With the rest of America, I watched in horror as details emerged on the shootings at Sandy Hook Elementary School in Newtown, Connecticut in December. Even though I know better, I’ll admit that the thought crossed my mind: “How can a sane person brutally murder so many fellow humans, especially innocent children and educators?”
I know better because I understand that violence is not associated with “insanity,” i.e., mental illness. I know it is as absurd to say, “People with mental illness are violent” as it would be to say, “People with diabetes are violent.” People without mental illness commit 96% of the violent crime in America. Research consistently shows that the two greatest risk factors for violent behavior are being male and being young.
I know better because data show that the rate of persons with mental illness who commit violence is no higher than the general population’s rate of violence. After eliminating confounding factors, the MacArthur Violence Risk Assessment study published in the June 2003 World Psychiatry concluded that the rate of violence committed by non-substance-using persons with a major mental disorder is the same as the rate for the non-substance-using general population. For some mental illness conditions, it is less. Substance abuse, however, does increase the risk of persons from both groups engaging in violent behavior.
Contrary to pop culture depictions of people with mental illness, I also know that this group is more likely to be victims of violence rather than perpetrators of it. A recent study of criminal victimization of persons with severe mental illness showed that 8% were victimized over a four- month period, much higher than the annual rate of victimization of 3% for the general population.
But facts and data aren’t enough to shape our national conversation after Sandy Hook. The public debate following the shooting has largely implied that people with mental illness are more likely to perpetrate mass murder and, therefore, the public must be protected from them. This approach is appalling because it is both inaccurate and unfairly stigmatizes people with mental illness. By misplacing blame, the public is misinformed about actual risks and distracted from pursuing more effective strategies for reducing violence.
I can understand people’s attempts to explain why the shooting occurred, as part of their attempt to feel safer or to find a simple explanation for an unimaginable tragedy. One simplistic strategy often used in these types of situations is to describe the violent perpetrator as a member of “another group.” It is an “Us” vs. “Them” mentality. However, in this case, the “Them” actually is highly likely to be “Us.” Over the course of our lifespan, half of Americans will meet the criteria for a diagnosis of a mental health condition. Obviously, being diagnosed with a mental illness will not make any of us suddenly more likely to commit a violent act.
Even though much of the post-Sandy Hook public policy debate has been muddled, one positive aspect of the discussion is the support for an influx of new resources for mental health services. I applaud this much-needed expansion of treatment, recovery, and prevention services for mental health. However, the mental health discussion related to violence would be more productive if it focused on advocating for immediate access to mental health services for the victims of trauma and the communities where violence has occurred. From MeHAF’s work to integrate behavioral health with primary care, we know what a positive difference timely access to mental health services in environments that reduce stigma can make.
Let’s keep our focus on the facts after the Sandy Hook tragedy and not further stigmatize people with mental illness. Our health care system—and society—has a vested interest in improving mental health services so people become healthier as we reduce the impact of trauma on mental health. It’s a policy recommendation we can all support.
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