Is being "wrong" a psychiatric disorder?

When someone commits a horrific crime or crimes we want to know what's the matter with them?  And having decided that something is in fact the matter with them we then want to know why.  Is what they did an "illness"?  Do they need treatment or incarceration?  Is it their "fault"?  How should we treat the perpetrators?

It is tempting to consider such people as "mentally ill".  In that way we don't have to think about what they are trying to accomplish or if they are trying to accomplish any goal in the real world.  A moment's thought, however, is (or should be) enough to recognize that all of the mass murders are goal-directed, not simply an errant momentary impulse.   For instance,  the recent Bakersfield killings were carefully planned over a long period of time and carried out by people whose public behavior had been "normal" even to their closest associates.  So what was their goal?

They were clearly  not motivated by personal gain.  They didn't expect to survive their actions.  Their goals were ideological and based on fervent religious beliefs.  Sanity was not the issue; their belief system was.  To decide they were somehow psychiatrically ill and in need of treatment is to trivialize their behavior.  It also dumps the responsibility for managing them and people like them on the mental health system, which is totally unequipped to deal with them.  These people are not mentally ill.  Giving them a "diagnosis" is to escape from the reality that sane people can actually want to kill us.  We don't want to believe that. To kill people for religious differences seems mad.  But of course many religions, including Christianity, have done exactly that in the past.

Some of the mass shootings fall in other categories.  Mentally ill people can also commit crimes, and the reasons for their behavior will never make sense to the "sane" among us.  A recent example is the multiple shootings in the Denver movie theater.  Such people may believe that others are plotting to kill or damage them, or they may believe they are given orders by supernatural beings.  Their behavior makes sense to them.  It is not difficult to detect the bizarre thinking patterns that characterize such disorders. The only real question is what to do with them.

By the way, the only difference between in psychotic beliefs in supernatural directives and those whose beliefs gave rise to a religious movement is an arbitrary one.  If Jesus lived today we would probably hospitalize him involuntarily and treat him with medication until he no longer heard "voices" and no longer believed in his own supernatural power.  However, he was able to convince others that he was sane.  Other people with similar delusions have not been so convincing and ended up medicated and relatively mannerly.  

School shootings by adolescents might have as a goal some form of revenge on their treatment at the school.  The desire for revenge is not a mental illness.  What they did was criminal and not the result of mental illness. It might be helpful, however, to inquire as to what happened to them to prompt such a desperate desire for revenge?

When sane people commit horrific crimes we need to understand why they feel it necessary to do so.  We can't begin to consider ways of stopping it when we do not understand what they are trying to accomplish.  To dismiss their acts as "mentally ill" is to trivialize them and attempt to ignore them.