Mental Illness and Violence: The Advocate's Dilemma

Posted on February 27, 2013

With the recent prominence of gun violence in the media due to the mass shooting at Sandy Hook Elementary School last December, we as mental health advocates are in a very precarious situation. The discussions resulting from this atrocity have centered around two topics: gun control and expansion of mental health services. While we may vary in our stances on gun control, increasing the public discussion about mental illness is every mental health advocate’s dream—unless the backdrop of that conversation is violent crime.

The uneducated public and the story-hungry media are quick to jump to conclusions about the mental health status of people such as Adam Lanza and others who commit these horrible crimes. They are quick to label these troubled young men as “mentally ill.” And perhaps they are. According to the National Institute of Mental Health, for a very small percentage of people—those with “episode[s] of psychosis, especially psychosis associated with paranoia and so-called ‘command hallucinations,’ the risk of violence is increased.” Co-occurring substance abuse or childhood antisocial behavior may increase the risk of violence. But the majority of people with mental illness are not violent.

Thus, when we use the risk of violence as a rationale for better and more available services for people with mental illness, we also put at risk all the good works we have done over the years to reduce the stigma surrounding mental illness. When we conflate mental illness and violence we do ourselves and our community a disservice.

For decades, Fountain House and other mental health organizations have fought to educate the public as well as the government about the causes and effects of mental illness - to challenge the myth that people with mental illness are violent, unintelligent, worthless, lazy, incompetent, and dependent. While we certainly know that some people with mental illness are prone to violence, we also know that some members of the general population are prone to violence for some of the same reasons. When factors such as substance abuse, being a victim of violence (physical or sexual), and poor school performance as a youth are present, the likelihood of a person committing a violent crime increases. These factors play a role whether or not a mental illness is present.

As advocates, it is our role to take advantage of every opportunity to engage the public in productive dialogue and agitate for more and better mental health services. But we must also weigh the cost of increasing our visibility in the gun control and violent crime debate. We must be cautious, like any social movement, that we do not let an extreme example represent our entire population and movement to the general public.

My diagnosis of depression does not make me a violent person. Most people with mental illness are not perpetrators of violent crime. As a movement, we must be sure to take hold of this opportunity to raise awareness of mental illness and push for improved funding and delivery of services. But we must be clear that we stand by our statement that people with mental illness can be and are productive members of society - that our communities are not put at risk by including people with mental illness in our schools, homes, and businesses, but rather enhanced and improved by the depth and breadth of the knowledge, skills, abilities, and talents we bring to the table.

Summer Berman
Michael Walther Executive Fellow, Fountain House


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