes first love, testified that she ended their relationship a few times before the shooting once on Valentines Day and again after Holmes confronted another man for talking to Datta on St. Patricks Day. Later that year, Holmes told Datta through instant messaging that he wanted to kill people, but was worried about getting caught.

Three years after Holmes shot more than 60 people, killing 12, in a Colorado movie theater in July 2012, 20 doctors confirmed he had schizophrenia.

The details of Holmes case illustrate a debate thats arisen from the prevalence of rampage shootings: Do gunmen plan and carry out shootings because of mental illness or is it a matter of retribution when they feel marginalized?

To Daniel King, Holmes defense attorney and chief trial deputy for the Colorado state public defenders office, theres no question that Holmes diagnosis of schizophrenia contributed directly to the Aurora shooting, for which he is now serving a life sentence.

A lot of times defendants are competent to stand trial and theyre not insane, but the truth is the crimes theyre committing are caused solely by mental illness, King said. All the doctors we had evaluate Mr. Holmes found him to be sane, but they said in open court that, but for his mental illness, this never would have taken place.

Yet some sociologists who study shootings contend that mental illness is only part of the underlying problem behind rampage shootings. A bigger question to be addressed, they say, is what it means to be a man in America today and how cultural ideas of manhood can lead some down a path of rejection, rage, mass murder and suicide.

There are so many people with mental illness that never commit violence, Stony Brook University researcher, criminologist and sociologist Rachel Kalish said. But many rampage shooters have been made to feel marginalized in some way and our culture makes violence seem like an appropriate way to assert masculinity.

Elliot Rodger, the 22-year-old who killed six people and injured 13 others in a mass shooting near the UC Santa Barbara campus in May, 2014, may have been a misogynist, some media outlets and Rodgers family contended, but ultimately mental illness was to blame.

But in looking closer at individual shootings and other acts of American terrorism, City University of New York sociologist Ralph Larkin says the common thread since Columbine is shattered expectations of manhood.

Theres a war going on about what it means to be a man and the criteria for being a male in American is very high, Larkin said. If you dont measure up, youre going to get bullied, which feeds this motivational syndrome of reasserting masculinity through violence.

Measuring up

To get to the possible causes of rampage killings, Larkin and Kalish both sought an answer to the central question of why these shooters are overwhelmingly male.

These incidents make people have a lot of feelings and what was most surprising to me as I researched it was the absolute absence of any discussion of gender, Kalish said. This is the missing piece of the puzzle.

Larkin says shooters are very often male for a reason they usually dont fulfill the expectations of manhood society promotes. Current ideals of masculinity are stereotypical: The consummate American man is invincibly strong, highly successful and is devoid of any feminine characteristics, including displays of emotion.

Masculinity is enacted publicly. The peer group becomes so important in letting us know if were doing it right or not, Kalish said. When (boys) become marginalized, the only way they see to recoup their masculinity is to prove themselves in some way publicly.

Moreover, the American man is expected to assert his masculinity through promiscuous sex, athletic prowess or the ability to provide a message boys are bombarded with through superhero and action movies, sports culture, music and possibly from their own parents expectations of how boys should be.

Violence and the threat of violence are necessary to maintain dominance over other males and females, Larkin wrote in a 2011 study. With the criteria for role performance so high, the probability of failure so great, and the punishment for failure so severe, the American male ego is fragile, protected by a wall of seeming invulnerability.

The need to assert dominance through violence is heightened for future gunmen when they're bullied for not fitting into accepted norms of masculinity. This was the case at Columbine High School, as Larkin argues in his 2007 book, Comprehending Columbine.

Larkin says another factor is male disenfranchisement, especially because of the disappearance of livelihoods that once supported traditional masculine roles like farming, family-owned businesses and more competitive pay for jobs that didnt require a college degree, like police work.

Working class, white males have suffered a tremendous amount of downward mobility in a country in which masculinity used to be identified as getting a job, getting a wife, children and settling down, Larkin said. But that is no longer possible for millions of American males who wouldve had a working class job that allowed them to support a family on in the past.

Seeking vengeance for what they see as their helpless station in life (a concept Kalish calls "aggrieved entitlement"), some men turn to violence and its not just shooters who fit into Larkins theory.

The perfect example is (Oklahoma City bomber) Timothy McVeigh, Larkin said.

After serving in the U.S. Army and rising to the rank of sergeant out of high school, McVeigh returned home to find few opportunities waiting for him.

