The therapist of the 2012 Aurora massacre says mental health access is not the way to control mass shootings.
On July 20, 2012, a 24-year-old man with fiery orange hair arrived at a packed cinema hall in Aurora, Colorado, during the midnight viewing of The Dark Knight Rises. Then, unspeakable horror and chaos ensued: He released smoke bombs into the hall and began recklessly shooting into the audience. That day, James Holmes, who had a frightening theory that taking the lives of others would add to his “human capital”, killed 12 people and injured at least 58 others.
With mass shootings occurring more than once a day in our country (the U.S. has endured at least 370 in 2022 so far), they may seem routine. But the Aurora massacre was unique for one particular reason: It’s one of the only mass-shooting cases in which a shooter’s existing therapist was able to release the patient’s mental health records. And thanks to Lynne Fenton, MD, we have terrifying insight into what might have inspired Holmes to take the lives of so many innocent people.
Dr. Fenton worked as a psychiatrist at the University of Colorado, where Holmes was a neuroscience Ph.D. student, and served as Holmes’ therapist for approximately three months. During this period, she treated him six times, with the last appointment on June 11, 2012, approximately 40 days before the shooting. Meanwhile, Holmes had started preparing his arsenal of firearms and ammunition in May, having bought all his weapons legally from stores in Colorado.
We spoke to Dr. Fenton, who, in collaboration with criminal defense attorney Kerrie Droban, recently released a book, Aurora: The Psychiatrist Who Treated the Movie Theater Killer Tells Her Story, detailing her interactions with Holmes and exploring the psyche of a truly dangerous individual.
Katie Couric Media: Tell us about your first impressions of James Holmes.
Dr. Lynne Fenton: James came in for anxiety. He first contacted the student mental health department at the University of Colorado and was seen briefly for triage by my colleague, Margaret Rose, who was a social worker on our team. After she saw him, she called me and said, “This is the most anxious guy I’ve ever seen. He says he has thoughts of killing people, but I don’t think he’s actually dangerous. I’d like for you personally to see him.” So I contacted him a few days later, and he was nervous and awkward, almost robotic. What was really striking was how little he would say — it reminded me of trying to speak to a teenager who doesn’t want to talk to an adult. It was next-to-impossible to get details out of him.
Did Holmes say he was planning to kill people? Is it common for your patients to come in and talk about the need to seek “revenge” or kill people?
Holmes’ statement was, “I have thoughts of killing people.” It’s pretty common for folks, especially if they’re under a lot of stress, to have unwanted thoughts in their head of stabbing or shooting someone, and they don’t like those kinds of thoughts.
With Holmes, it was different. At first, I assumed that obsessive thought was coming into his head and he didn’t want it. Then, at one point, he said, “I don’t mind thinking about it.” He told me he thought about [killing people] three or four times a day, and I kept trying to get more details. I’d ask questions like, “If you were going to do something, what would you do? Are there any people you’re mad at?” But he didn’t seem like one of those people who was seething and wanted revenge. If he had anger, it was very deeply buried and he didn’t recognize it.
But he had called the health department to get help for anxiety.
Yes, and that’s unusual, because most people who are capable of a mass shooting don’t think there’s anything wrong with them. Only about a quarter of those folks who actually commit a shooting have a mental health diagnosis. Even those who do have a diagnosis usually think there’s nothing wrong with them; the problem is the rest of the world. So it’s very unusual to get a person like this in treatment, especially before they go on to commit a shooting.
Did you notice any particular red flags during your interactions?
The scariest session was our very last one on June 11. That’s when we learned he had failed the preliminary exam that you have to pass in order to continue in the Ph.D. program. The [University of Colorado] will give you another chance to pass it, but Holmes said he didn’t want that, and was already thinking about leaving the program. Then I thought, This could be the type of event that would set somebody off to actually kill people — a firing, or a divorce, or some big thing like this. So I and a highly experienced senior psychiatrist at the university, who I’d pulled in, were trying to get more information about how upset Holmes was. But he seemed pretty calm. Still, I just had a bad feeling about him.
Then I went ahead and called all the members of our threat assessment team at the University, which includes somebody from campus police, who could check and see if he had a criminal record or history of domestic violence — anything that could give us reason to believe he could be a risk. At the time, I thought the authorities would also be able to find out if he had weapons, but I didn’t realize that in Colorado, like a lot of states, there isn’t a gun registry — you don’t need a license to buy a gun. So there was nothing that would’ve picked up those recent gun purchases.
His statement about “thoughts of killing people” was so vague. [He didn’t say] something like, “I hate this group of people,” or “I’m thinking about shooting up a movie theater.” Then we could have informed the police. Or even, “I’m not going to tell you who I’m going to kill, but I’m gonna kill somebody.”
He never really qualified for a mental health hold as a “danger to others.”
But even if we were able to get a mental health hold, I don’t want people to have the false hope that putting folks like this on that kind of hold is the answer. With a mental health hold, you can put somebody in a psychiatric unit for up to 72 hours, and that gives you a chance to investigate further. [During that time], you could call the family or friends, maybe the police could check out some things. But the person could still lie or not answer your questions. And at the end of the three days, without enough evidence, you have to let him go.
What was your reaction when you first heard about the shooting?
It was probably about 6:30 a.m. The senior psychiatrist called me and said, “It’s our guy. He shot up the theater.” On the one hand, I couldn’t believe it, because it was so awful. On the other hand, I’d had this terrible feeling about Holmes. And I thought, He did something and we didn’t stop it. It was just devastating.
Now, 10 years out, do you think there was anything you could have done to stop it?
I scrutinized everything, looking for something else we could have done. And the university did an internal investigation. But even before that, right when it happened, the department had some experts from across the country take a look at the notes and review what happened, to see if there was something that went wrong. None of them found anything else we could have done.
At the time, we did not have a red-flag law in Colorado. Since then, Tom Sullivan, the father of one of the people killed in the shooting, got elected to state Congress and had a red-flag law passed. It allows any person to report to the police if they’re worried that a person might be dangerous. That gives the police the possibility of confiscating weapons or preventing them from buying weapons for a period of time. If we’d had a red-flag law, I would have called that in. But again, that’s not foolproof. We’ve seen some recent shootings where, even with that law, people went on to buy guns and committed mass shootings. But at least it gives us an additional chance.
What’s your response to people blaming the increase in mass shootings on insufficient access to mental health treatment?
A lot of people are saying that we really just need better access to mental health treatment, because a lot of these people [who commit mass shooting] are sick. It’s true, we do need better access to mental health resources, and that will really help with the other type of gun violence and suicide. But I really don’t think it’s going to make a dent in the mass shootings, because very few of those folks would come in for treatment. So that’s really not the answer.
With more recent mass shootings, what patterns have you noticed?
So many of these mass shooters are young, and they’re becoming younger over the decades. For the school shooters, two-thirds of them are under age 18. And for all mass shooters, about a quarter of them are under 25.
It makes sense biologically, because our brains don’t stop developing until our late 20s, and one of the last things that really comes is self control. So, in the late teens and early 20s, especially with men, there’s this big mismatch of anger, impulsivity, aggression, and the ability to control yourself. If there’s a way for us to keep lethal means out of the hands of this younger group, that really could make a difference.
