As the nation continues to mourn the deaths of schoolchildren and educators in Newtown, Conn., it’s important for people everywhere to be aware of the facts surrounding mental illness.
Every time there is a horrific mass shooting, mental health professionals are caught in a serious dilemma. Clearly, killing innocent children and strangers is not sane. But research shows that people with mental health issues are not more violent than the general population. In fact, they are more likely to be the subjects of victimization.
As authorities learn more about what precipitated the Newtown tragedy, it is not helpful for the country to apply its anger to the mentally ill in general. It is important, though, to discuss — in a way that doesn’t add to the stigma already attached to people with psychological disorders — what makes someone more likely to act violently.
The conversation requires an examination of context. A small group of people with mental illness, especially those with severe and untreated symptoms of schizophrenia with psychosis, major depression or bipolar mood disorder, have been shown to have an increased rate of violence, according to several studies. But early and good treatment lowers a risk of violence.
In general, mental illness alone doesn’t incline a person toward violence. But the presence of other risk factors does make assaults more likely. Those factors include: a history of violence (whether the person has witnessed it or been a victim or perpetrator); substance abuse (whether of drugs or alcohol); and lack of a support system, including homelessness, poverty and inadequate housing.
Even among those who have mental illnesses and fall into these higher-risk pools, the general public is not likely to be the target of violence, according to the World Psychiatric Association. The most likely targets of violence are family and friends, and it usually happens in a private setting like a home.
Knowing the facts is important, not to lessen the unbearable tragedy in Newtown nor to comment about the shooter, but to prevent a widespread, negative reaction against people with mental illness — which would only make it more difficult for them and their families to get the social support necessary for treatment.
Discrimination against the mentally ill can have a profound effect. It can cause embarrassment and shame, leading those with illnesses to try to conceal their problems and avoid help. The stigma may prevent employers from hiring people with mental illnesses. And it may cause the public to not support funding for key services.
Medical treatment and therapy does work. People can manage their conditions and lead productive lives. But a key part of their recovery includes support from their family, friends and community. In fact, one approach that has had success is called Assertive Community Treatment. It uses a team of people, who might have backgrounds in psychiatry, nursing, social work and substance abuse treatment, to provide services wherever and whenever clients need them. Results have shown fewer hospitalizations and arrests, according to the National Alliance on Mental Illness.
It may be important to be aware of the small risk that comes with those who have certain mental illnesses and backgrounds of violence or substance abuse. But it’s not helpful for the general public to blanketly assume that the mentally ill are dangerous. As Richard Friedman wrote in a Journal of Medicine report: “Most people who are violent are not mentally ill, and most people who are mentally ill are not violent.” Avoiding those with mental illnesses, or seeing the illnesses as a social rather than biological problem, doesn’t engender the healing that is so desperately needed.
Excellent editorial.
The problem is not just the stigma of mental illness — it’s the cost of treatment. Even if people *have* medical insurance, it covers mental illness differently and inadequately, if at all.
The Affordable Health Care Act is going to help with that.
Not the mention the ‘stigma’ among the public is being enhanced by their behaviors out on street with no supervision. The public has grown weary.
And I’m afraid if we continue on the path of this failed social experiment believing the magic pill could put some in the community as normal people we will have further stigmatized mental illness among the public’s perception.
So are you willing to help shoulder the costs of institutionalization in order to keep them “off the street with no supervision?” Because, of course, that is what would be involved.
I hear you. We have to get our priorities in line.
Removing psychiatric beds and hospitals for the last 60 years isn’t helping matters.
Too many with mental disorders find themselves in jails and prisons. Where their chances of getting real help for their disorders are next to nonexistant. They will be released back into socieety based on a sentence rather than on their medical recovery.
The cold hard reality is that 75% on the streets mentality ill and homeless need round the clock supervision. That percentage is a conservative estimate.
The other big worry if we revamp the traditional asylum up is what had happen since that ideal was enacted, and that was parents unloading their adult children in to the States institutions.
Obviously some had to because they could not control their behavior, but many more where simply dumped off and after a few years inside where even in worst shape.
But, never the the less we need to revisit the traditional asylums without all the horrors, and most importantly restore the rights to have someone committed.
As it stands now, they are dying a slow death out on the streets, without monitoring they will not take their med’s. And by the way those med’s. while horrible side effects in some cases do stabilize. The key is it sometimes takes years with a patient to figure out what works.
