Let's be realistic.  If there were no such thing as guns, James Holmes would likely find a different way to try to kill people.  Fire, improvised explosive devices, booby traps, acid.  There is no limit to the cruelty of the human imagination when not properly calibrated for mental health.  So let us shift out attention to something that needs fixing, can actually be fixed, and can actually do something to prevent this type of macabre event.

There is no denying that anyone who would spend months concocting such a brutal expedition is not mentally fit.  James Holmes, whether he acted strange in the courtroom or not, is not a mentally fit fellow.  

The case of Mr. Holmes has less to do with guns (or any other ridiculous political point for that matter) and more to do with the anemic state of modern psychiatry in our country.  So far, we absolutely refuse to properly educate the populace on mental health, and when someone is suspected of having a mental health condition, we tend to ignore or ostracize that person rather than help.  Our profession is completely reactive, waiting until someone calls us before any action is taken.  

If someone is suddenly walking with a limp, we help them.  If someone is exhibiting labored breathing, we help them.  If someone is experiencing some kind of physical pain, we help that person and as a society, have no problems offering a helping hand.

If someone starts acting strange, we are mystified as to what to do.  We are quick to judge that person and label them an outcast.

Currently, in our country, we go to the dentist for routine checkups.  Were we having symptoms?  Probably not.  Might the dentist find a cavity where you didn't know you had one?  Sure.  We take care of our teeth because we know that if we don't it can lead to not only a morose smile, but health problems can ensue later on down the line.

Currently, in our country, we go to our primary care physicians for a routine checkup.  Are we sick?  No.  Might your doctor find something to draw to your attention to make sure that you are maintaining optimal health?  He or she very well could.  We take care of our body because we know that if we catch problems early enough, our ability avoid early death is significantly increased.

Currently, in our country, we wait until we can't take it anymore before we seek mental health help.  Moreover, our professionals make no active effort to offer preventative screenings for mental illness.  Can mental illness lead to physical health problems such as heart disease that will kill you later on down the line?  The literature is very definitive on this.  And if your lack of self preservation leading to physical health problems doesn't get you, a mental health problems severe enough might have a hand in convincing you to take the initiative and end your own life.

All of this can be avoided.

As Dr. Keith Ablow points out in his latest article on the subject, "If we care whether our kids are exposed to tuberculosis, shouldn't we care if they are exposed to people struggling with voices, visions or paranoia?  If students show up at university health services for physical examinations and medical histories and there is no evidence that they were screened for psychiatric symptoms, and tragedy ensues, shouldn't colleges be liable for the fallout?"

Pursuit of Happiness has long been a leader in developing mental health screenings that can catch problems before they develop.  We have teamed with the University of Columbia's Teen Screen program, and have developed a multitude of proprietary mental health checkups to make sure that our minds are taken care of.  We take care of our bodies.  We take care of our teeth.  We even take our animals to the vet for routine exams.  But the most important tool of our humanity, our mind, is ignored until problems develop into full blown diagnosable conditions. 

What can you do?  Contact your schools.  Contact your after school programs.  Contact your doctors.  Contact your state and local legislators, your PTA boards, members of your family, and any member of any organization you can think of and tell them you want to see mental health checkups become a routine part of their stewardship of your children and your loved ones.  Share this page on your social network.  Like this page on your social network.  +1 this page.  As a society, willing to do what is necessary to propel ourselves out of the dark ages of mental health, if we all join together we CAN and WILL accomplish this for ourselves and for our future.  And be sure to tell them you know of a little ol' organization called Pursuit of Happiness right here in Dallas that has the tools at the ready to combat and take steps to prevent mental illness once and for all.

For dozen in Aurora Colorado, and for hundreds of their friends and families it is too late.  Somewhere in the world is another homicidal maniac brewing and stewing and waiting to explode.  With mental health checkups, we have the potential to reach out and help that person before the unthinkable happens. 

I'll assume that we have all read or have seen the news and don't need a recap of what happened.  

First some disclaimers:

These guys don't come around often, and when they do, they usually kill themselves before they are able to be apprehended.  Thus, we don't have just a whole lot of data on these guys, so it would be impossible to be able to make assumptive generalizations about them because we don't have a random enough sample to statistically be able to do that.

Also, we aren't going to take this opportunity to get into a political debate.

Finally, our condolences to the friends and family of those that are lost.  This is a difficult time, and for those survived we hope that they may find peace in the cherished memory of the loved and the lost.

Now, can we ever put an end to this sort of thing?  I believe we can.  

First we must turn to our dear friend psychology in an attempt to identify and understand these sorts of rare birds.  

It is long been a legend of psychology (not well backed by the literature though there are a number of those in the field who take these traits very seriously) that there is a "unholy trinity" of three traits that comprise a future psychopath.  Having just one of these traits can be fairly normal, so any one trait alone should not be considered cause for alarm.  Even if all three of these are present in a child that you know, it doesn't necessarily mean that they must be taken immediately to the padded walled basement of the psych hospital.  But it is certainly a piece of evidence that will need to be carefully considered and monitored by a licensed professional.

