Copycat, Contagion, and the Robin Hood Effect as Risk Enhancers in Targeted Violence
In the wake of the tragic death of UnitedHealthcare CEO Brian Thompson, there are ongoing concerns about potential follow-on violence, especially in the healthcare and healthcare insurance industries. The attacker is still at large, and therefore represents a threat of additional violence. It is not known if his grievance was isolated to one healthcare insurer and its top executive or to the wider health insurance sector, putting other workers and leaders at risk. (Editor's note: the suspected attacker has since been arrested. Read more here.)
As the investigation into this attack continues, many unknowns remain. Amongst the many concerns that may be on the minds of threat assessment and security professionals today should be the possibility of copycats, contagion, and the Robin Hood Effect.
The attack in New York is correctly being described as an act of targeted violence and appears to have been highly motivated, focused, and disciplined in the attacker’s preparation and execution of the attack.
Many of the elements of the pathway to violence are apparent, including the formation of a grievance (as evidenced by the writing on spent bullet casings citing healthcare insurance terms associated with the non-payment of claims), the development of violent ideation to address the grievance, obvious research and planning to determine where and when he could best access his target, detailed preparation including the inscriptions on the casings, allegedly fitting the weapon with a silencer, prepositioning himself for final surveillance, and ultimately, the attack.
Contagion and copycats. High-profile instances of targeted violence that receive intense media coverage can be the catalyst for follow-on violence in the form of copycat attacks and contagion. Contagion refers to the immediate period following a widely publicized attack, potentially lasting for several weeks, when the probability of a similar attack is more likely. There can be an increase in targeted violence events during this timeframe.
The term copycat refers to a more chronic risk that may extend months or years after an attack and involves the imitation of both the act and the attacker. Mass shooting contagion theory is the studied nature and effect of media coverage of mass shootings and the potential increase of mimicked events. Given the level of media attention this attack is receiving, copycat and contagion must be concerns for law enforcement, security, and threat assessment professionals.
Robin Hood Effect. There have been reports of social media posts empathizing with the shooter. The impression that healthcare insurers are heartless when making decisions regarding the payment of claims or approval for critical care can generate feelings of ill will, especially when an individual believes that they or a loved one was harmed by an adverse determination by the insurer.
In the context of medical malpractice suits, "ill will" refers to a situation where a plaintiff files a lawsuit against a medical professional not because they genuinely believe there was a medical error, but due to personal animosity or a desire to cause harm because the plaintiff feels harmed and sees no sense of remorse or compassion from the medical provider. This same concept extends to those making critical healthcare decisions, including insurers.
Many people have experienced frustration and anger with healthcare insurers and not only feel that decisions about coverage and payment of claims can be arbitrary and unfair, but also that insurers put profit for shareholders and lavish salaries for executives above the wellness of their customers. In this instance, the United Healthcare CEO’s was reported to have a $10.2 million annual pay package, including salary, bonus, and stock options awards. Individuals and families who may be struggling to afford healthcare insurance or who may be dealing with the high cost of care for a serious injury or illness can feel betrayed and mistreated when they believe the insurer is “nickel and diming” every line item on a claim while paying executives exorbitant salaries.
The Robin Hood Effect is an economic occurrence where income is redistributed so that economic inequality is reduced. That is a redistribution of economic resources due to which the economically disadvantaged gain at the expense of the economically advantaged. It can be more simply described as taking from the rich to give to the poor as a form of altruistic punishment. The impression that healthcare insurers and their executives are enriched at their expense by withholding care for the sick contributes to the sort of social media backlash and lack of empathy for the displayed for the victim.
From a clinical perspective, neuroscience research suggests a possible link between the neural circuitry of retaliation and strong cravings for revenge, especially in males. Researchers have found that the same reward-processing centers of the brain that activate for and are implicated in narcotics addiction also activate when people are delivering altruistic punishments—that is, willingly incurring a cost to punish others who commit perceived injustices. In non-clinical terms, this amounts to what the researchers have described as combating the sting of rejection with the pleasure of revenge. To feel abandoned by an insurer during a time of need can be experienced as rejection, potentially fueling the impulse for retaliation and altruistic punishment—increasing feelings that violence is justified.
The belief that violence against healthcare executives may be justified in the minds of those who feel that they or their loved ones have been hurt by cold-hearted, profit-driven decisions made by rich executives contributes to the Robin Hood Effect, which may serve as a threat multiplier for potential copycat and contagion in this situation.
Those charged with the safety and security of healthcare insurance organizations and their executives should be aware of these behavioral dynamics that can raise the risk of additional violence directed at the sector in the near-term.
Steve Crimando, MA, CTM, is an emergency behavioral health specialist and threat assessment professional. He is the director of the Homeland Security Human Factors Institute™, a division of Behavioral Science Applications LLC. He is a member of the steering committees for the ASIS International Extremism and Political Instability Community and the Human Threat Management Community. Crimando can be reached at the office of Behavioral Science Applications LLC at www.behavioralscienceapps.com or by email at [email protected]
