Emotional Health

Stop Blaming the Mentally Ill

A raging debate continues about the factors that contribute to the epidemic of mass shootings in this country. Those who say that the fault lies with the mental health system are ignoring the fact that the vast majority of people suffering from psychiatric disorders are not prone to violence. In fact, they are consistently more dangerous to themselves than to others, and many suffer flat affect and low energy that contribute to an inability to act, either positively or negatively.

The severe kinds of mental illness, which render the victims psychotic, often rob them of their sense of agency as well. This is especially true of schizophrenia. Contrary to popular belief, the “schism” referred to in the name of this illness does not mean the individual suffers from a “split personality.” There are cases of “multiple personality disorder, now called Diffuse Identity Disorder (DID). The split in schizophrenia is between the patient and his affect, or emotions, and his relationship to reality. These people usually have delusions (ideas that are divorced from reality) and/or hallucinations, usually auditory. These symptoms rarely take the form of violent ideas about others. On the contrary, these patients usually hear voices that are directed against themselves. When you see a “crazy” person yelling on the street, chances are he is responding to persecutory voices that are attacking him. Victims are often very frightened and intimidated by these voices, and feel powerless to overcome them.

Symptoms can be controlled with the use of antipsychotic medications, though. The medications have powerful side effects, including lethargy and weight gain. They also leave the patient with what are called “deficit” symptoms. As opposed to the “active” signs of schizophrenia, these include flat affect, or emotions, and a lack of personal agency that make it hard for the sufferer to make decisions and take action. A person whose illness is controlled by medication is actually less likely to act on violent impulses than the average “healthy” person. According to The New York Times,  “In an analysis of 235 mass killings, many of which were carried out with firearms, 22 percent of the perpetrators could be considered mentally ill. Overall, mass shootings by people with serious mental illness represent 1 percent of all gun homicides each year, according to the book “Gun Violence and Mental Illness” published by the American Psychiatric Association in 2016.” Put another way, the other 78 per cent were NOT considered to be mentally ill.

People who suffer from depression, another major group of people diagnosed as mentally ill, don’t pose much of a threat either. Largely understood as anger turned toward the self, depression rarely causes a person to be violent. Sufferers usually experience low energy, feelings of uselessness and worthless, and indecision, among other things.

Again, a “healthy” person has access to more energy, agency, and aggression than a depressed one, in general. On the other hand, one could argue that a mass shooting is in itself proof that someone is ill, and perhaps new diagnostic criteria can be found to help diagnose and treat these individuals. There is no question but that something is “wrong” with them, though often it is not mental illness as we usually understand it.

The fact is that mental illness can cause violence, but access to guns is by far the bigger factor in predicting mass shootings. According to John T. Monahan, a professor specializing in psychology and law at the University of Virginia:

“Two things typically happen in the wake of a mass shooting. First, politicians claim that mental illness is the major cause of violence in America. Then, advocates for people with mental illness respond by denying there is any relationship whatsoever between mental illness and violence. Both groups are wrong. Research shows that the association between mental illness and violence is not strong, but it does exist.”

 

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  • Jessica Heriot, Ph.D. March 1, 2018 at 11:38 am

    There have always been and there will always be mentally ill people, most of whom are not violent. It’s the access to guns that is the problem.

    Reply
  • Grace Graupe-Pillard March 1, 2018 at 9:25 am

    Thank you for this article which I shared on Facebook.

    Reply