1) Bedwetting (enuresis or encopresis):  Not the typical child bedwetter, these bedwetters will wet long past the usual stage in their development when such behavior should have been grown out of.  Still wetting the bed through late childhood and early teenage years is typically an indication that something is wrong.  

2) Fire setting (pyromaniac): A lot of kids, and especially males can be very curious about fire.  So from time to time you may catch kids burning various things.  Certainly take the time to educate your children on the potential dangers of fire setting, but if your kid strikes a match, we should not sound alarm bells and take them immediately to the psych hospital either.  If the problem with fire grows larger, there may be something going on.  Consider that at a fundamental level, fire is, on the continuum of order versus chaos, one of the more chaotic assimilations of matter.  So a preoccupation with this type of matter state (as opposed to being fascinated with building blocks or putting things together or something more progress based) is certainly not the path of development we would optimally like to see.

3) Animal cruelty:  Intentionally inflicting pain on animals is arguably the more serious of these three characteristics.  The base of our humanity must be modeled to engender good will and help to each other.  However, sometimes when we are mad our reaction is to attempt to inflict pain on each other.  Here, though, we are concerned with the infliction of pain where it is not instigated.  Youths who engage in these types of behaviors are at risk to develop into cruel adults if not properly treated.  Antisocial personality disorder is often a direct mutation of childhood cruelty, especially when that cruelty is not a result of being incited.

In adulthood, we should be suspicious of any sudden and significant deteriorations in functioning.  In the case of James Holmes, we know that he was in the process of withdrawing from a neuroscience program at the University of Colorado.  "Significant deterioration in functioning" is a criterion for just about every diagnosable mental health disorder, but in the case of Mr. Holmes, we might expect that his deterioration may have been the result of the onset of schizophreniform disorder, which is the precursor to schizophrenia.  Though once again we must be reminded that we don't have a plethora of data to back up any assertions that we make about the psychopath population due to their relative seclusion from society and the professionals that could help them, we have seen a number of mass murderers and serial killers who have been afflicted with schizophrenia, most prominent of which is Ed Gein, the basis of myriad Hollywood horror movies such as "The Texas Chainsaw Massacre" and Hitchcock's "Psycho."

Now, this isn't to say that schizophrenics are ticking time-bomb murderers waiting to happen.  There are plenty of schizophrenics who, when properly treated, enjoy a high level of functioning such as John Nash, the basis of the movie "A Beautiful Mind" and Elyn Saks, featured in this Ted Talk video.  A good portion of schizophrenics are fully capable of independent living when the right treatment is rendered.

In the case of Mr. Holmes, his recognition would have been more difficult to spot.  As of this writing, there isn't a lot of history to connote a definite affinity to psychopathology.  Indeed his only societal infraction seems to have been a traffic summons, and those that knew him describe him as "quiet."  But we must be careful here, as there are plenty of kids dropping out of their collegiate program who are "quiet" who aren't dressing in black battle gear and shooting up the place.  In fact, this year all of that sample, save for one lone mismanaged soul, failed to go ballistic.

Keep in mind that in the case of Mr. Holmes, we may not have been looking at schizophrenia at all.  Mental health disorders such as Major Depression and Bipolar can both come complete with audio hallucinations as a symptom criteria, and a number of those audio hallucinations can be of the command variety.  Thus, we have a number of people afflicted with mental illness that are hearing voices telling them to either kill themselves, kill others, or both.  These audio hallucinations are brought on typically because the brain is undergoing a fair amount of stress when not relieved of the negative intensity of psychiatric disorders.  When the brain is distressed in this way, it may release cortisol, a chemical that operationally is poisonous to the brain, and thus can cause parts of the brain to malfunction.  Audio or visual hallucinations are often the result of this type of neuronal poisoning, and sometimes the individual who is traumatized by this ongoing condition will feel relief may only came by satiating these commands.

So can we prevent this type of thing?

I would put money on James Holmes failing to receive mental health services anywhere.  I suspect that had he been receiving some sort of services, this tragedy could have been suppressed.  But so far, the news is not reporting that he was receiving any such services.  At this time we would like to pause and remind any entities rendering services to Mr. Holmes that they may do well to re-familiarize themselves with these relevant Privacy Rules.

Now, we obviously cannot force adults into getting treatment for mental health problems unless a medical doctor issues an Order of Protective Custody, which will be issued in the event of a person who is imminently suicidal, homicidal, or suffering from a serious deterioration in functioning such that they cannot make an informed decision on their own behalf.

But...

We can make a better effort as a society to screen for mental illness, even when we don't think there is a problem.  Currently, most people go to the doctor for annual exams, even when they do not believe there is anything medically wrong with them, just to make sure they are in tip top shape.  We fail to keep up with ourselves in the same capacity for mental health.  This is why Pursuit of Happiness has developed mental health checkups.  We believe that your mental health is every bit as important as your physical health, if not more so.  The body is controlled by the mind, and when the mind is at risk, a variety of mental and physical health problems can ensue.

