Tuesday, May 24, 18-year-old Salvador Ramos fatally shot nineteen students and two teachers, and wounded seventeen other people, at Robb Elementary School in Uvalde, TX.

As soon as the incident was over, everyone was asking the same question. How could someone do this? Was it evil? Or mental illness? Or both? That question dominated TX Gov. Greg Abbott’s May 25 press conference.

Abbott struggled to offer an answer. He confidently asserted that Ramos suffered from untreated mental health issues, and he consoled Texans that more mental health care will be provided.

But with equal confidence he said, “To begin with, let me point out the obvious, [that] evil swept across the valley yesterday. Anyone who shoots his grandmother in the face has to have evil in his heart,” Abbott said

Then back to mental health, Abbott said, “I asked the sheriff and others an open-ended question . . .  what was the problem here? And they were straightforward and emphatic,” he said.  “They said ‘we have a problem with mental health illness in this community’.”

And then, “Anybody who shoots somebody else has a mental health challenge, period.”

But as the press conference closed, Abbott circled back. “We talked about mental health,” he said. “To me, someone who is as demented as it takes to kill little kids, goes beyond, it seems to me, a mental health issue. That is the sheer face of evil itself. . . .Is there a difference between a mental health challenge that can be addressed and evil? I don’t know.”

Why the difference matters

Is there a difference? Yes, and it matters.

If we conflate mental health struggles with evil, we imply that mental illness is evil, or that it always leads to evil. That’s both inaccurate and dangerous. We risk, on the one hand, further stigmatizing people who struggle with mental health and, on the other hand, denying the existence of evil.

Knowing how evil relates to mental illness helps us understand what evil is and distinguishing between the two helps us better respond to both.

Was Jesus confused?

Liberal scholars of the 20th century conflated mental illness and evil. They usually dismissed episodes of demon possession in the New Testament as mental illness.

For instance, the Bible records Jesus casting out demons from a man who lived among the tombs. He couldn’t be restrained, tore his clothes, and wailed at night. The neighbors appealed to Jesus. He confronted the demons and cast them out (Mark 5:1-20).

But was the man demon-possessed or mentally ill?

Which is it, mental illness or evil?

Today’s naturalist diagnoses the man as being schizophrenic and claims that Jesus, as a man of the ancient world, simply did not know the difference.

But here’s the problem.

First, how could Jesus possibly not know the difference? I mean, c’mon. This is Jesus we are talking about. Would you truly entrust your salvation—your eternal destiny, your forgiveness of sin–to an incarnate God who cannot tell the difference between a demon and mental illness?

And worse, Jesus speaks to the demons! (See Mark 1:21-28). So, if Jesus so confuses a mental health crisis with demonic possession that He talks to the demon, what does that say about Jesus’ mental fitness?

But second, the Bible frequently distinguishes between Jesus healing and Jesus casting out demons. That’s right. The fact is, Jesus not only knew the difference, He exerted His authority over both demons and sickness in keeping with the priorities of His ministry (Mark 1:34).

Jesus knew the difference, and both evil and sickness, in all their manifestations, submitted to His authority.

What does the Bible say?

So, what does the Bible say about evil and mental illness, and what is the relationship between the two?

  • What does the Bible say about evil?

Start here. Evil is real.

Evil originated when Satan, a creature wholly given to motivating and generating evil, enticed the first people to misuse their free will by disobeying God (Gen. 3:1-5). Sin and death resulted, and now evil influences the practice of sin.

When people inflict evil on other people, scholars call that “moral evil.” From lying to murder to wars to riots to abuse, when humans consciously sin and when we inflict pain and suffering on other humans, that is moral evil.

But not only were human beings impacted by the first sin. All of creation was corrupted (Rom. 8:19-22). That corruption is manifested in “natural evil.” Cancer, earthquakes, mental illness and much more are the product of living in a world corrupted by human sin.

Jesus knew the difference between moral evil and natural evil, and He addressed them both (Luke 13:1-5).

  • What does the Bible say about mental illness?

Mental illness, like all illness, is the result of living in this fallen and corrupt world. And Jesus answers sickness of all kinds.

The Bible depicts Jesus healing people of various illnesses. And while specific stories are provided in the New Testament, the Bible often summarizes His healing ministry by saying that Jesus healed “every disease and every sickness” (Matt. 9:35).

The phrase “every disease and every sickness” can be translated “every kind of sickness.” That is to say, at one time or another in His ministry, Jesus healed every type of sickness that He encountered. That, we can safely assume, included mental illness.

He knew about it, and He treated the mentally ill with the same love and compassion He did those with physical illness.

  • So then, how are the two related?

Satan hasn’t changed. He is wholly evil, and he seeks to kill and destroy human beings (John 8:44, 10:10).

So, he capitalizes on our weaknesses. He exploits our tendencies to sin, our pride, anger, bad habits, and character flaws. And he takes advantage of our suffering and pain. Like physical illness, mental illness gives Satan an opening to entice people to sin and corruption.

He doesn’t cause mental illness, but he can contribute to how we perceive ourselves or act toward other people, even using our mental health challenges against us.

He is a liar, so he attacks the mind’s perception of the self (John 8:43-44). A person with mental illness may be more susceptible to lies that motivate paranoia, murder, and feelings of worthlessness and shame, to name a few.

Suicidal thoughts, depression, schizophrenia, and a host of other types of mental illness or issues related to mental illness are not themselves evil. But Satan can use them for evil. The broken mind can be fertile ground for the influence of the Evil One (1 John 5:19).

But the good news is—

But the good news remains the same. Jesus heals and helps those who are broken and in need of healing (Ps. 34:18). And we can wrap loving arms around anyone in need of help and healing and lead them toward freedom.

Just because someone is mentally ill doesn’t make them evil, capable of violence, or likely to harm others. But we need to be aware of the severity of mental illness and advocate for helping those in need.

And the Bible teaches we are all sinners first and foremost in need of salvation. All people are capable of evil against other people and of making sinful choices.

But the grace of God covers all. Isn’t that good news?