Could We Have Prevented the Lewiston, Maine, Tragedy?

After each mass shooting, such as that on Oct. 25 in Lewiston, Maine, where gunman Robert Card killed 18 people and injured 13, gun control advocates rebroadcast their core message about the need to control access to semiautomatic weapons. Gun rights advocates oppose such restrictions and suggest instead that Americans need better access to mental health treatment.  

There’s another commonsense strategy for approaching this problem that is often overlooked: a public health approach to violence prevention that relies on the police and other professionals, from social workers to mental health professionals to teachers, working together to assess threats that individuals pose by showing concerning behaviors. Managed interventions can help mitigate those threats and the underlying problems that drive them. 

An often emphasized pillar of this approach is what is called a “behavioral threat assessment and management team.” You can find these teams in corporations, health care organizations, schools and the Veterans Administration. Yet they are rarely deployed, let alone adequately staffed, to protect public safety in communities.

Mass shootings and other forms of targeted violence typically don’t occur out of the blue. They are preceded by indicators — communications and behaviors that reflect a potential shooter’s intentions and capabilities. Two key questions to ask are: Do community members who observe concerning behavior have a place to call for advice and help? And, is there a mechanism in place to ensure that a community’s front-line professionals who learn of an individual’s behavior are able to adequately assess and manage the threat? 

There are other questions that have arisen regarding the conclusions and actions of those who had contact with Robert Card, a sergeant in the Army Reserve, before he opened fire in a Lewiston bowling alley and bar. These include:

Did Card show behavior that worried those around him? Yes, many times — in fact, the Army said he should not have access to a gun or ammunition. Studies have shown that up to three-quarters of those who commit a mass attack have demonstrated warning signs to their family, friends, or co-workers.

Did those who knew Card share their concerns with law enforcement or other professionals? Yes, on several occasions — with the Topsham School Resource Officer, who his son and ex-wife approached in May, the Sagadahoc County Sheriff’s Office, and the Army Reserve base in Saco. Many times, the intimates of someone of concern do not share information because they are afraid, but in this case — and to their credit — they did.

What steps were taken — and why weren’t they enough to stop Card’s violent actions? Many steps were taken by law enforcement, mental health professionals, and military officers over a period of months. Each person — from an Army psychologist to a sheriff’s deputy to other individual professionals who encountered Card — may have done what they were required to do, but it appears they did not do enough to suitably recognize the threat he posed and to use available resources to keep him in sight, including by referring the case to a violence prevention team. Just days before the shooting, Card legally purchased guns, adding to his stockpile.

What more was needed? Card should have been looked at through the lens of threat assessment and wider violence-prevention best practices. Had authorities done this, they likely would have concluded that he was on what is referred to as “the pathway to violence.” With the acuity of the threat recognized, authorities might have mitigated it by taking coordinated actions.

Instead, those involved apparently did not think he was enough of a threat to take away his guns, hospitalize him for mental health treatment, or arrest him. They did not keep him under observation or find other ways to engage with him, essentially leaving it up to his family to deal with the potential problem.

Would a community-focused violence prevention team have made a difference? Yes, a team with a behavioral threat assessment and management component very likely could have made a difference. A team that includes a range of professionals, people who know the community they are seeking to safeguard, likely would have better assessed the threat and perhaps found a way to prevent the violence that ensued. 

Such a team typically determines that more actions are needed, both to complete an assessment and to devise a plan to ensure the community’s safety. A trained team would not have left it up to Card’s brother and father to collect his guns. The team likely would have found ways to push him to get further treatment, which might have involved ensuring that he took medication. 

For such a team to work, law enforcement and mental health professionals must be involved and must understand how they can help in situations like this. Too often, they work in their own silos, in part because of mandates or habits, or because they lack trust and understanding of each other’s roles.

Does Maine have a community-focused prevention team? The state does not, but a regional behavioral threat assessment and management group based in Boston is meant to cover New England, including Maine. However, it is up to local, state or federal law enforcement, or mental health professionals or other practitioners, to approach the team for assistance. With limited connections between the Massachusetts team and state and local professionals in the Lewiston area, it should come as little surprise that Card’s case wasn’t referred to the team. 

Despite the unfortunate reality that any community could become the site of a mass shooting or other targeted violence, behavioral threat assessment and management teams covering communities are present in very few states. Spurred largely by mass shootings at schools, Colorado, Florida and Hawaii have threat assessment protocols and Illinois is building them. Following the May 14, 2022, shooting at a Buffalo, N.Y., supermarket that killed 10 people and injured three, Gov. Kathy Hochul required the establishment of county-level teams and provided initial funding for them.

While the debate continues over gun control measures, Congress should consider incentivizing states, through funding and training programs, to establish threat assessment teams as part of a wider public health and community-focused approach to violence prevention in America.  

Many discussions about how to prevent mass shootings end up mired in political bickering, in Congress and elsewhere, and the search for solutions remains elusive. However, it is crucial for policymakers and the public — regardless of political affiliations — to avoid paralysis on the topic. Instead, they should call for more investment in community-based threat assessment and management teams. It’s a tool that just might save lives. 

Stevan Weine, M.D., is a professor of psychiatry at the University of Illinois College of Medicine and director of its Center for Global Health. His new book is “Best Minds: How Allen Ginsberg Made Revolutionary Poetry from Madness.”

Eric Rosand is executive director of the Strong Cities Network and a former senior counterterrorism official with the State Department. 

The views expressed are their own.