He could only find work as a rent-a-cop, Larkin said. He was a good sharpshooter in the army and then he comes home and hes got a much lower social status.

Larkin says McVeigh became disillusioned and espoused the teachings of extremist hate groups who offered him a twisted answer to why he struggled in life: The government was dismantling an economy that once supported Americans and giving jobs to minorities. McVeighs accomplice, Terry Nichols, also blamed his lot in life on the government. As the son of a Michigan farmer, Nichols saw many family farms repossessed in the 1980s.

Its retribution sometimes against the government, bullies or sometimes women this notion that if you feel that you are ill-treated or emasculated, you can get back at these people by doing something that is powerful, that is hyper-masculine, Larkin said.

Although Larkin and Kalish both believe that failure to meet norms of masculinity contributes to some young men becoming rampage shooters, neither rules out the role of mental illness.

Both mental illness and this sense of aggrieved entitlement are operating in these cases, but to what extent each is a fact varies, Kalish said. A lot of this comes down to the way we conceptualize masculinity in general, but also how we look at men with mental illness.

Equal-opportunity disaster

Stanley Medical Research Institute associate director of research E. Fuller Torrey believes that the rise of rampage shootings traces back to the shrinking of mental health resources that began in the 1960s.

Torrey argues that many shooters are deeply disturbed and that their crimes could be prevented if the federal government would reprise its once-substantial role in providing mental health care and maintaining psychiatric hospitals.

That would be a tall order since the federal government ceded its responsibility and funding for mental health services to individual states during the Reagan administration in 1981 a move commonly referred to as deinstitutionalization.

(Deinstitutionalization) was an equal-opportunity disaster carried out equally among Republicans and Democrats, by people with the best of intentions, Torrey said. If we were smart we would have reversed course 30 years ago, but instead were looking at the consequences.

Ironically, mental health care in the U.S. has practically come full circle since the mid 19th century, when public efforts began to improve care for the mentally ill, who were then housed mostly in prisons. By 1880, there were more than 100 government-sponsored psychiatric hospitals in the U.S. and horror stories of their abominable living conditions abounded, especially in the wake of an 1887 expose penned by New York journalist Nellie Bly, which revealed patients living in freezing temperatures with minimal food in New York's Women's Lunatic Asylum.

By the mid-20th century, mental hospitals routinely conducted procedures considered barbaric today, including electroshock therapy, surgical sterilization and prefrontal lobotomies.

Both presidents John F. Kennedy and Jimmy Carter tried to reform mental health care using modern pharmaceuticals and community-based treatment centers that would allow mentally ill people to be treated without being institutionalized. But with President Ronald Reagans decision to shut down federally run hospitals, Torrey said more mentally ill people are left untreated and wind up homeless or in prison today.

In 1955, we had about 550,000 people in mental hospitals. Based on todays population, it would be well over one million, Torrey said. We have now about 35,000 people left in state mental hospitals, so thats a huge margin of people who arent getting treated and, surprise, surprise, some of them dont react well and commit violent acts.

A 1984 study of the homeless population of Ohio found that 30 percent of homeless people there qualified as mentally ill, a statistic that led the Toledo Blade to question the costs of deinstitutionalization. The study was published just three years after Reagan signed off on deinstitutionalization.

In 2009, the Substance Abuse and Mental Health Services Administration estimated that 20-25 percent of the U.S. homeless population suffers from severe or debilitating mental illness in large part, Torrey argues, because they have less access to care.

A 2010 study from the Treatment Advocacy Center, a non-profit mental health care group Torrey founded in 1998, revealed that the number of mentally ill people in prisons was triple the number of those in remaining privately funded or state-run hospitals. Without adequate access to treatment, Torrey says the fraction of mentally ill people who become violent have a heightened chance of acting on the urge to kill. He includes rampage gunmen in that category.

The evidence is overwhelming to me when you look at homelessness to homicides to prison population to mass shootings that whatever were doing hasnt worked, Torrey said "People like James Holmes or (Tucson gunman) Jared Loughner are clearly people who are mentally ill and didnt get the treatment they needed.

To truly prevent rampage shootings, solving problems like access to mental health care, gun control or media fixation on gunmen may only be symptoms of a bigger problem that comes down to questions of basic human decency, Kalish said.

If there were a simple solution, it wouldve been implemented years ago, but a big step would be to take a hard look at how we raise our children and how we treat people, Kalish said. As a culture and as a humanity, we need to look at how we raise people to interact with each other.