Alert: Trump Administration Considers Monitoring People with Mental Illness to Prevent Shootings

NYAPRS Note: The following materials have been culled from a variety of news sources and primary source Washington Post (see below). NYAPRS has joined with over 30 national mental health and disability rights groups to develop advocacy materials and strategies and also responses to these and other likely outrageous proposals in the coming days. One participant on yesterday’s call said it reminded him of the group that helped win passage of the ADA. Your participation will likely be needed: stay tuned.

Trump Administration Considers Monitoring People with Mental Illness to Prevent Shootings: Report

A digest from articles by the Washington Post, Washington Examiner, The Hill, Vanity Fair, Gizmodo, Common Dreams.com and Reason.com

September 10, 2019

President Trump's administration is considering a proposal to study whether monitoring people with mental illnesses could prevent future violence, The Washington Post reported Monday.

The reported proposal, coined SAFEHOME (Stopping Aberrant Fatal Events by Helping overcome Mental Extremes), is part of a project proposed by friend of the President Robert Wright to develop an agency to look for creative ways to solve health problems. 

Wright has presented the proposed agency known as Health Advanced Research Projects Agency (HARPA) after Ivanka Trump the president's senior adviser and daughter, reportedly asked if the team advocating for the agency could also look into methods to stop mass shootings.

Talks about HARPA were reopened as Trump was assuring the NRA that he would not pursue universal background check legislation to prevent mass shootings, and doubling down on previous claims that people with mental health challenges are the primary cause of shootings—suggesting to reporters last week that the U.S. should institutionalize mentally ill people en masse to prevent violence.

Among other initiatives, this new agency would reportedly collect volunteer data from a suite of smart devices, including Apple Watches, Fitbits, Amazon Echos, and Google Homes in order to identify “neurobehavioral signs” of “someone headed toward a violent explosive act.” The project would then use artificial intelligence to create a “sensor suite” to flag mental changes that make violence more likely.

The document also mentions “powerful tools” collected by health-care provides like fMRIs, tractography and image analysis.

Per the Post, the four-year, 40-to-60-million-dollar project would “attempt to use volunteer data” to detect signs of mental instability that may foreshadow shootings before they happen.

It’s not clear how the agency would detect these possible shooters, or precisely how the data would be collected. But Trump reportedly responded “very positively” to the proposal. “Every time this has been brought up inside the White House—even up to the presidential level—it’s been very well-received,” a person familiar with the discussions told the Post.

2012 study that the Defense Department commissioned after the 2009 mass shooting at Fort Hood in Texas explains the significance of that fact in an appendix titled "Prediction: Why It Won't Work."

The Defense Department report illustrates the problem with a hypothetical example. "Suppose we actually had a behavioral or biological screening test to identify those who are capable of targeted violent behavior with moderately high accuracy," the report says. If "a population of 10,000 military personnel…includes ten individuals with extreme violent tendencies, capable of executing an event such as that which occurred at Ft. Hood," a test that correctly identified eight of those 10 dangerous people would wrongly implicate "1,598 personnel who do not have these violent tendencies."

That scenario assumes a predictive test that does not actually exist. "We cannot overemphasize that there is no scientific basis for a screening instrument to test for future targeted violent behavior that is anywhere close to being as accurate as the hypothetical example above," the report says.

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Some Reactions

  • Outside the White House, the plan has already set off alarms. “The idea of the [Trump administration] creating a new agency focused on mental health led by a Trump-appointee, all for the purpose of advancing the view that mass gun violence is a mental health problem, should alarm us all,” remarked Sherrilyn Ifill, president of the N.A.A.C.P. legal defense fund.

  • The research program imagined by Wright is aimed at developing a predictive test. But even in the unlikely event that it succeeded, the enormous false-positive problem would remain.

  • Would people with certain psychiatric diagnoses be legally required to carry electronic monitors aimed at detecting "small changes that might foretell violence"? How could such a requirement be reconciled with due process or the Fourth Amendment?

  • “This is scary and dangerous,” writer and disability rights activist Lydia X.Z. Brown warned Thursday. “Negatively racialized disabled people WILL be the most likely to be victimized/targeted by increased psychiatric and police surveillance, leading to confinement or death.”

