In a December 2015 press release, National Alliance on Mental Illness Executive Director Mary Giliberti said that most people with a mental illness are not dangerous, something she wishes was more widely understood.
"Too much of the public dialogue about mental health over the past three years has been framed relative to violence," she stated. "The Newtown tragedy and other events undeniably have helped to fuel public demand for mental health care reform. At the same time, studies clearly show that the vast majority of individuals living with mental illness are not violent."
She continued, "Tragedies are happening every day. They include people living with mental illness who end up in emergency rooms, jail or living homeless on the street. They include young people whose symptoms aren't recognized early enough to avoid the worst outcomes. They include deaths by suicide."
Mental Health Colorado President and CEO Andrew Romanoff agrees that people can get the wrong idea about mental health based on media stories, which, by design, focus on rare circumstances.
"'Woman gets care for depression, gets better, and rejoins her family' is not usually a headline," he says with a laugh.
The problem with media reports, he says, is that when people are struggling with mental illness, they will often avoid getting help for fear of being lumped in with murderers and other criminals. And that can only make their struggle worse.
"You think, I'm not that," he says, "I don't want anyone to associate me with that."
Of course, the vast majority of people with a mental health issue are never going to mow down innocent civilians with an automatic weapon. Like any other health concern, mental illness requires proper treatment, Romanoff says. After that, most people go on to lead normal lives.
Nevertheless, NAMI concedes that studies show a few factors appear to increase the risk of violence in a small number of individuals with mental illness. Those factors include:
• Co-occurring abuse of alcohol and drugs
• History of violence
• Being young and male
• Untreated psychosis
Johnny had many of these risk factors at the time of Mary's email in January. While no one described Johnny as a drinker, family members did note that he smoked "a lot of pot," though they thought the drug actually seemed to calm him. Johnny had some smatterings of violence in his past, plus a deep interest in fighting and first-person shooter video games. He is, of course, young and male. And, for a long time, despite the efforts of his family, Johnny's schizophrenia was untreated.
Johnny also had what might be considered another risk factor, though NAMI doesn't list it. He had access to a lot of weapons.
While it's very rare, it is obviously not unprecedented for someone with mental illness to lash out violently. There are plenty of examples locally.
In 2011, for instance, Marcus Allen Smith broke into the Colorado Springs home of 87-year-old church deacon Kathryn "Kit" Grazioli and strangled her to death before setting her body on fire.
Smith was a terror in court, lashing out verbally and physically in an abhorrent and shocking manner. While in jail, he attacked staff and ate his own fecal matter. In 2016, prosecutors convinced jurors to convict Smith (he was sentenced to life in prison without parole), saying he was faking symptoms of schizophrenia, though he had repeatedly been diagnosed with the disease.
According to the Gazette's coverage of the marathon legal proceedings, Smith's defense attorneys claimed that he began showing signs of mental illness at age 8 or 9, and had schizophrenia by age 19. His family did seek help for him, and he apparently behaved much more normally when forced to take medication. Smith's family also called 9-1-1 on him, and begged for help, including one call that took place about a month before the murder, after Smith hit his sister in the face.
Smith wasn't being treated for mental illness when he murdered Grazioli.
Likewise, in May, a judge found that Robert Dear, the man who killed three people and wounded nine others at the Colorado Springs Planned Parenthood on November 27, was incompetent to stand trial. State psychologists found that Dear, who calls himself a "warrior for the babies" and thinks the government has long been spying on him, suffers from delusions. He will be treated by mental health professionals until he is once again found competent to stand trail, should that time come.
And then, of course, there's James Holmes, who killed 12 people and injured 70 others in an Aurora movie theater in 2012. While jurors rejected insanity as a defense in the trial, convicting Holmes of all charges, he was variously diagnosed with schizotypal personality disorder and schizoaffective disorder.