Tuesday, January 11, 2011

Violence and Mental Illness: NOT Automatically Connected

Sometimes, when you are talking over the news of the day with someone, a whole side issue comes to your mind. It was during such chat with a friend that the topic of violence and mental illness came to mind.

Now, I have to remember that being a health care worker in the acute setting means that I see the worst of the worst--people at their most acute and sickest. Even then, while there is violence in the ER and elsewhere in the hospital, most of it is related to illicit drug and alcohol abuse and the inappropriate use of prescriptions. Studies have shown that the majority of the mentally ill are mainly dangerous to themselves, as they engage in self harm behaviors and suicide attempts.

The things that attract news coverage--the man biting the dog that gets eyeballs and internet hits--they are the very worst actions the mentally ill can do. Like the schizophrenic man in New York who pushed a woman to her death in the subway. (Google Andrew Goldstein and/or Kendra Webdale if you are not familiar with the case.) In a way, it is amazing that most people who struggle with mental illness are just trying to cope, trying to get from one day to the next in their lives, do not have violent episodes and most do willingly seek help when things are spinning out of their control. I wish I could tell you about every patient who looked me in the eye and said, "I want help, I'll do whatever you need me to do, I'll wait, I'll get blood drawn, I'll pee in the cup. I know it's the right thing for me to do." Even patients with very distressing symptoms such as hearing voices or feeling paranoid will sit still for the slow hospital machine to move so they can get the help they need.

So here is my message, and hear it please. The majority of people with mental illness, even the mental illnesses considered most acute and severe--schizophrenia and bipolar disorder (manic depression)--are NOT violent and NOT to be feared.

They are just folks, looking to make their way through life as best they can. Most of them can use a friend, someone to talk with, someone who is not afraid to sit by them in public, someone who will greet them at church or at the store. They have a chronic problem that sometimes has acute crises. This does not make them any less human or, to put it theologically, any less of God's loved creation.


Ann T. said...

Dear The Observer,
Thanks for de-linking violence and mental illness. I do think they can be related, but are NOT NECESSARILY related. And it drives me nuts! (but not to violence)

It is part of instinct, a part of our survival, to be in the food chain (kill or be killed--even vegetarians kill Something).

How we control it has been a progress of millennia. Both sane and insane are coded for it. Just as most sane people are not murderers or assassins, most insane people aren't either.

Ann T.

chuck said...

Good read.


Bob G. said...

I'm going to echo Ann's sentiments here.
I've known people who worked with clients in special facilities, and any violence encountered was self-directed.
There were the infrequent times when they lashed OUTWARD (upon staff members), but that wasn't the norm.

It's the sociopaths and psychopaths we have to keep that eye on if they have been diagnosed with severe mental illness with violent tendencies.

Trying to get those that NEED help, but manage to fly under the radar is the real challenge.

Also, given the proper set of circumstances (motivation or impetus), ANY one of us can be quite capable of exhibiting similar behaviors as those that are institutionalized or incarcerated.

Most of us just tend to have help controlling it and keeping that "creature" within us in it's place.

Excellent post.

Stay safe out there.

the observer said...

Ann T:
I just thought it important that it be stated clearly that most people with mental illness do not commit acts of violence.

What happened in Arizona has the potential to make the problem of stigma even worse, which has implications for seeking treatment.

Bob G:

That stigma is indeed a discouragement to seeking treatment. The whole issue of getting folks treated is a complex topic, with civil and human rights implications...

Good comment!

Thanks! :-)

The Observer