Monday, December 17, 2012

Mental Illness and Violence

Since I am not a clinical or counseling psychologist, I typically avoid discussions of mental illness. However, since I am a social psychologist who studies aggression, I do occasionally get questions about the potential link between "subject variables" such as mental illness and aggressive behavioral outcomes. The question has been again brought to the fore in the aftermath of the most recent gun-related massacre, since the young man who committed the mass murder appeared to have had a troubled life. My main concern is that this latest incident will merely perpetuate a stereotype of the mentally ill as "psycho killers" rather than lead to a much needed discussion of the factors that facilitate gun-related violence in the US relative to other nations.

Recently, a woman blogged about her own kid, under the title "I Am Adam Lanza's Mother: A Mom's Perspective On The Mental Illness Conversation In America". When someone close to me asked me my opinion of the article, I told her that I thought it missed the point. The author managed to make a number of assertions about her son's future as a potential violent criminal that I found quite harmful to the kid in question, and could amount to something of a self-fulfilling prophesy to the extent that her behaviors toward her kid (given her apparent attitude) likely betrays any of a number of hostile appraisal biases (in particular hostile expectancy and perception biases). That aside, the author makes an assertion about mental illness and violence that does not hold up under careful scrutiny. In essence, it would appear that having a mental illness is not in and of itself sufficient as a predictor of violence. One needs to consider other factors, such as socioeconomic status, age, substance abuse, etc. as well.

I want to close with some lines from "You Are Not Adam Lanza's Mother," as it expresses quite nicely a perspective that I share:

3)      The article complains about mental illness stigma while reinforcing it by explicitly tying it to violence, and in particular, mass killings. The reality is that there is no such observed link: “after analysing a number of killers, Mullen concludes, ‘they had personality problems and were, to put it mildly, deeply troubled people.’ But he goes on to add: ‘Most perpetrators of autogenic massacres do not, however, appear to have active psychotic symptoms at the time and very few even have histories of prior contact with mental health services.’” And most people with mental illness are not violent, although they are far more likely to be victims of crime (see here, for instance).

4)      The article, with this link established, implies a desire to stop violent crime allegedly perpetrated by those with mental illness should motivate better care and provision for those with mental illness, and not, say, the lower life expectancy, unemployment, isolation, suicidality, homelessness, victimization or in general the suffering endured by those with it. The continual disregard for this reality perpetuates stigma on all levels of society and further exposes those with mental illness to harm.

5)      Antipsychotics and antidepressants are not designed for children and most of them are not indicated for disruptive behaviour in children. Zyprexa, the prescription given to the child in the article, is not indicated for disruptive behaviour or autism in the US.  This sort of willy-nilly prescribing with little real knowledge of or regard for the long-term consequences, particularly for those whose brains are not fully developed yet, is potentially extremely damaging, and it’s not unlikely that a forever-changing cocktail of unwise psychotropic prescriptions contributes to worsening psychological problems. However, there is no criticism of psychiatric or pharmaceutical practice in the article: merely a cry for more of the same.

6)      You are NOT Adam Lanza’s mother. The sort of quasi-solidarity expressed in “We are [oppressed people]” or “I am [dead person]” appropriates the experiences of people who are unheard, in this case the victim of a mass homicide, and uses that to bolster a narrative that doesn’t even attempt to discover or represent the experiences of those they claim to speak for. Don’t do that.

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