01 July 2009

Campus killings: how prepared is SA?

Last year’s ‘samurai’ murder in a Krugersdorp school was reminiscent of the campus murders Americans are all too familiar with.

Last year’s ‘samurai’ murder in a Krugersdorp school was reminiscent of the campus murders Americans are all too familiar with. Hardly a year goes by in the United States without such a tragedy, but still experts battle to identify potential campus killers in time. What can we learn from their mistakes?
Dr Michael Ewart-Smith writes in What's New Doc

When the next school or university shooting happens, no matter where in the world, we will know about it. The international news networks will interrupt TV programmes with the ‘breaking news’ and as the story develops, we will be better informed about it than many people at the actual scene of the crime.

Friends and family of those involved will be interviewed. Experts will be wheeled out to analyse and explain the grisly details. But we won’t get answers to our most obvious and pressing questions. How was this allowed to happen? Who was to blame? The perpetrator must have been ‘crazy’, so why didn’t the mental health system do something to prevent the deaths of these innocent young people?

Are campus mass murderers driven by mental illness?
In a sense a young person who randomly shoots fellow students then kills himself has to be abnormal. And psychological post mortems after the killings, massively dissected and analysed nowadays on the internet, invariably reveal that the shooters were known to have personality quirks and behavioural oddities not quite typical of their peer groups. But in only a few cases is there evidence of mental illness as it is currently defined by psychiatrists.

The recent college massacre in Finland where 10 people were shot and killed by 22-year old Matti Saari, is a case in point. Although some of Saari’s behaviour was worrying, it did not fall outside the boundaries of what society, rightly or wrongly, is prepared to tolerate.

He was actually questioned by police the previous day after complaints were received about a violent and threatening film of himself he posted on YouTube. But although he had been planning the next day’s massacre and suicide for many months, he easily persuaded the investigating officer that he was not a dangerous person, that he was well within a latter-day ‘normality spectrum’.

We will never know if a mental healthcare worker (even a psychiatrist) would have elicited any indication for involuntary intervention. Sadly, it’s doubtful. It’s not surprising that most of the debate around school shootings concentrates on gun ownership and the availability of guns.

A lot is also said about the apparent influence of violence in movies, television and computer games on young people – particularly perhaps on vulnerable people, which several of the shooters have turned out to be. Criminologists, psychologists and sociologists have created complex profiles of potential shooters, but unfortunately as with most such profiles, they have not yet proven to have reliable predictive value.

Two troubled shooters
But there were two shootings in the United States – in April 2007 at Virginia Tech and in February 2008 at the University of Illinois – in which the shooters undoubtedly suffered from psychiatric illness, and had actually been patients within the mental healthcare system. Yet they had legal access to firearms and eventually engaged in psychotic killing sprees before committing suicide.

On April 16 2007 a 23-year old student, Korean-born Cho Seung-Hui, went on a shooting spree at Virginia Tech that eventually claimed 33 innocent lives including his own, the largest number of deaths in such shootings so far. A further 17 people were injured.

On Valentine’s Day last year, Steven Kazmierczak (27) shot five students and himself in a lecture hall at Northern Illinois University. Sixteen others were wounded. Until the spring of 2007 Kazmierczak had been enrolled at the university as a postgraduate sociology student and was initially remembered as a very normal, successful student.

But information has since emerged of a history of psychiatric disorder, and although he had apparently been in at least partial remission for some time, in retrospect there were mood and behavioural changes before the shooting that could have acted as significant red flags if his psychiatric history had been known to those around him.

Surprisingly, there has been very limited discussion within the psychiatric world about these two incidents, although they raise extremely important issues including, for example, concern about healthcare legislation, the state of mental healthcare systems and, of course, the relationship between mental illness and dangerousness.

Dr Michael Ewart-Smith was formerly principal psychiatrist at Sterkfontein Hospital. He is chairman of the South African Society of Psychiatrists task team on psychiatric disability, and has a special interest in that field. He is an honorary clinical consultant in the department of psychiatry at the University of the Witwatersrand.

(This is an edited extract of an article first published in What’s New Doc, 2nd issue, March 2009. What’s New Doc is a publication for medical doctors, produced in association with Health24.)

Read more:
Cho Seung-Hui: a tragic case history
Campus killings: a timeline
Can SA prevent campus killings?


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