Normally, I like to stay away from topical pieces, but I'd like to say thank you to a friend for giving me the courage to write this piece. What follows is something that needs to be talked about.
The idea for the article came to me when I heard someone in my clinic talking about their worries about this mental illness debate. He worried people will look at him sideways because he sees a therapist and considered dropping out of treatment. It broke my heart to hear this because it is the exact opposite of what we're trying to do as providers. We don't want less people to get seen, we want MORE people to access care.
We have only recently started accepting the fact that seeking out therapy does not mean you're "crazy", but now mental illness is back in the spotlight simply because people want to find a quick answer to a problem within our culture. It's easier to find the "other," the "outlier," the "quiet one," rather than ask ourselves tough questions and be ready for tough solutions.
Before going any further, let me make a bold assertion: Mental illness is NOT the reason why a person commits a crime.
I don't need to quote research, but I will:
In 2003, Heather Stuart published in World Psychology, that "...mental disorders are neither necessary, nor sufficient causes of violence," (213) and "... members of the public undoubtedly exaggerate both the strength of the relationship between major mental disorders and violence," (213). Lastly, "... substance abuse appears to be a major determinant of violence and this is true whether it occurs in the context of a concurrent mental illness or not " (Stuart, 213).
A 2009 study concluded a link between mental health issues and violence, but only for those with a co-occurring substance abuse condition. Even then, the researchers concluded that mental illness did not "independently predict future violent behavior." (Elbogen and Johnson, 152). I'm sure if I were to continue looking for sources, I would find similar results.
Though mental health issues can be a factor in whether a person goes down a dark road, that only comes after a long history of neglect, loss, poor treatment, or lack of access to care. The reality is that, in my practice, I have met far more people who are more likely to hurt themselves than to ever hurt another person.
The reasons for this are: boundaries and empathy. It takes a whole lot of disconnection from society for a person calmly put a plan together to hurt another human being. Most people can't stomach the idea of hurting someone in a fit of rage and so it takes a truly disordered mental state to put together a plot and plan then carry out that plan to hurt someone else, especially children.
And what's more is the fact that many people have aggressive thoughts. Yes, I am sure that everyone who decries the mental state of the Parkland shooter has had aggressive thoughts towards another human being. The difference between your thoughts and theirs is we don't act out on those thoughts because we have a well-developed system of checks and balances.
Namely, a conscience.
People with mental health issues haven't lost their conscience. They haven't somehow lost their empathy. However, there is a small percentage of the population who lack basic empathy or developed in such horrible conditions that they didn't learn proper socialization or impulse control.
I'm not judging those who latch on to the idea of mental illness as the sole reason why a person commits a crime because it's typical for people to want to know why someone did what they did and that need for answers is exponentially increased when it is a crime involving children
Here's the thing, though, people say "mental illness" as if they somehow know what this means. Say the words "mental illness" and I think many people will start to think about people who talk to themselves, hear voices, or perhaps they have seen images or heard stories about old-time insane asylums.
However, mental illness is a misnomer because it's not the flu. It's not cancer. It's not something you catch because you didn't wash your hands. Most often, a mental health issue is a normal response to the world around you, yet we define someone as "ill" because they experience something that appears different from the norm. Think of our vets or people with harrowing jobs that develop PTSD. Think of a friend or family member with depression or anxiety. Think of a mother experiencing postpartum depression. Think of people with phobias. These are all under the blanket term: mental illness.
Before decrying mental illness as the reason behind heinous crimes, please consider the damage being done to the mental health movement because in all likelihood it may make someone think twice before seeing a therapist.
1. Elbogen, Eric B. and Johnson, Sally C. (2009). The Intricate Link Between Violence and Mental Disorder. Archives of General Psychiatry.66(2) 152-161.
2. Stuart, Heather. (2003). Violence and Mental Illness: An Overview. World Psychiatry. 2(2) 121-124.