And then the problem of them mixing drugs and booze, and they all do it.
Certainly the only real problem is do we want to pay for it. I would propose that the public who has a mentality ill relative who needs that asylum help pay for it. This will also help curtail those just dumping them off because they ran out of energy.
They could be educated in the home environment in how to deal with some of the mental illness’s and also making sure they are in fact taking their medications. And perhaps help then financially to do it, and that could very well be a cost saving in the long run itself.
“The cold hard reality is that 75% on the streets mentality ill and homeless need round the clock supervision. That percentage is a conservative estimate.”
Citation, please.
14 years living on the streets, how’s that for a citation.
Now, here is another sad tale, we are creating ‘mental illness’ in this country. The ones I mention where genetically prone, and waiting to blossom and get triggered.
That’s not a valid citation.
Yes, you’re right. There are many people out there genetically wired with a potential mental illness-just as we are for cancer, autoimmune, and other diseases. There are many theories that suggest stressful triggers in a person’s life can manifest these diseases, such as the stress of homelessness, poverty, abuse, neglect and sometimes even divorce or the death of a loved one. Some of us have just been lucky.
You are absolutely correct, which is why we need reform to help get these folks off the street and into their own homes, into jobs, with regular healthcare to include medication monitoring and counseling. The problem isn’t as easy as some make it sound. Our economy, our views as a society that these folks are somehow not ‘worthy’….all of this contributes to the problem in ot getting these folks back on their feet. There are those who do not have the capacity to help themselves, and we as a society owe it to them (yes, I said OWE) to help. Just as it would be appalling if we ignored and left young children, helpless and immature, to fend for themselves, how is it we can expect someone who’s brain isn’t functioning to capacity to do the same just because they’re in an adult body?
Apparently the BDN’s Editorial Board has a problem so here we go again. The BDN’s editorial all but calls for the openly labeling anyone that is either a witness, or a victim, of a violent crime as legally mentally ill. By what right does BDN call for such blatently illegal and dangerous policy’s to be made into Maine public law ? This type nonsense has happened before, both here and in WW 2 in Germany and Japan, and lead to some of the worst abuse’s of civil law and society’s norm’s seen. The mere fact that by declaring anyone mentally ill, and having the accusation stand as so-called ‘proof and evidence’, is both beyond offensive and clearly violates any standards of civil right’s as called for under The Constitution. It also opens up another serious issue, that being abuse of civil right’s and abuse fo the Court’s, when these type accusations are used as so-called proof of incompetence in family law and estate / guardianship of asset’s case’s, and especially in elder abuse case’s. How many such civil guardian ship case’s are likey to rise out of this nonsense before someone says ‘Enough !’ and takes the State to Court and gets this stopped ? BDN should know better and act responsibly, not by blocking anyone that has a differing viewpoint on such a painful, by highly relevant and discussion needed, topic. That they don’t like getting called out on their own OP-ED page is bad enough. But to use that page to stifle public comment on such a topic, in such a hghly charged atmosphere, should tell us all just how close we are to going over the edge again. After all, how many victims or witness’s were ther to the Twin Tower’s ? BDN’s policy now has a more frightening view, doesn’t it ?
You appear to have read quite a different editorial than the one preceding these comments…
Oh, and please learn how to use an apostrophe correctly.
Go get a life, or at least get off your high horse and find out what the real world has to go thru on a daily basis, not your Mtt and Paul Wonderland Show where everything is handed to them by a bunch of aXXkisser’s and straphanger’s. The mentally ill need help and treatment, not being labeled as some kind of nut that needs to be locked up just because they see things differently. BDN seems to think that by hiding their position in a bunch of words that no one can read thru the words and see, and hear, the actual message they are giving. Segregating the ill because they make some feel ill at ease is just something that we as a society is going to have to accept and get over if we are ever going to deal with the mentially ill in a responsible way. The alternative is to treat the mentally ill very much like the AIDS folk’s ALMOST WERE when there were calls for there segregation into ‘Special Facillities’.and treat them like some kind of boogyman. Society managed to get over AIDS and the Screaming Chicken attitude. The mentally ill deserve no less.
Uh, do some homework on my position on these issues. It won’t be hard to find. You’re reading between the lines of this editorial when there’s nothing to read other than what is actually there.
