In the wake of the Sandy Hook massacre, the nation is frenzied about this heinous slaughter of innocents. Everyone is demanding answers. “More gun control!” “More background checks!” “More screening of the mentally ill!” If the media’s response is a correct indication, the nation is hysterically hyperventilating and not thoughtfully reflecting. For our fellow citizens with psychiatric disabilities, this poses a serious danger. Overwrought, careless, even reckless presumptions of an inexorable link between mental illness and violence only further stigmatizes an already unfairly marginalized minority in need.
Here’s an example. Earlier this week I was asked to sign an online petition on Change.org initiated by a Mr. Jason Eckker of Illinois. The intent was good: he wanted people to petition for more mental health care funding in light of the tragedy. As the parent of a loved one with a psychiatric disability, at first I naturally wanted to join. But a closer reading stopped me cold. I could not sign. Mr. Eccker’s introduction reflexively stated a stinging, stigmatizing untruth about people with psychiatric disabilities:
“However, almost all of the people who commit such a violent and senseless crime do so because of untreated mental illness.”[i]
No, no, Mr. Eccker, a thousand times no! Not all or even most who commit such crimes are people with untreated mental illness. Some are, but only a small percentage. Dr. E. Fuller Torrey, a leading expert on schizophrenia, estimates that only 1% of all 4 million Americans with severe psychiatric disorders, or 40,000, are potentially “dangerous” because they are not receiving treatment.[ii] But how many of these actually commit violent crimes of any kind? A reasonable conjecture is that only a small percentage of these 40,000 (maybe 5% or 2,000?) ever do. By contrast, according to the FBI there were over 14,000 homicides in the US in 2011.[iii] This difference between Mr. Eccker’s rash presumption and a reasonable conjecture about actual statistics suggests that we must take care with our public expressions about any presumed associations with mental illness, especially at such moments of understandable yet insufficiently informed public hysteria.
Those with mental illness bear enough burden without having to fend against society’s loathsome blanket associations. Rather than reflexive petitions in the heat of emotion, this is a time for judicious, dispassionate dialogue. A balanced, bipartisan Federal commission should review all the factors in a circumspect, thorough way without overweighting “mental illness”, since such overweighting further stigmatizes by presumption. (Hopefully, President Obama’s recently appointed Administration-insider gun-violence study team under Vice President Biden–unfortunately, decidedly not a commission–can and will really do so.)
What should be studied? Such a complex matter has so many considerations. We mustn’t reflexively demonize those with mentally illness. We mustn’t let the highly charged gun control issue distract from other essential considerations. If we are honest and refuse to buckle to hysteria, ideology, or political correctness, a thorough search for answers would include:
Culture and society, e.g., society’s utter saturation with violence in movies, video games, television, and the internet; possible consequences of erosion of respect for individual dignity and the sanctity of human life; our society’s infatuation with individualism, materialism, and narcissism.
Public health, e.g., insufficient funding for mental health services; possibly excessive reliance on psychiatric deinstitutionalization and community-based mental health treatment; shrinking availability of psychiatrists and other mental health providers; increasing polypharmocology and reducing psychotherapy in psychiatric practice; inadequate reimbursement rates in Medicare and especially Medicaid for psychiatrists, psychologists, social workers, and peer providers; lack of Medicare and Medicaid funding for evidence-based psychosocial supports like Supported Employment, Dual-Disorder Treatment, Family Psychoeducation, Assertive Community Treatment, and clubhouses; insufficient supported housing for those who need it; inordinate focus on cost-reduction by payors for indivudal procedures rather than value-maximization for patients over a continuum of care.
Ethics and morality, e.g., increasing societal stigmatization, marginalization, and discrimination against people with mentally illness; implications of unempathetic behaviors possibly arising from increasingly accepted utilitarianism and reduced protections for the weak and helpless, as inadvertently encouraged by legally permitted practices but politically controversial philosophies of “right-to-die” (euthanasia) and “right-to-choose” (feticide); reticence and confusion about capital punishment as the only just recompense for premeditated murder.
Psychiatry, e.g. continuing public ignorance about the distinctions between psychopathy, sociopathy, derangement, and mental illness; overuse of psychiatric medications in children and their possibly de-emphathizing effects; increasing evidence of lesser efficacy and greater long-term side-effects of certain psychiatric medications.
Psychology, e.g., the effects on boys of society’s demasculinization; the psychological impact of divorce, family breakdown, and father abandonment on young men; the long-term effects of severe emotional or psychological trauma at earlier ages; the underappreciated influences of “family systems” upon individual psychological development.
Law, e.g., overly strict privacy and civil rights laws that stymie information sharing and earlier access to psychiatric services; the impact of drug abuse and the contradictory implications of now legalized yet still psychoactive marijuana; the state of crisis interventional training of law enforcement; increasing societal acceptance of legal emphasis on individual freedoms over social responsibilities.
Spirituality and philosophy, e.g., the increasing secularization of society and its effects on character development in men; lessening societal acceptance of and belief in a transcendental ideal greater than the self; confusion and denial about the existence and nature of evil in the world.
After such a slaughter of innocents by a troubled loner, gun control should obviously be a concern. So should be the unbalanced shooter’s motivation and state of mind. But there is so much more that only these two factors. Our society must not jump to conclusions about a presumed inexorable link of mental illness and violence. Fearlessly identifying and following all the possible factors of this outrage to whatever truth they
lead is best way to serve the public’s interest—and better to safeguard and serve our brothers and sisters with mental illness.
[i] Retrieved from: http://www.change.org/petitions/us-federal-government-increase-the-availability-of-mental-health-services-now?utm_source=action_alert&utm_medium=email&utm_campaign=15486&alert_id=jIubrVUkkl_ZLwzvyvzaV
[ii] Torrey, E.F. (2008). The insanity offense. 2008, New York: W.W. Norton & Co., Inc.