June 20, 2018
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Breaking down stigma of mental illness

Jill Toyoshiba | MCT
Jill Toyoshiba | MCT
Denise Baynham, left, has struggled with schizophrenia for most of her adult life; she hears voices that tell her to harm or kill herself. She is assistant director of Side, Inc., a peer-run organization that serves Wyandotte County, Kansas, residents with severe and persistent mental illness. She was recently elected president of the Kansas Consumer Advisory Council for Adult Mental Health.


As the nation continues to mourn the deaths of schoolchildren and educators in Newtown, Conn., it’s important for people everywhere to be aware of the facts surrounding mental illness.

Every time there is a horrific mass shooting, mental health professionals are caught in a serious dilemma. Clearly, killing innocent children and strangers is not sane. But research shows that people with mental health issues are not more violent than the general population. In fact, they are more likely to be the subjects of victimization.

As authorities learn more about what precipitated the Newtown tragedy, it is not helpful for the country to apply its anger to the mentally ill in general. It is important, though, to discuss — in a way that doesn’t add to the stigma already attached to people with psychological disorders — what makes someone more likely to act violently.

The conversation requires an examination of context. A small group of people with mental illness, especially those with severe and untreated symptoms of schizophrenia with psychosis, major depression or bipolar mood disorder, have been shown to have an increased rate of violence, according to several studies. But early and good treatment lowers a risk of violence.

In general, mental illness alone doesn’t incline a person toward violence. But the presence of other risk factors does make assaults more likely. Those factors include: a history of violence (whether the person has witnessed it or been a victim or perpetrator); substance abuse (whether of drugs or alcohol); and lack of a support system, including homelessness, poverty and inadequate housing.

Even among those who have mental illnesses and fall into these higher-risk pools, the general public is not likely to be the target of violence, according to the World Psychiatric Association. The most likely targets of violence are family and friends, and it usually happens in a private setting like a home.

Knowing the facts is important, not to lessen the unbearable tragedy in Newtown nor to comment about the shooter, but to prevent a widespread, negative reaction against people with mental illness — which would only make it more difficult for them and their families to get the social support necessary for treatment.

Discrimination against the mentally ill can have a profound effect. It can cause embarrassment and shame, leading those with illnesses to try to conceal their problems and avoid help. The stigma may prevent employers from hiring people with mental illnesses. And it may cause the public to not support funding for key services.

Medical treatment and therapy does work. People can manage their conditions and lead productive lives. But a key part of their recovery includes support from their family, friends and community. In fact, one approach that has had success is called Assertive Community Treatment. It uses a team of people, who might have backgrounds in psychiatry, nursing, social work and substance abuse treatment, to provide services wherever and whenever clients need them. Results have shown fewer hospitalizations and arrests, according to the National Alliance on Mental Illness.

It may be important to be aware of the small risk that comes with those who have certain mental illnesses and backgrounds of violence or substance abuse. But it’s not helpful for the general public to blanketly assume that the mentally ill are dangerous. As Richard Friedman wrote in a Journal of Medicine report: “Most people who are violent are not mentally ill, and most people who are mentally ill are not violent.” Avoiding those with mental illnesses, or seeing the illnesses as a social rather than biological problem, doesn’t engender the healing that is so desperately needed.

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