Terrible Ideas + Evil Actions /= "Mental Illness"

"One problem I have with the whole 'mental illness' frame for talking about mass shooters," Paul Campos writes at Lawyers, Guns & Money, "is that the 'mental illness' often appears to be garden variety authoritarian ethno-nationalist misogyny, with the misogyny being the really critical ideological lynchpin [sic]."

Campos is riffing on reports that Mauricio Garcia, who killed eight people at a Texas mall on May 6, was discharged from the US Army (before completing recruit training) over mental health concerns, and posted to social media -- in between racist and misogynistic rants and applause for mass shootings, including one in 2014 in which "involuntary celibate" Elliot Rodger killed six -- about his mental health problems.

Campos's response raises interesting questions. Is it ever reasonable to blame "mental illness" for terrible ideas and violent behavior? If so, what are the metrics for distinguishing between individual responsibility and helpless derangement?

"The concept of disease is fast replacing the concept of responsibility," psychiatrist Thomas Szasz wrote in 1990's The Untamed Tongue: A Dissenting Dictionary. "With increasing zeal Americans use and interpret the assertion 'I am sick' as equivalent to the assertion 'I am not responsible.'"

To be fair, Szasz wasn't coming at this subject from out of the blue or from a previously neutral position. He's best known for a book he wrote three decades before The Untamed Young, the title of which gets right to his most well-known holding: The Myth of Mental Illness.

While Szasz is generally treated as a heretic for questioning the foundational principles of modern psychology/psychiatry, most US legal systems seem more Szaszian than establishmentarian on the subject.

About half of US states (including Texas) adhere to the "M'Naghten rule," which only allows a "not guilty by reason of insanity" verdict in cases where the defendant literally did not understand what he or she was doing, and/or that what he or she was doing was morally wrong.

Depression is not enough. A chip on your shoulder over supposed social mistreatment won't get over the bar. "My father beat me daily with a belt when I was a kid so now I'm always angry" doesn't cut it.

To use "mental illness" as an absolving trump card, one must have e.g. heard the supposed voice of a god giving orders to do the thing, or hallucinated that the victim was an alien assassin sent to abduct the children of Earth.

That seems like a reasonable standard to me. It's not that I don't sympathize with those who suffer from chemical imbalances in the brain, or who were abused as children, or who've become convinced that all their problems are someone else's (or some other race's or religion's) fault.

But those people are, generally, living entirely or almost entirely in the real world. Whatever their problems or grievances, they retain agency in how they respond and react. They know that walking into a mall and gunning people down is wrong. If they choose to do that, it's on them, not on their problems or their victims.