Study: Mental Illness Alone is no Trigger for Violence

Posted by Mark Radulich on 02.05.2009

There are a slew of reasons people become violent and one of them is inadequate services.

I've been a social since 2000 and have been working in the mental health field since 2004 so I have a fair amount of experience dealing with both the mentally ill children as well as adults. My two areas of specialty are in fact substance abuse and child and family therapy. I've been asked on countless occasions why a particular child acts the way he does and each time the answer more complex than questioner was counting on. I've noticed, just through experience, that when children become violent it's because of a mix of problems: absence of a father, abuse at home, exposure to violence (at home or in the street), lax or inconsistent parenting, and exposure to drugs. There's no one predictor of violence in a child that can be legislated against. The answer to society's ills is simply that nobody should have a child until they are ready, there should always be two parents involved in that child's life and said parent's should not abuse the child (physically, sexually or otherwise).

The AP reports that:

A new large study challenges the idea that mental illness alone is a leading cause of violence. Researchers instead blame a combination of factors, specifically substance abuse and a history of violent acts, that drives up the danger when combined with mental illness in what they call an "intricate link."

People with serious mental illness, without other big risk factors, are no more violent than most people, according to the study of more than 34,000 U.S. adults. The research was released Monday in Archives of General Psychiatry.

"Mental illness can provide the knee-jerk explanation for the Virginia Tech shootings," but it's not a strong predictor of violence by itself, said lead author Eric Elbogen of the University of North Carolina at Chapel Hill School of Medicine.

It's really sad that it takes mass killing at a college for this country to give a crap about mental health issues. The reality is that in most families throughout this country (and the world most likely) people are dealing with mental health issues all of the time, diagnosed or otherwise. My mother suffered from Bipolar Disorder for years before she was actually diagnosed and treated for it. And then of course there's substance abuse treatment. Apparently the only way you can get it in this country is either to be rich or be ordered by a judge. For me, this is the money shot of the whole article:

"We are being misled by our own fears," said Columbia University psychiatry professor Dr. Paul Appelbaum, who wasn't involved in the new study. "We ought to be concerned about providing good treatment and helping people lead fulfilling lives, not obsessed with protecting ourselves from phantom threats that appear to be unrelated to mental illness."

U.S. systems to treat mental illness and substance abuse are separate, uncoordinated and could do a better job treating people with both problems, Appelbaum said.

This is a problem I confront every day. Many of my clients are dually diagnosed (they have a mental health disorder and are drug addicted) but we only treat the mental health disorder. If you need detox or substance abuse treatment, we send you elsewhere, which may seem OK on paper but is trying and often debilitating for the client. I remember one lady who suffered from Bipolar Disorder with psychotic features(she heard voices telling her to kill herself), who when confronted about her co-occurring alcohol addiction, got up and walked out the door vowing not to return. Instead of attempting to use a harm reduction model to help this women, we told her to come back after she went to detox. It takes an incredible amount of courage for most people to even walk through the door seeking mental health treatment but due to lack of funding, we continue to treat sick people like her as if they were dogs.

One more example of the flaws in our mental health system. If someone attempts to hurt himself or someone else (suicidal or homicidal intent) they can be forcibly admitted to a crisis stabilization unit here in our local county. They will spend usually up to three days and receive about a months worth of medication to treat their condition. However, no provisions are made for them to continue to see a physician in order to continue receiving anti-psychotics and mood stabilizers and so shortly after they run out of medication they are back in a CSU. This will typically happen 3 - 4 times before an outpatient doctor finally can see them for an evaluation. The reason is partly because mental health services are so underfunded but also because we don't have wrap-around services to make sure the clients needs are taken care of in a competent and caring fashion. We have isolated programs that act as islands, barely communicating with one another and usually adding to the suffering of sick people.

We can't solve the problem from the front because we simply can't stop people from having children in less than ideal circumstances. However, we could do a much better of providing wrap-around services so that those children (and adults) don't suffer at the hands of a callous and indifferent mental health and substance abuse system.