Alleged shooter Scott Thorpe circa 1989. (Submitted Photo)

They were after him and there was only one way to stop them - kill them.

Pick up the 9 mm Ruger and get in the Dodge Caravan. Drive. Have to end it.

Hurry. Get them.

Through the door at reception. Young woman.

Where is my doctor? Never mind. Too late. Shoot. Bullets explode through a glass partition, shattering glass and her life. Death.

Shoot. Death again. Shoot another, she falls.

Screams. People running. Slamming doors. Chair through window. A woman jumps and bones shatter on impact with the ground. Screams. Fast, fast.

This is Barbara Drew at Behavioral Health - This is an emergency - We're hearing gunshots out front in the lobby.

Poisoning him. He has to get them. Back to van. Hurry. Fast.

Nevada County Sam Eight - Notify Sierra Nevada (Memorial Hospital) we're going to have multiple casualties.

Pull up to restaurant. In the door.

Where is the manager?

Young man. Shoot. Death. Cook runs, shoot. He is down. Fast, hurry. Screams and running. Walk out. Go.

Someone is shooting at the Lyon's Restaurant on Nevada City Highway!

We have two shootings going on.

Drive home. Safe.

A gunman walked into Nevada County Behavioral Health Services in Nevada City on Jan. 10 and shot three people, killing two, at about 11:30 a.m. A fourth person broke her pelvis and suffered other injuries when she jumped from a second-floor window to escape.

Less than 10 minutes later and four miles away at Lyon's Restaurant in Glenbrook Basin, a gunman asked for the manager, killed him, and shot a fleeing cook.

Scott Harlan Thorpe, 40, was arrested at his Smartville home at 5 p.m. that day on suspicion of the murders.

He was examined by two psychiatrists and a psychologist to determine his competency to stand trial. Thorpe was found to be incompetent at present. He is paranoid, schizophrenic and delusional, according to the doctors' evaluations.

Thorpe was prescribed Risperdal, the newest and most potent anti-psychotic medication, psychiatrist S. Miles Estner said in his report to the court. Thorpe was receiving antidepressant and anti-anxiety medications as an outpatient at Behavioral Health services, Estner said.

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Potential spree killers walk among us. They are the headlines. They are also the vast minority of the mentally ill, say psychiatrists, psychologists and criminologists.

Lonnie Athens, Ph.D., a criminologist at Seton Hall University in New Jersey, has done extensive research and found no evidence that mental illness causes violent crime.

"Labeling violent people mentally ill does not make them violent," Athens said. "A paranoid schizophrenic may be violent, but every paranoid schizophrenic is far from being violent."

How the ones who kill became murderers is the subject of a vast ongoing study and debate.

A mentally ill person who kills does so with different motivations than someone who is sociopathic, experts said. The sociopath, or psychopath, is just plain evil, said Barbara R. Kirwin, Ph.D., of Huntington, N.Y. She is a clinical psychologist, a forensic expert and a commentator on "Court TV."

The psychopath is not mentally ill. A psychopath's behavior is not traced to his genetics, and he cannot be helped with medication. His actions are under his control.

"A psychopath will take steps to not be caught," Kirwin said. "Though basically lacking a conscience, (psychopaths) are able to conform their behavior to the law, but choose not to."

Ted Bundy, who murdered more than 30 women for his own sexual pleasure, was a psychopath. Jeffrey Dahmer, the Milwaukee sexual cannibal, was another, Kirwin said.

Violence results from a developmental process rather than a mental illness, said Athens. It is learned behavior. Violent criminals learn it will get them what they desire.

A delusional person will make a choice to use violence to achieve his ends. In his universe, the delusion is reality.

If a delusional person believes the FBI is out to get him and he is being poisoned, he may act on that delusion as if it were real. But, said Athens, to use violence, the delusional person must have gone through a degree of what he calls "violentization" - learned that violence will meet his or her needs.

Violentization can be ingrained by intimately familiar groups such as family, gang or clique. It is a process that goes on over time.

Athens' theories on violent behavior and mental illness contradict leading psychiatric theory.

A mentally ill patient - one who was delusional, not a morally devoid sociopath - who has committed murder has a "mental illness (that) substantially interfered with his ability to know and appreciate what he was doing and to know it was wrong," Kirwin said.

In a universe of delusion, experts say, a paranoid schizophrenic decides to kill because it is a way to stop the persecution he believes he is enduring.

Risk factors indicating a patient may become violent are a history of violence, threats and a belief violence is a solution, said psychiatrist Drew Ross of Hawaii.

A New York psychiatrist, Dorothy Otnow Lewis, who teaches at New York University's School of Medicine, believes there are three issues in the makeup of violent criminals.

A murderer, Lewis concludes from her research, has a genetic predisposition to psychosis, such as paranoia, and has had ongoing extreme abuse and severe head trauma.

Agreeing with Lewis, Nevada County psychiatrist Emmett E. Miller said, "I'm almost certain that people who do this kind of thing (spree murder) often have damage to the temporal lobe ... where we get our emotional control. This temporal lobe is located in the brain so that when there's a fall, or when you are hit, there is a tendency for this part to be damaged."

Athens further adds to the debate by saying, "Of course there is brain damage. Brutalization is part of violentization. You get hit a lot, your brain gets damaged."

Direct links between genetics, head trauma and mental illness are correlated. The links are there, but no cause and effect relationship can be definitively shown.

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They walk among us.

Psychiatrist Terry Kupers of Berkeley blames California's reinstitutionalization of the mentally ill by the government begun by then-Gov. Ronald Reagan in the late 1960s.

After mental hospitals were virtually emptied, community health centers where mental patients could be monitored and given the medications needed to fight delusions were supposed to take over. The centers were never organized. The budget for mental health services has declined ever since.

"A large number of mentally ill citizens are left adrift in the community, their safety net destroyed as social welfare programs are cut," Kupers said. "And a certain number get into trouble."

A very small percentage kill.

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