A Mental-Health Expert Explains How to Stop the Next Elliot Rodger

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Ideally, in the wake of a mass-killing tragedy like the Elliot Rodger murders from last weekend, society will at least come away with an insight or two about how to prevent the next one. Toward that end, Science of Us reached out to Jeffrey Rowe, clinical director of child and adolescent psychiatry at Rady Children’s Hospital in San Diego (and a psychiatry professor at UCSD), to ask how mental-health professionals separate young men who are merely troubled or upset from those who pose a genuine threat.

This is tricky, of course: There are a lot of quiet and/or lonely and/or taciturn young men out there, and many of them come across as creepy. The vast majority of them aren’t a threat to anybody and grow up to be well- or relatively well-adjusted. Rowe’s recommendations, which he described as “rough,” are designed with this in mind. (This is male-focused, because while female adolescents have their own issues, males are much more likely to engage in acts of mass violence.)

It’s a two-stage process, he explained in an email. First comes an initial screening to determine “who COULD be a danger at some point” — that is, who fits the basic profile of being potentially dangerous, even if the vast majority of people in this category won’t end up harming anybody:

The screening would be all the things you read about — male gender, socially poorly connected to others (family, friends, co-workers, romantic connection), unsuccessful in school or vocation, isolated and ruminative (hard to talk to, always going on about the same subject), angry, external locus of control (my life would be better if other people would change their behavior) while also being extremely egocentric.

Once they’ve been identified, the next step is an assessment geared at determining whether a dangerous act is actually likely:

The assessment would include major risk factors and current symptoms — risk factors like (1) recent loss or humiliation, (2) recent small crimes in which the rights and possessions of others are violated, (3) problematic use of drugs or alcohol, (4) acts of build-up (writing, practicing or rehearsing, obtaining the methods for his future action), and (5) possession of weapons; and then symptoms like (6) emotional arousal or outbursts in public, (7) evidence of illogical thought, (8) loss of reality testing, unusual distortions of perception (hallucinations, grandiose delusions), and (9) end to doing of their usual activities (hygiene, attending school or work, losing contact with those they usually do have some contact with). [numbering mine]

Now, surely when Rowe was laying this out, he had Rodger in the back of his head, but it’s still striking how neatly Rodger fits these criteria, at least based on his manifesto:

1. Yes. In addition to the fact that he felt humiliated by the mere presence of women or men who he saw as having success with women, there was an incident in which he got really drunk, confronted some people at a party, and got beaten up.

2. Yes. Rodger outlines several instances in which he threw coffee on couples because he was so outraged that they … well, existed. He also filled a Super Soaker with orange juice and sprayed down a group of young people.

3. Yes. By the time of the shooting he was engaging in some problem drinking, though he didn’t recount any other drug use.

4. Yes. The manifesto itself, but also the planning he went through, the videos, and so on.

5. Yes.

6. Yes.

7. Yes. I would say that wishing to gain ultimate power over humanity so as to end the practice of sexual intercourse constitutes an “illogical thought.” There’s also his obsession with winning the lottery.

8. Sort of. There’s no evidence of hallucinations, but definitely some grandiosity.

9. Yes. There’s a steady decline in his courseload and social interactions during high school and college, and he eventually becomes infuriated that World of Warcraft, his favorite video game and main sanctuary for many years, has become infested with “normal” people who don’t share his sorts of problems.

Obviously, the whole point here is that society can’t access the private activities — let alone the brain — of Elliot Rodger and other troubled young men. But if more people knew what to look for, it might increase their odds of intervening and getting law enforcement or mental-health professionals involved when they encounter a friend or neighbor who exhibits these warning signs.