Saturday, March 10, 2018

Mental health & violence

There has been a lot of discussion lately about the role of mental illness in mass shooting/violent incidents. There is a portrayal that mentally ill people are prone to violence & that the people who perpetrate these crimes do so because they are mentally ill. The issue can be solved, the argument goes, by increasing funding for mental health services.

First, we absolutely need more funding for mental health services. However, we don't need it because people with mental illness are more prone to violence. We need it because it can be very difficult to lead a healthy, safe, fulfilling life when someone is suffering from untreated mental illness. So yes, please fund this area more!

However, the constant focus on mental illness as the reason people commit heinous crimes is unfair & inaccurate. It stigmatizes people with mental illnesses.

Anecdotally, my experience with violent crimes committed as a result of someone's mental illness has resulted in only two out of thousands of cases I have handled in 9 years. It's important to differentiate between violent crimes committed by people with mental illness versus violent crimes committed as a result of mental illness. It's entirely possible for someone to have a mental illness & commit a "violent offense & those two things not be connected. In those cases, it's not the mental illness that leads to the behavior.

Example of this difference: someone with bipolar disorder who burglarizes a house bc they know the homeowner has lots of money under the mattress & they want it. The decision to burglarize the home is not caused by the bipolar disorder.

In contrast, someone with paranoid schizophrenia is actively symptomatic & as a result of the delusions caused by the schizophrenia, they believe that their roommate is plotting against them to kill them. In order to protect themselves from the attack they believe is coming, they stab the roommate. In this case, the person's mental illness caused them to suffer from delusions that they believed were reality & they acted as a result of those delusions.

In the first example, while treating the bipolar disorder would likely benefit the person overall, it is not necessarily going to change the person's decision to burglarize the home, because the mental illness did not cause the behavior.

In the second example, if the person received treatment for their schizophrenia & were not suffering from delusions caused by that, they would likely not have stabbed the roommate, because the mental illness caused the behavior.

The second example is not something I have seen often in my 9+ years representing people accused of crimes. I can count on one hand the number of clients whose actions were a result of their mental illness. It's just not really common.

Often people can't imagine going into a school & gunning down first graders or setting a bomb to blow at a marathon, so the easy answer is "They're crazy!" No rational, sane person could do these things, the reasoning goes, so the people who do must be mentally ill. Society can't wrap its mind around a mentally sound person doing such atrocities.

But the truth is, it happens. Are these people who could benefit from therapy or other treatment interventions? Sure. But being an angry, bitter, resentful, or evil person is not the same thing as being mentally ill. Some people choose to do horrible things simply because they want to.

It's true that a chunk of these mass shooters/perpetrators of mass violence have been found to have a mental illness. But the inquiry should not end there bc it's possible to have a mental illness & commit crimes unrelated to the mental illness.

There is a lot of data that demonstrates people with mental illnesses aren't inherently more dangerous. It's easy to pin the problem of mass shootings/mass violence on mental illness. But it doesn't solve the issue. The term "mental illness" encompasses a wide variety of disorders. There have been calls to prohibit anyone with a mental illness from owning a firearm. Technically that would include people who deal with depression & anxiety, which are extremely common disorders. The issue is much more nuanced than simply prohibiting anyone with a "mental illness" from accessing a firearm.

We do need more funding for mental health resources. However, it is naive to think that if we simply treat people with mental illness & prohibit them from accessing firearms, this epidemic of mass violence will be fixed. It's not that simple.

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