Could we have identified potential amok runners like James Holmes with a mental health checkup?  Obviously we can't guarantee that we would, but at least, at that point, we would have stepped up to the plate, where right now, that same batter's box is vacant.


Pursuit of Happiness

It's been a tough offseason for the Dallas Mavericks, owner Mark Cuban, and GM Donnie Nelson.  Deron Williams chose to stay with the New Jersey Nets.  Jason Kidd decided to jump ship to New York.  Dwight Howard isn't really coming either.  And ESPN is running quotes from a few weeks ago of Dirk Nowitzki saying he is too old to rebuild.  Yes folks, we are in it deep!

The 2011 champion Dallas Mavericks are no more.  Dirk Nowitzki and a cast of nobody.  At this point I wouldn't be surprised if poor Dirk requests a trade.

How did the Mavs get into such a mess?  How did we go from champions to 1st round sweeps to a probable lottery team ... NOT on purpose? 

Let's refer to our old friend psychology shall we?

Once upon a time they did a social study with populations from one of two socioeconomic statuses: top percent moneymakers or impoverished people.  Individuals were asked to choose between one of two options.

1.  They could have five dollars right now, and that's it.

2.  They could have twenty dollars in two weeks.

Individuals were categorized by their socioeconomic status and the result, predictably, was that the person from the lower socioeconomic status tended to choose the lesser money up front while the more economically inclined reliably chose the higher amount of delayed money.

So are poor people just idiots looking for a quick fix?  Assumptions about why this occured raged as expected. 

The prevailing wisdom seemed to be that the more economically disadvantaged person was more likely to choose the lesser amount up front because they were taught by their environment to not be able to depend on things, and probably had people in their lives that made promises that never materialized.  As such, when faced with a guaranteed payout right then and there versus having a larger payout later potentially go up in smoke, the lower SES group would be at an advantage to go ahead and take the up front money.  Anything could happen later, reasoned the researchers reasoning for the subjects, even their own mortality.  In their world, nothing is guaranteed and if you find a guarantee it is in your best interest take that guarantee while it is still on the table rather than wait for some impending calamity to ruin your piece of the pie.

For the higher SES group, of course, you take the higher amount of money later.  You don't have to worry about what your next meal is going to be so obviously it is to your advantage to wait for the more lucrative payout, in spite of the fact that this payout will not happen right away.

For Cuban and the Mavs, we are dealing with folks who are from the higher SES group.  Here, the much, MUCH higher SES group.

The potential of having Deron Williams and Dwight Howard become free agents and join the Mavs, thus creating an unbelievable lineup featuring Howard at center, Williams at the point backed up by Kidd, Nowitzki at PF, Marion at SF, and who even cares about who the shooting guard is because that is a surefire, championship piling, world beating team. 

So for the Mavs front office, they felt like they could afford to swing for the fences.  They've been winning every year, won the championship last year, and even if they lose they are still millionaires and billionaires.  It's not like if Deron Williams didn't sign with the Mavs then that meant that Cuban wasn't going to eat for a week.  He's still going to wake up a billionaire, and probably feels like he'll get another opportunity to win a championship in the future regardless of this summer's free agent outcome.  

For most of us, we are not from the same socioeconomic stratosphere as Mavs front office people.  Our safety net is nowhere near as deep.  Even for most in the middle class, we take a risk and say, mortgage our house on a potential business venture, we could be left in financial ruin and/or homeless for the foreseeable future.  So for us lesser mortals, our inclination would have been to keep the 2011-2012 title team together because we know we had a good thing going right then, and anytime we get a good thing going we usually like to try to keep that good thing going as long as possible.

Would we risk our loving wives for a shot with a glitzy supermodel?  For us small business owners, would you sell your successful business with the idea of getting into some kind of riskier, yet potentially more profitable business?  Wanna bet your kid's college fund on it?  Would you quit your job because you are certain you have an idea for the next bestselling book?  Would you quit your job and move to LA because you are certain you will become a major motion picture star?

Since socioeconomic status occurs on a continuum (being that there are several tax brackets you could theoretically fall under and that there is not just a black and white, rich or poor situation) our tendency as we move up the class ladder seems to be to take riskier and riskier moves given the increasing amount of safety nets you have to catch you as you climb the ladder.  

So for Cuban and the Mavs, they are already on top of the world.  These guys are milionaires and billionaires, owners and front office of a top valued professional sports franchise, and just got through winning it all 13 months ago.  When you are on top of the world like that, you can afford to take some mighty Casey-at-the-bat swings, because even if you whiff, you aren't exactly going into exile on Dagobah and eating frogs out of a stew pot in the swamp with Yoda.  So I salute these guys.  They stepped up to the plate and this time struck out.  They had a grand design to put a team together that would have destroyed all comers.  But little ol' me would have kept the championship team together.