Investigators have not yet disclosed whether Adam Lanza, the 20-year-old who invaded an elementary school and killed 20 children and six adults, had a mental illness.

The distinction might sound academic — after all, don’t his actions answer the question?

But experts say that not all people who commit horrific crimes like mass shootings necessarily have a major psychiatric diagnosis.

“Some people would say, ‘Well yeah, but wait a minute, if you are capable of picking up a gun and killing 20 children, you are obviously mentally ill,’” said Dr. Harold “Hank” Schwartz, psychiatrist-in-chief at the Institute of Living in Hartford. “To which I can only say, ‘OK, if you want to make that the definition of mental illness you can, but it’s not the definition that currently is in use.’”

Robert Davidson, executive director of the Eastern Regional Mental Health Board, put it this way: “Not everybody who does something crazy is crazy.”

He noted that there was little talk of mental illness after a man killed six people in a shooting at a Sikh temple in Wisconsin in August. That’s in contrast to the man who killed 12 people in a Colorado movie theater that same month, whose behavior had reportedly led a psychiatrist to raise concerns before the shooting.

Some reports about Lanza have included speculation that he had Asperger’s syndrome, a form of autism. But there’s no link between Asperger’s and violence.

Of the mass shootings that took place in the past three decades, about half of the perpetrators would be considered to have a major psychiatric disorder, Schwartz said.

“It is true that in the small number of people who ever are going to commit an act like this, there is a disproportionately large number of people who do carry a psychiatric diagnosis,” Schwartz said. “But we’re talking about a very, very low base rate event” — too low to extrapolate about mental illness in general, he added.

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Arielle Levin Becker covered health care for The Connecticut Mirror. She previously worked for The Hartford Courant, most recently as its health reporter, and has also covered small towns, courts and education in Connecticut and New Jersey. She was a finalist in 2009 for the prestigious Livingston Award for Young Journalists, a recipient of a Knight Science Journalism Fellowship and the third-place winner in 2013 for an in-depth piece on caregivers from the National Association of Health Journalists. She is a 2004 graduate of Yale University.

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