Very important article that everyone should read. People forget that the brain is an organ just like any other in the human body. We may think and reason and feel with it, but we certainly cannot always control it. We can’t ‘will’ a heart to not have heart disease. We can’t ‘will’ a pancreas to work if it has failed, resulting in diabetes. Those with mental illness would rather not have the disease. Look how scary some of these disorders sound! Understanding and support for those afflicted is what is needed so that those who need treatment will not avoid it for fear of retribution from employers or judgement from others.
What a money racket.. over prescribing …who knows what mess mental illness has become.
While this editorial is well-meaning (probably in response to NAMI feedback on yesterday’s editorial), I worry that the result will be to once again put this issue on the back burner. If violence perpetrated by a psychotic person is statistically insignificant (happening, as it does, rarely and usually in the person’s home), why should society act to prevent it? The relatively few people who die at the hands of a psychotic are something like “collateral damage” in this war to retain our gun rights, civil rights, etc. NAMI’s job is to protect the majority of the mentally ill–those who respond well or fairly well to the various treatments available–by constantly telling us the mentally ill are no more violent than any other group and that what they need is (mostly nonexistent) community-based care and (often completely ineffective) drug therapy. It is small consolation to me, as I could well become “collateral damage” in this struggle, where (PLEASE BELIEVE ME) there are no good options for the seriously psychotic mentally ill. If you don’t believe me, please read “I am Adam Lanza’s Mother” at http://thebluereview.org/i-am-adam-lanzas-mother/ , along with some of the nearly 2,000 comments that follow it. I am Adam Lanza’s mother, too, and, as much as I’d like to protect you all, I can’t do it alone.
Hold on. Mental illness and “psychotic” are not necessarily the same thing. Psychosis is a severe condition in which a person loses touch with reality with the senses through hallucinations, mostly auditory. But psychosis is a hallmark of schizophrenia and in extremely severe cases of manic-depression. (It can also happen in major depression, but it’s rare.) “Mental illness” is no different from saying “physical illness,” in which you could be referring to everything from a foot ailment to a heart ailment to kidney failure, etc.
Too often, people lump “mental illness” into one illness and automatically think of someone who experiences psychosis.
I completely agree with you: most mentally ill people are not psychotic. However, all psychotic people are mentally ill and the mildly, or manageably, mentally ill are not the ones killing people. What I often hear in the media these days is that ALL mentally ill people respond to a combination of support and medication. It’s just not true. So what remains for us to figure out is what to do with those who do not respond to current treatment regimens. We’re failing to address that. Should we continue to accept what happened in Connecticut because, statistically speaking, it doesn’t happen that often? Or should we really try to come up with strategies that will help?
Bah- Humbug!
I do appreciate this article but we need to seriously consider keeping beds open at DDPC and across the states. If the known dangerous psychotic patients are going to refuse there medications then they need medications over objection. Too many mass shootings ( is this a matter of being non compliant with meds.Who knows .Most likely yes.) Again this statement is for the percentage of patients who refuse to take their medications and cannot be managed in a community setting.
“If the known dangerous psychotic patients are going to refuse there medications then they need medications over objection.”
That would require a court order. And the only way a court would agree to force medication on a patient is if an examining doctor can show the patient poses an immediate danger to himself or others.
WHICH the doctor couldn’t do unless the patient had already threatened or injured self or others. Catch 22.
Some brave doctor somewhere might risk a malpractice suit by attempting to predict future behaviors without any past record, but bravery and stupidity sometimes go hand in hand.
Yes, we need to reexamine criteria for involuntary treatment; it can’t just be immediate danger because too often once that point is reached, it’s too late to prevent acts of violence. But the real key is what happens after medication and release. It’s not enough to stabilize and release; there has to be real support after that point–for patients, family members and the community members surrounding the affected individuals. A psychotic person, even a stabilized one, probably needs someone with them or near them all the time. That might cost less to society than the price we’re paying now.
I agree.ACT……..
You folks seem to believe that once a violent psychotic patent is on medication than that person no longer poses a threat. A human is not a car where you can just install some trans medic and go. Sometimes the medication doesn’t work, and sometimes it works just fine for a number of years, then just stops working.
And thats why we have an ACT Team or inpatient for med adjustment. I am certainly not a proponent of pill pushing. (maybe u need to watch the movie Beautiful Mind)