Recognizing potential warning signs among troubled people is an inexact science, an Omaha psychiatrist said, but some behaviors warrant attention.
Declines in a young person’s home, school or social life can indicate that he or she may need an evaluation by a mental health provider, said Dr. Howard Liu, a child and adolescent psychiatrist who is an assistant professor of psychiatry at the University of Nebraska Medical Center.
Experts across the country are offering suggestions for identifying potentially violent people in the wake of last week’s deadly shootings in Newtown, Conn. An event scheduled for today in Omaha will address school safety, suggestions on how to discuss the tragedy with children, available resources for crisis counseling and intervention and recognizing warning signs.
Problems with home life are evident, Liu said, when a child or teenager withdraws from family members, isolates himself or gets into major conflicts. School problems occur, he said, when grades slide from a normal level and the child either doesn’t care or can’t muster the energy to pull up her grades. And social problems, especially among teens, are a concern when the youths start avoiding their peers and spending more time alone, Liu said.
“If these signs are present, particularly for more than a couple of weeks, a parent should seek help for their kid,” he said.
But Liu and others say it is difficult to predict who is likely to become dangerous.
Most such killers are young men who are not fully psychotic, said Dr. Michael Stone, professor of clinical psychiatry at Columbia University and an expert on mass murderers. “They tend to be paranoid loners who hold a grudge and are full of rage.”
Studies have found that a young, psychotic male who is intoxicated with alcohol and has a history of involuntary commitment is at a high risk of violence, yet most individuals who fit the profile are harmless.
“Can we reliably predict violence? ‘No’ is the short answer,” said Jeffery Swanson, a professor of psychiatry at Duke University and a leading expert in the epidemiology of violence. “Psychiatrists, using clinical judgment, are not much better than chance at predicting which individual patients will do something violent and which will not,” Swanson said in an email.
People who plan violent acts do, however, generally follow a pattern, said Robin Zagurski, a therapist/social worker in UNMC’s Department of Psychiatry.
The first step, she said, is a grievance, when someone feels as if he has been wronged. The next, she said, is the idea stage, when people start to feel as if violence is the only way to solve a problem. That’s followed by research and planning, preparation, a “breach” in which the person reviews the layout of the place they plan to attack, followed by the attack itself.
Along the way, Zagurski said, the person often will tell others about his grievance and his plans. That, she said, frequently is shared via a social media outlet such as Facebook.
“It’s really kind of stunning how often writing is found on the planning,” she said.
If people learn of the plans, they should try to talk to the person and offer to get him help. Intervening anywhere along the process of a planned attack could avert it, she said.
“The important thing is, we need to take care of each other,” Zagurski said. “We need to listen to what people around us are saying. If people make threats, either to themselves or others, we need to take that seriously.”
If the threat is to a school or business, she said, the school or business needs to be notified. Zagurski said she also would notify police.
This report includes material from the New York Times.
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