  • “The research already exists to tell us that mental illness does not predict gun violence. Growing gun violence is not the product of disability, rather it’s a product of political inaction and cowardice tied to an unwillingness to reform how America interacts with guns," Rebecca Cokley, director of the Center for American Progress's Disability Justice Initiative, said in a statement responding to the report. "Increased monitoring, surveillance, and institutionalization of people with disabilities is not a research-based approach and has a real and negative impact on people’s lives.”

  • "I would love if some new technology suddenly came along that would help us identify violent risk," Marisa Randazzo, former chief research psychologist for the U.S. Secret Service, told the Post, "but there's so many things about this idea of predicting violence that [don't] make sense."

  • The question we have to ask here is whether the freedom to use a high-bandwidth telephone is really more important than the lives of our kids. As the Trump administration has made clear, HARPA wouldn’t ban cell phones outright; it would just impose some common sense safety regulations on their use. What’s the problem?

  • "To those who say this is a half-baked idea, I would say, 'What's your idea? What are you doing about this?'" said lead researcher behind the HARPA proposal, Geoffrey Ling. If the program proves unsuccessful at preventing mass shootings, he maintained, it might end up helping address other issues, like suicides or child abuse. "The worst you can do is fail, and failing is where we are already," he added. "You need to find where the edge is so you can push on that edge.”

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White House Weighs Controversial Plan on Mental Illness and Mass Shootings

By William Wan  Washington Post  September 9, 2019

The White House is considering a controversial proposal to study whether mass shootings could be prevented by monitoring mentally ill people for small changes that might foretell violence.

Former NBC chairman Bob Wright, a longtime friend and associate of President Trump’s, has briefed top officials, including the president, the vice president and Ivanka Trump, on a proposal to create a new research arm called the Health Advanced Research Projects Agency (HARPA) to come up with out-of-the-box ways to tackle health problems, much like the Defense Advanced Research Projects Agency (DARPA) does for the military, according to several people who have been briefed.

After the recent shootings in El Paso and Dayton, Ohio, Ivanka Trump asked those advocating for the new agency whether it could produce new approaches to stopping mass shootings, said one person familiar with the conversations who spoke on the condition of anonymity because they were not authorized to discuss them.

Advisers to Wright quickly pulled together a three-page proposal — called SAFEHOME for Stopping Aberrant Fatal Events by Helping Overcome Mental Extremes — which calls for exploring whether technology including phones and smartwatches can be used to detect when mentally ill people are about to turn violent 

Using his personal connections to Trump and others, Wright has pushed his HARPA proposal to the White House and Health and Human Services Secretary Alex Azar and several senators and House members, according to two people involved in the effort. Last month, on the presidential campaign trail, former vice president Joe Biden also advocated for creating such an agency.

The violence detection plan has alarmed experts studying violence prevention, technology, psychology and mental health.

“I would love if some new technology suddenly came along that would help us identify violent risk, but there’s so many things about this idea of predicting violence that doesn’t make sense,” said Marisa Randazzo, former chief research psychologist for the U.S. Secret Service.

Beyond the civil liberty concerns about monitoring people through their gadgets, Randazzo said, there’s the problem of false positives.

Even if the technology could be developed, such a program would probably flag tens, or hundreds of thousands, more possible suspects than actual shooters. How, she asked, would you sort through them? And how would you know you were right, given the difficulty of proving something that hasn’t happened?

Most concerning, she said, is that the proposal is based on the flawed premise that mental illness is directly linked to mass shootings. “Everything we know from research tells us it’s a weak link at best,” said Randazzo, who spent a decade conducting such research for the Secret Service and is now CEO of a threat-assessment company called Sigma.

In recent weeks, Trump has repeatedly pointed to mental illness as the cause of the United States’ mass shootings. “Mental illness and hatred pull the trigger. Not the gun,” Trump said immediately after last month’s shootings in El Paso and Dayton. Federal health officials have taken steps to make sure government experts don’t publicly contradict Trump.

But studies of mass shooters have found that only a quarter or less have diagnosed mental illness. Researchers have noted a host of other factors that are more significant commonalities in mass shooters: a strong sense of grievance, desire for infamy, copycat study of other shooters, past domestic violence, narcissism and access to firearms. Experts note that those with severe mental illnesses are much more likely to be victims of violence than perpetrators.

