Mental health problems explain school killings

Autism spectrum disorders often underlie threatened mass killings

Young people who threaten with mass killings often have psychiatric disorders. They are also more likely to have an autism spectrum disorder than the population on average.

This was found in a research data consisting of a group of 77 13- to 18-year-old Finnish adolescents who had been treated in youth psychiatric clinics in 2007-2009. The data was used to analyse threatening behaviour that copycats the Kauhajoki and Jokela school shootings. In addition, those who expressed their threats online were compared to those who expressed them offline (by talking, shouting, phoning, by letter, in a school essay etc.).

”It was not surprising to me as an adolescent psychiatrist that there were more than average autism spectrum disorders in the research population. It was completely expected, but it has never been scientifically proven before, says Riittakerttu Kaltiala-Heino, Professor of Adolescent Psychiatry at the University of Tampere.

Kaltiala-Heino has co-authored two research articles based on the data together with Nina Lindberg, Eila Sailas and Atte Oksanen.

Isolation is a risk to adolescents

What is typical of adolescents who suffer from autism spectrum disorders (ASD) are difficulties in reciprocal social interaction and communication. ASD is particularly harmful in adolescence when peer relationships are crucial for development.

”If the way in which you express yourself is very atypical and odd, the adolescent is rebuffed and excluded from normal peer relations. If you cannot take the initiative and you understand others in the wrong way, there is a risk of isolation and you can become bitter and angry. You can start thinking about strange things, like suicide and death,” Kaltiala-Heino describes.

Depression can also trigger threats of mass killings and Kaltiala-Heino thinks that adolescent depression is a serious public health problem.

“Depression can involve living in a vacuum or avoiding social contacts if the adolescent is so depressed that s/he does not have the energy to make contact and join the others. The adolescent can make the interpretation that s/he is bad and unworthy. This can turn into violent thoughts against other people.”

Psychoses, which are severe mental health disorders, can also be found underlying threatening behaviour. They entail a difficulty of separating the real world from the inner world.

”It is not to the adolescent’s advantage to end up in prison”

Talking about violence has been thought to label people who suffer from mental health problems. Kaltiala-Heino says that as an adolescent psychiatrist she understands this critique. Most of the people who use psychiatric services are not violent but many psychiatric disorders nevertheless increase the risk of violence.

”It would be naive not to grasp that you must be able to recognize symptoms and thought patterns that are typical of the risk of violence.” Kaltiala-Heino compares the risk of violence with the risk of suicide.

”There are not many people willing to take to the streets to demand that we cannot talk about the risk of suicide anymore because it needlessly labels all patients. The risk of violent behaviour is a bit like the risk of suicide.”

Kaltiala-Heino makes the point that it is also to the patient’s advantage not to drift into acts of violence. ”It is not to the adolescent’s advantage that s/he gets to do an act of violence and then suffers the consequences by being locked up either in a care facility or a prison. We have the duty to try to prevent this. We have not always been successful, but we must keep trying.”

According to Kaltiala-Heino there should be better awareness in social and health care to estimate the risk of violent behaviour.

“Psychiatric health care is already quite well able to estimate the risk of suicidal behaviour, but we are much more helpless with the risk of violent behaviour.”

Text: Heikki Laurinolli
Photograph: Touko Hujanen
Translation: Laura Tohka

This story was originally published in Finnish in Aikalainen 2/2013