Why Diagnosing Adam Lanza Is A Problem

Augie Pantellas, a sixth-grader from Broomall, Pa., got quiet when he heard that the man who killed 27 people in Connecticut on Friday may have had Asperger’s syndrome. Augie, too, has Asperger’s. His mother, Michelle, could tell he was contemplating the news, comparing himself with Adam Lanza.

“I turned to him immediately and told him, ‘Don’t think that because this kid has Asperger’s, it has anything to do with the fact that he chose to go through with this terrible shooting,’” Michelle said. “I wanted him to understand that these are two completely different issues.”

Authorities are wrestling to understand what drove Adam Lanza to commit the unthinkable massacre of 20 children and their guardians. While details of his mental state are still unclear, many have said that Lanza may have suffered from a mental illness like schizophrenia or a disorder like Asperger’s. But here’s the problem: these diagnoses are total speculation.

Associating mental illnesses or disorders with extreme violence without real evidence can add stigma to already stigmatized conditions and fuel harmful stereotypes, mental health experts say.

It’s irresponsible, said Dr. Ken Duckworth, a child and adolescent psychiatrist and medical director for NAMI, the National Alliance on Mental Illness, adding that when catastrophic things happen, people often look for a psychiatric diagnosis.

“We don’t know anything about his condition,” Duckworth said. “It’s really important to respect the fact that we don’t have any facts. And the idea that a neighbor thought he had something isn’t what I’m looking for. As a child and adolescent psychiatrist, it doesn’t cut it for me. I don’t find that to be particularly compelling.”

The shooting comes at a time when states have cut a combined $1.8 billion from their budgets in the last three years and eliminated 4,000 inpatient hospital beds in the last five, according to the National Alliance for Mental Illness. And while the U.S. Preventative Task Force recommends screening all teenagers for major depression, most systems aren’t properly set up for that, Duckworth said.

Many have been angered by the associations people are making between Lanza and Asperger’s, a mild form of autism.

There is no evidence linking Asperger’s to violent behavior, said Peter Bell, executive vice president of programs and services at Autism Speaks. Those diagnosed with Asperger’s often have trouble with social cues and communication. And while some have trouble controlling aggressive thoughts and behavior, “there’s a big difference between aggression and planned violence,” Bell said.

“Autism did not cause this horrific event,” he said. “There are a lot of things that need to be factored into this — his age, where he grew up, the family challenges he faced in recent years, his access to guns. Trying to make it seem like autism or Asperger’s contributed to this is harmful and irresponsible.”

Bell said that he’s spoken with many parents over the course of the last 24 hours, and some were nervous about children who have Asperger’s going to school “because of what others might be thinking,” he said. “This could change the dynamic for these children in terms of the basic way their peers treat them or think about them.”

At Augie Pantellas’ school in Broomall, Pa., Asperger’s specialist Randi Rentz teaches a range of children — some “innocent and passive,” and some “hostile.” There’s a saying in the autism community, she said: “If you’ve met one person [on the autism spectrum], you’ve only met one person on the autism spectrum.” Rentz, for example, tailors her curriculum individually to each student.

“With many kids, there are a lot of things going on in addition to Asperger’s. They can have attention deficit hyperactivity disorder coupled with obsessive-compulsive disorder or depression,” Rentz said. “Each child is different. There are many who are sweet. Some have ADHD, some are naïve, some are extremely brilliant, like little professors. There’s no way to generalize.”

Mental illnesses too can’t be generalized. While a small subset of people with mental illnesses become violent, the vast majority of people with psychiatric disorders do not, stressed Linda Teplin, a professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine.

“If our goal is to really get at the roots of what went wrong and to fashion solutions, then premature speculation about diagnosis is ultimately not that helpful,” said Ron Honberg, director of policy and legal affairs at NAMI.

A primary goal of associations like NAMI is to battle the sort of stigma that makes people reluctant to reveal the nature of their mental disorder or illness. People often fear that exposing their illness could affect employment or lead to social rejection or insensitive comments, Honberg said.

It can also be a barrier to seeking treatment at a time when we need better access to mental health care.

And access, Honberg added, means more than just health insurance and medication, but also help with employment, housing and other quality-of-life issues:

“Pumping someone with medication isn’t going to do the trick,” Honberg said. “We have to give people reasons to live, help with employment and help developing meaningful social relationships.”