The Help That Came Too Late: Another Look At Mental Illness In Violence
I have survived child and sexual abuse, abandonment, rejection and ostracism. I have been an outcast amongst loved ones and associates. And, for a short period of time in my youth, I was institutionalized for threatening to commit suicide because of the experiences I endured.
I am well acquainted with the shadowy depths of the mind—anxiety, loneliness, depression and rage. In my despondency, pain evolved into anger, and then bitterness formed into hatred. On more than one occasion, I imagined exacting revenge upon those who abused and took advantage of me. In those moments, I saw few options to assuage the pain and anger that I raged within me.
Eventually, I sought clinical intervention—inclusive of therapy and medication after receiving counsel from a friend. I also declare that it was the peace of God that prevented me from harming myself and others. When there was no one to talk to or the medication depleted as I lost my grip on reality, I prayed. But many mentally-ill people are not receiving clinical help, support or spiritual guidance from their family and friends, or the surrounding community in which they are embedded.
For the sake of this discourse, let’s define the term, mental illness. The Mayo Clinic (n. d.) describes mental illness as a “range of mental health conditions or disorders that affect a person’s mood, thinking and behavior.” As the American Psychiatric Association explains, “mental illnesses are associated with distress and/or problems functioning in social, work or family activities.”
There is a sub-population of people, who believe that mental illness is a “hoax” or a human-engineered phenomenon. Such beliefs project from an uneducated and uninformed mind. Scientific Investigation into cognition and behavior commenced well before advancements in technology, and thus, challenges the notion of conspiracy. As someone who has experienced mental illness, I can confirm that psychological abnormalities are real and are socio-environmentally impacting.
Are people giving much thought to the maelstrom of emotions that develop from living in dysfunctional households, child or sexual abuse, child abandonment, rape and other traumatic events? How many people realize that emotions do not simply vanish into a void within the brain never to emerge again? Whether repressed or expressed, emotions manifest in behavior.
Technology transports data real-time, allowing us to access information virtually anywhere and at any time. Given the convenient accessibility, it seems that violent crime is increasing daily. Upon criminal investigation, some cases are found linked to mental illness. Either the perpetrator ceased taking their medication, lack support from social networks, or they never sought clinical diagnosis, enabling the disorder to rage uncontrolled.
The reality is that some people are psychotic and may classify as clinically-insane. In contrast, others exhibit abnormal behavior or psychotic tendencies that with proper care and management, can be overcome. Knowledge and active involvement are necessary to identify the differences and achieve more positive outcomes.
In researching the role of mental illness in violence, Stuart (2003) asserts, “mental disorders are neither necessary nor sufficient causes of violence, whereas substance abuse is a major determinant of violence whether it occurs in the context of concurrent mental illness or not.” According to a MacArthur Violence Risk Assessment Study, “31% of people who had a substance abuse disorder and psychiatric disorder, committed a least one act of violence in a year compared with 18% of people with a psychiatric disorder alone” (“Mental Illness and Violence”, 2011). Other studies challenge these conclusions. For example, in the Fazel et al (2014) study that “examined 24,297 patients with schizophrenia and related psychosis in Sweden, 10.7% of men and 2.7% of women were convicted of a violent offense” (“Risk Factors For Violence”, 2016). Miller (2017) states, “only 3 to 5 percent of all violence, including but not limited to firearm violence, is attributable to serious mental illness.”
Despite Miller’s conclusion, “2 million people with mental illness are booked into jails each year—15% and 30% of men and women for non-violent offenses” (National Alliance on Mental Illness”, n. d.). NAMI notes that during incarceration, mentally-ill patients are not treated for their disorders, which worsens their condition. Living behind bars is challenging enough, given inadequate protection against abusive inmates, overcrowded jail cells, poor circulation, and limited clothing and food sources. The probability of re-arrests and subsequent convictions double.
Based on the research data, it can be inferred that the potential for violence scales in respect to the severity of mental illness, particularly schizophrenia. This inference raises the question, how many cases of schizophrenia or any other type of psychosis are being diagnosed, especially when such evaluations are contingent upon clinical intervention? In absence of adequate diagnoses, it is impossible to determine with complete accuracy whether a person ails from a mental disorder. It is probable that many cases in which mental illness was a factor in violent behavior do not reference thorough evaluations of the perpetrators’ disposition.
Insufficient and inconsistent documentation of mental illness in criminal offenses partially account for the variances in research studies examining the relationship between the two variables. Actual studies are typically based on data obtained post acts of violence. How much consideration is given to the potential for violence to occur under the right conditions? Do many believe that proactivity is unnecessary?
Regarding substance abuse and the influence thereof, it is necessary to evaluate its precursors. Traumatic experiences (i.e. abuse, rape, domestic violence, abandonment, rejection, etc.) may trigger alcohol and/or drug use in some victims as they attempt to self-manage negative emotions (i.e. anxiety, depression, etc.) triggered by the event. Dependency on alcohol and/or drugs develops gradually from the victim’s reliance on the temporary “relief” produced by the substance. Such behavior is a result of educational deficiencies regarding the effects of using drugs or alcohol, in addition to the mismanagement of emotions, which enable unhealthy and destructive thoughts to direct behavior. Dependency fails to create permanent relief, causing substance abusers to become increasingly emotionally unstable and erratic. If untreated for emotional instability and substance abuse, a person could “snap” and perpetrate violence on themselves and/or other people.
While mental disorders do not account for all instances of violent crime, the outcomes are no less disturbing. Violence is a serious matter. Just one instance is enough to produce a wide range of effects in the lives of people and surrounding environments. The pain and loss caused to victims and families of the victims are heartbreaking.
Addressing the role of mental illness in violence and crime constitutes one aspect of the complex problem. If you know a family member or friend, who may be mentally ill, accompany them on the journey to receive clinical intervention. Provide encouragement and support throughout the process. As a recommendation, refrain from agitating and belittling persons with mental disorders, because these negative behaviors only worsen the existing psychological problem.
American Psychiatric Association. (n. d.). What Is Mental Illness? Retrieved April 7, 2019 from https://www.psychiatry.org/patients-families/what-is-mental-illness.
Mayo Clinic. (n. d.). Mental Illness. Retrieved April 7, 2019 from https://www.mayoclinic.org/diseases-conditions/mental-illness/symptoms-causes/syc-20374968.
Mental Illness and Violence. (2011). Retrieved April 7, 2019 from https://www.health.harvard.edu/newsletter_article/mental-illness-and-violence.
Miller, J. (2017). Gun Violence and Mental Illness: Myths and Evidence-Based Facts. Retrieved April 7, 2019 http://www.amhca.org/blogs/joel-miller/2017/10/03/gun-violence-and-mental-illnessmyths-and-evidence-based-facts.
National Alliance on Mental Illness. (n. d.). Jailing People With Mental Illness. Retrieved April 7, 2019 from https://www.nami.org/learn-more/public-policy/jailing-people-with-mental-illness.
Risk Factors For Violence In Serious Mental Illness. (2016). Retrieved April 7, 2019 from https://www.treatmentadvocacycenter.org/evidence-and-research/learn-more-about/3633-risk-factors-for-violence-in-serious-mental-illness.
Stuart, H. (2003). Violence and Mental Illness: An Overview. Retrieved April 7, 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525086/.