More mentally ill Americans are in prison than in a hospital, which is a big problem when it comes to potential for violent behavior.
An issue related to gun violence, especially the kind that makes a huge splash like the Sandy Hook Elementary School massacre, the movie theater shooting in Aurora or student shooting incident Columbine High School, both in Colorado, is mental health.
The obvious point that anyone who would amass weapons and ammunition, then carefully plan and carry out a mass shooting, must clearly be mentally unstable.
Contributing to that potential is a severe drop in services made available for mental health, both through government reimbursements and private insurance coverage. And confidentiality issues with health care contribute by making it difficult to connect services with those who need them but may not realize they need help at all.
Then there is a legitimate concern by citizens who might observe questionable behavior, even feel threatened, but are reluctant to risk stigmatizing someone else unnecessarily, especially a child, who might be entirely innocent of any ill intentions but still end up never recovering from false allegations.
There are ways to seek help, however, on the Lower Shore, and it seems wiser to err on the side of caution. It would be better to intervene and prevent someone from injuring himself or others than to choose not to get involved and allow something tragic to unfold.
Mental health is, unfortunately, a subjective science for the most part. There is no hard-and-fast list of warning signs. And there is no easy way to force evaluation of someone who does not wish to be examined.
Being informed that someone may pose a threat does pose a dilemma for mental health professionals, however. There is the confidentiality issue, yet what if someone actually does act in a violent way? Who is responsible and liable?
Another issue is people who are not mentally ill at all, but who are pushed over the edge by the words and actions of others, by the pressure of societal expectations or is just bullied to an intolerable level.
Some may snap and commit mass murder or kill random innocent people. Huffington Post recently published a story about a 22-year-old aspiring fashion designer who jumped off a bridge and died, leaving behind a purse containing a list of five girls she did not want attending her funeral because they had been bullying her unbearably.
Most mentally ill people cannot afford to purchase semiautomatic weapons. And it's worth pointing out that more mentally ill people are imprisoned than in hospitalized. They are more likely to be victims themselves than perpetrators of violence.
There are many contributing factors that can lead a person to gun violence. But limiting access to semiautomatic weapons and high-capacity clips can limit the damage. Forcing a deranged killer to stop and reload can give the good guys a chance to intervene.
However, neither limited access to weapons of mass killing nor universal background checks can stop all killers. Since Adam Lanza gunned down 20 first-graders in Newtown, Conn., and seven adult caretakers in mid-December, 2012, more than 4,500 Americans have died by gunshot.
What can we do to stem this hemorrhage?
Schools have - or should have - protocols and programs for such situations. More universal and affordable access to mental health services might also help.
If you truly feel threatened by someone's behavior, there is a hot line run by the Life Crisis Center: 410-749-HELP (4357). It is staffed 24 hours a day, seven days a week, and it can at least get someone alerted to the possibility of a problem. If deemed warranted, an intervention may take place. The people who answer those phones are trained and can direct your call to the proper resources if they cannot help directly.
Or if you feel imminent danger, you can always call police.
But remember, just because someone is a loner, socially awkward or unfriendly does not mean that individual poses a threat to society or himself. The sad truth is there is no way to pick out the next mass murderer. But picking up the phone and reporting suspicions or fears to mental health professionals can mitigate the threat.