“To those who say this is a half-baked idea, I would say, ‘What’s your idea? What are you doing about this?’ ”said Geoffrey Ling, the lead scientific adviser on the HARPA proposal.

A Johns Hopkins University neurologist, Ling was a founding director of DARPA’s Biological Technologies Office. Ling said having the gumption to tackle really big problems and think creatively is what led to DARPA’s successes.

“The worse you can do is fail, and failing is where we are already,” Ling said. “You need to find where the edge is so you can push on that edge.”

Ling said he began working with Wright on the idea of creating HARPA shortly after the death of Wright’s wife in 2016 to pancreatic cancer. According to Ling and others who have worked on the project, Wright was frustrated with the lack of major progress in halting illnesses such as his wife’s pancreatic cancer — which has an overall five-year survival rate of just 9 percent, according to the American Cancer Society.

Wright was not available for comment while recovering from surgery, said Liz Feld, president of the Suzanne Wright Foundation, the organization Wright has used to lobby for the HARPA proposal. Feld said the foundation has worked methodically to gather support for HARPA in the past two years, meeting with Trump officials and congressional leaders.

The idea has backers in both parties. During an Aug. 8 speech at the Iowa State Fair, Biden said creating a HARPA agency could help solve health problems including Alzheimer’s and obesity. “Those who have been in the military know there’s an outfit called DARPA,” he said. “It’s the thing that allows the military to do advanced research on everything from stealth technology and the Internet and all those other things. . . . We should be doing the same thing with health care.”

There is a huge gap between government research bodies such as the National Institutes of Health that fund research in its early stages and the private sector that often applies them to problems and brings solutions to market, said Michael Stebbins, former assistant director for biotechnology during the Obama administration, who has been hired as a consultant for the Wright Foundation.

“That’s the massive hole that HARPA would fill,” Stebbins said. “It’s about creating new capability, driving innovation.”

According to a copy of the SAFEHOME proposal, all subjects involved would be volunteers and that great care would be taken to “protect each individual’s privacy” and “profiling of any kind must be avoided.

Ling said that even if SAFEHOME fails to predict mass shooters, it could lead to other advances, such as new ways of predicting and preventing suicides or child abuse.

Matthew Nock, a leading suicide researcher at Harvard University, agreed that a new health research arm like HARPA might be helpful. For decades, Nock said he has tried to find ways to predict and prevent suicides. In an email, Nock said he’d welcome an agency that would apply advances in machine learning and artificial intelligence to such efforts.

But he added that using such a proposed agency to “find” links that science has shown don’t exist is dangerous. While research shows mental illness is strongly linked to suicide, Nock noted, the link between it and violence toward others is much weaker.

Other researchers pointed to worrisome results from other recent attempts to use artificial intelligence to predict risk of violence. In court decisions on parole and sentencing, for instance, artificial intelligence programs have at times deepened problems of racial bias, overestimating the likelihood of black offenders committing further crimes and underestimating the likelihood of white offenders doing so, said Stephen Hart, a clinical forensic psychologist and researcher on violence risk assessment.

“The irony is that there are low-tech solutions that already exist for some of these problems that we simply aren’t funding or deploying enough,” said Hart, including research and policies that address the prevalence of guns in the United States.

Another already existing low-tech solution, Hart said, is threat assessment, which emphasizes preventing violence by identifying and addressing problems flagged by fellow students or co-workers.

That was also the conclusion of a 2012 study commissioned by the Pentagon after the mass shooting at the Fort Hood military base. The study’s task force surveyed every technology available that might help predict violence — including DNA swabs, retinal scans and merging big data from military personnel records. Like the HARPA proposal, the task force experts also looked at physical, neurological and genetic biomarkers, but ultimately concluded that predicting violence was a fool’s errand. The study’s panel devoted an entire appendix to dispelling the notion, entitled “Prediction: Why It Won’t Work.” Instead, it recommended approaches such as threat assessment.

“PREVENTION should be the goal rather than PREDICTION,” the task force concluded in its final report.

Jacqueline Alemany and Alice Crites contributed to this report.

Read more

White House considers new project seeking links between mental health and violent behavior

https://www.washingtonpost.com/health/white-house-considers-controversial-plan-on-mental-illness-and-mass-shooting/2019/09/09/eb58b6f6-ce72-11e9-87fa-8501a456c003_story.html