The myth of school shooters and psychotropic medications.

There has been an assertion in certain parts of the media, especially social media, that the majority of individuals who have engaged in a school shooting were prescribed psychotropic medications prior to the event. To determine if there is any validity to this assertion, the authors of this article reviewed publicly available information regarding individuals involved in "educational shootings" per FBI publications for active shooters from 2000 to 2017. Sources of information included news reports with official citations, official reports regarding events, available court records, and FBI Freedom of Information Act requests. Secondary data-points were also collected, such as location, number of weapons used, number of victims, legal outcome, and whether the shooter committed suicide. From the information obtained, it appears that most school shooters were not previously treated with psychotropic medications - and even when they were, no direct or causal association was found.

Comic Books, Dr. Wertham, and the Villains of Forensic Psychiatry.

Comic books have been part of popular culture since the 1930s. Social activists quickly became concerned about the risk that comic books posed for youth, including that their content was a cause of juvenile delinquency. Dr. Fredric Wertham, a forensic psychiatrist, led efforts to protect society's children from comic books, culminating in multiple publications, symposia, and testimony before a Senate subcommittee on juvenile delinquency in 1954. During the course of his activities, and quite possibly as a backlash, comics started to represent psychiatrists and particularly forensic psychiatrists as evil, clueless, and narcissistic characters (e.g., Dr. Hugo Strange went from being a mad scientist to a mad psychiatrist). Clinical forensic psychiatrists who were not necessarily evil were often portrayed as inept regarding rehabilitation. There are very few positive portrayals of forensic psychiatrists in the comic book universe, and when they do occur, they often have severe character flaws or a checkered history. These negative characterizations are woven into the fabric of contemporary comic book characters, whether represented in comic books or other media offshoots such as films and television.

Guns, schools, and mental illness: potential concerns for physicians and mental health professionals.

Since the recent shootings in Tucson, Arizona; Aurora, Colorado; and Newtown, Connecticut, there has been an ever-increasing state and national debate regarding gun control. All 3 shootings involved an alleged shooter who attended college, and in hindsight, evidence of a mental illness was potentially present in these individuals while in school. What appears to be different about the current round of debate is that both pro-gun control and anti-gun control advocates are focusing on mentally ill individuals, early detection of mental illness during school years, and the interactions of such individuals with physicians and the mental health system as a way to solve gun violence. This raises multiple questions for our profession about the apparent increase in these types of events, dangerousness in mentally ill individuals, when to intervene (voluntary vs involuntary), and what role physicians should play in the debate and ongoing prevention. As is evident from the historic Tarasoff court case, physicians and mental health professionals often have new regulations/duties, changes in the physician-patient relationship, and increased liability resulting from high-profile events such as these. Given that in many ways the prediction of who will actually commit a violent act is difficult to determine with accuracy, physicians need to be cautious with how the current gun debate evolves not only for ourselves (eg, increased liability, becoming de facto agents of the state) but for our patients as well (eg, increased stigma, erosion of civil liberties, and changes in the physician-patient relationship). We provide examples of potential troublesome legislation and suggestions on what can be done to improve safety for our patients and for the public.