Tom Guarriello, a former clinical psychologist, analyzes the Virginia Tech shooting through a psychiatric lens. He argues the shooter likely had paranoid schizophrenia, but stresses that violent crime among the seriously mentally ill is rare. The real problem: a system that can't reach clearly ill people who fall outside its boundaries, caught between gun rights and mental health protections.
Well, hi guys, it's Tom. I'm making a video this evening, just a very quick one, because I just saw— it's a little after 7 Eastern Time— and I just saw the material that the Virginia Tech shooter sent to NBC News, and I wanted to just make a quick comment about this material. First of all, you know, I was, I was trained as a clinical psychologist and worked for almost 6 years in institutions for the seriously mentally ill. I worked in state institutions in Ohio and Pennsylvania, in private psychiatric institutions in Ohio. And one of the things that happens when you train in an institution for the seriously mentally ill is that in spending hundreds and thousands of hours in the presence of people who are seriously mentally ill, you, um, you learn to recognize what the experience is of being in the presence of someone who is seriously mentally ill. Now, I am no longer a clinical psychologist. Uh, my license to practice psychology is in Pennsylvania is in an inactive state because I'm no longer a practicing clinician, although I'm still licensed in that sense. So please take what I'm saying as just the opinion of someone who has these experiences. But this young man who we just saw on the news talking about his intent and his experience of his life, appears to me to have been a very seriously mentally ill young man. And if I were to be asked to give an opinion as to a diagnostic, um, framework to put his statements into, I would say, just based on what I have seen and what I know about what he's done, I would say this is an individual who's suffering from paranoid schizophrenia. We have a very seriously mentally ill man here who has done things that seriously mentally ill people rarely do, which is to act upon the perceptions of the world and themselves that they have. The only reason I'm making this video is that it's very important for us to understand that people who are mentally ill do not typically act in the way that this young man acted. Um, it would be horrible if we began to, uh, believe that seriously mentally ill people are all a danger to others and to themselves. Now, I know that we're going to hear a lot about the laws in Virginia. Those laws are no different than the laws in other states. When I was working in Ohio in the very early days of, let's call it, the mental health enlightenment period, it doesn't always feel that way, people could be institutionalized for any reason. And I literally mean any reason. If a husband believed his wife had been unfaithful, I have seen women institutionalized for not an insignificant period of time because their husbands believed that because they were unfaithful, that they were mentally ill and therefore could be institutionalized. And judges agreed with that opinion and institutionalized women for those purposes. So, I mean, I, we have seen a lot of changes in the the mental health legal system over the past, now for me, almost 40 years that I've been involved in this system. Let me just say to you that those of us who are, who have been involved, and I'm not today involved in that system, were often as frustrated as we all feel right now about the inability of the system to respond in a caring, therapeutic manner to someone who was obviously mentally ill but who was outside the boundaries of the system to respond. And it's an awful— it's an awful feeling to be in that predicament and watch someone who you, in your bones, with every bit of your training and education and intuition, believed to be a dangerous person. When you watch someone like that, walk away because the system does not permit you to take action which will be beneficial to that person, not to mention to others. So, um, I just wanted to say this is one of those moments when we're really confronted with the clash of values that our American system presents to us, whether it be the Second Amendment right to bear arms, which we have tremendous differences about, whether it be the right to liberty and freedom that is protected by the mental health laws. All of these things are the result of enormous conflicts in our system, and we try to resolve them the best we can. And this horrible tragedy is an indication of what happens when our system falls short. So thanks, and I'll see you again soon. Bye.
