Murder-Suicide: Can it be prevented?

It’s happened again; this time in at Virginia Tech. This headline is far worse than most, but the theme is the same: innocent people killed by gunfire from a murderer who saves at least one bullet for himself.

Does anyone see a pattern?

We who study self-destruction for a living know that homicide is often followed by suicide. The fact that innocents are killed before a final act of self-destruction only adds to the public’s sense of anger, confusion and helplessness. Any hope to understand the motivation for these “senseless murders” dies with the suicide victim and we are left wondering, why?

Yet we know a few things about murder-suicide. We know that no homicide or suicide is without purpose or meaning. We know that murder-suicide, while rare, always makes sense to the perpetrator and therefore can be explained with a thorough historical examination of the facts. A brief review of the basics may be helpful.

First, when suicide follows murder it is important to understand that only the utterly hopeless kill themselves. A murder-suicide perpetrator’s last day on earth does not begin with the question, “After I kill these people, how will I escape?” It begins with “This is my last day on earth.” No escape is necessary because death is the ultimate escape.

Second, to carry out a murder-suicide the perpetrator must answer several questions: why, who, with what, where and when. The motive (unendurable psychological pain and perceived injustice by others), means (firearm) and opportunity (where and when to find victims) are at once understandable and knowable.

Third, the vast majority of suicidal people are suffering from serious untreated psychiatric illnesses, illnesses that can be reasonably detected, diagnosed and successfully treated. According to the National Institute of Mental Health (www.nimh.org) more than 90% of those who die by suicide (whether homicidal or not) are suffering from a mental illness.

If America had a viable mental health treatment system, as many as 16,000 thousands lives per year could be saved from untreated mood and substance abuse disorders alone. Perhaps hundreds of murder victims might be saved as well. In the Virginia massacre it is too soon to know the details of the shooter’s life but the script, I fear, may prove all too familiar.

Fourth, the decision to die by suicide is typically made well before the shooting begins. Since you cannot arrest, humiliate or punish a dead man, these homicidal acts are not indiscriminate, impulsive or random, but planned and premeditated. In most cases these deadly acts are preceded by observable warning signs that a tragedy is about to unfold.

Fifth, suicide warning signs (statements of a desire to die, threats to end one’s life, giving away prized possessions and such) are at once observable and detectable and can be responded to before the shooting begins. The most common dynamic for murder-suicide is a woman leaving a man who is unwilling to lose her. Suicide warning signs and death threats are a common communication in these conflicted relationships.

Sadly, there is no mystery in Virginia. There was no mystery at the University of Washington, in Amish country or in Littleton, Colorado. There will be no mystery next week, next month or the next time we learn that a murderous shooter was suicidal.

The facts are in, the causes familiar. The odds are good that this shooter, like the others, was not receiving mental health care, but needed it. If we are little comforted by what we will learn about this young man, we should remember that the families of the victims (and I mean all who died) will suffer for their rest of their lives.

The only salient question is: Are these tragedies preventable?

According to the experts, the answer is yes. To quote our former Surgeon General, Dr. David Satcher, “Suicide is our most preventable form of death.” A successful US Air Force suicide prevention program not only lowered rates of suicide substantially but also significantly reduced other forms of violence, including the very kind of intimate other violence that often leads to murder-suicide.

To prevent murder-suicide we must first raise our collective awareness and develop a sense of shared responsibility to understand the nature of the suicidal and homicidal mind and how such people can be helped before they launch their deadly agenda.

Campus shootings won’t be stopped by banning guns because guns are already banned on university campuses. Campus shootings won’t be stopped by turning our universities into armed fortresses because armed guards and metal detectors are a tribute to fear, not enlightenment, and absent of enlightenment we will never stop a suicidal person willing to die to make a statement.

Our only hope is to learn to recognize, refer and treat suicidal people before they act against themselves or others. We must remove the stigma, taboo and shame associated with seeking help for pain so deep in the heart and mind that ending our own lives seems the only cure. We have the knowledge and we have the tools. The question is do we have the will?