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Tuesday, 18 December 2012

Mass homicides - making sense and learning from tragedy

The Newton massacre is weighing heavily on all of North America.   It is a tragedy of immense proportion and no words will ever do justice to the impact on the families and children involved.  

The parallel conversations are notable.  First is the valid conversation on the effectiveness and utility of gun control.   Only in the US is this a constitutional right to bear arms, but the spin-off into Canada has killed many Canadians.  The US sees in excess of 11,000 firearms homicides annually, Canada at 10% of the population has 1.5% the number of firearms homicides.  Places like Japan with strict gun control an order or two fewer firearms homicides. 

The second parallel conversation is just on the social ramification of firearms in society which was well reviewed by the US National Research Council in 2004 NRC meta analysis .  The report is exceptionally conservative in its interpretation of the state of knowledge at the time.   The absence of wide ranging reviews since 2004 is a notable gap in the literature.   There are multiple reviews prior to the NRC documentation. (eg Harvard portal on injury control

The third substantive conversation links to the discussion on media reporting such that is parallels suicide reporting Dr P Health copycat suicides.  The Globe’s self criticism is a good starting point in the discussion Globe and Mail self critique.  The criticism does not speak to the public health impact in any fashion, just about misinformation in publication.   Two weeks post the Columbine tragedy, the Taber High School shooting was a demonstrable instance of copycat behaviour related to attention seeking behaviour.

The fourth of the substantive discussion relates to mass shootings.   Tragic events, where multiple deaths have occurred and asking the question why.  The US only listing can be accessed at Mass shooting timelines and a reminder of the major incidents such as Virginia Tech in 2007 with 56 deaths. At last half of the incidents ended in suicide of the perpetrator.   Canada has had its share including the Ecole Polytechnique de Montreal shooting in 1989 that resulted in 15 deaths and a defining point in Canadian gun control.

The motivation of the perpetrators becomes the fifth discussion topic.  Inherently assumed to be associated with mental illness and potentially the shortcomings of our community mental health system, there is very little literature on the subject.  One relatively inaccessible article sounds interesting and would be great to provide a link to – but alas, welcome to the shortcomings of academic journals.  (Mass Murders: implications for mental health professionals Int J Psychiatry Med. 2008;38(3):261-9


No doubt there will be the calls for action, and sets of recommendations – but will sustainable constructive change be achieved.  Other than legislative controls, community based responses have rarely been sustained beyond the initial required reaction, and the lack of any rationale sense or communications in Newton will not likely lead to sustainable societal change despite the evidence.      

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