The subject title is long, but – I think – apropos.
The Treatment Advocacy Center’s post, “A classic case of shooting the messenger,” has been bothering me all day. I’ve been wanting to do further research on their claim that “patients with schizophrenia were 10 times more likely to engage in violent behavior than the general public.” Funny thing is, I didn’t have to look far.
The TAC links to a summary of the CATIE violence study and surprisingly, it contradicts the TAC’s post. I couldn’t help but chuckle once I realized I could easily debunk their claims from what they considered supporting evidence.
USPRA: “Violence is no more prevalent among individuals with mental illness than the general public”
Fact: The CATIE violence study found that patients with schizophrenia were 10 times more likely to engage in violent behavior than the general public (19.1% vs. 2% in the general population).
MY TAKE: “Overall, the amount of violence committed by people with schizophrenia is small, and only 1 percent of the U.S. population has schizophrenia. Of the 1,140 participants in this analysis, 80.9 percent reported no violence, while 3.6 percent reported engaging in serious violence in the past six months. Serious violence was defined as assault resulting in injury, use of a lethal weapon, or sexual assault. During the same period, 15.5 percent of participants reported engaging in minor violence, such as simple assault without injury or weapon. By comparison, about 2 percent of the general population without psychiatric disorder engages in any violent behavior in a one-year period, according to the NIMH-funded Epidemiologic Catchment Area Study.”
This data is a little skewed here. (CLPsych or Philip Dawdy could do a better job at clarifying this for me.) First of all, “about 2 percent of the general population without psychiatric disorder engages in any violent behavior in a one-year period.” How many people does this constitute? The sentence doesn’t specify ‘without schizophrenia’; it says “without psychiatric disorder.” That means Americans who do not suffer at any given time from depression, bipolar disorder, psychosis, anxiety, schizophrenia, obsessive-compulsive disorder, postpartum depression, and the list goes on and on. Can anyone compile complete data of Americans who suffer from a psychiatric disorder? (Why do I have the funny feeling that Americans without psychiatric disorders are becoming the minority?)
In the January 1994 issue of the Archives of General Psychiatry, results of the National Comorbidity Study were released. Diagnoses from the DSM-III were applied to the participants ranging from ages 15-54. The study found that 50 percent of participants reported “one lifetime disorder” and 30 percent said they had “at least one 12-month disorder.”
That was January 1994. The American population has grown significantly since then, so I have a hunch that there's an increase in diagnosing people with psychiatric illnesses. But like I said, that’s, uh, just a hunch. (Keep in mind that the study does not include children ranging from ages 4-14 who are likely to receive ADHD and/or bipolar diagnoses.)
Humor me: Let’s take the NC study’s findings and apply it to the current estimated U.S. population (assuming that the percentage of those with a lifetime disorder has remained the same). Out of nearly 300 million Americans (July ’06 estimate), that means about 150 million Americans have at least some form of a psychiatric disorder. If 1 percent of the general population suffers from schizophrenia, that comes out to 3 million people. If we apply CATIE’s violence percentages, TAC’s right; 19.1 percent of schizophrenic patients engage in violent behavior of any kind. However, the CATIE study also says that two percent of the general population without psychiatric disorder engages in violent behavior. That means out of the remaining 150 million, 2 percent of that would be —*drumroll please* — 3 million Americans! Maybe it’s just me, but doesn’t seem 10 times likely. I could always be wrong.
USPRA: “Public perceptions that violence is strongly associated with mental illness are fueled by graphic media reports of violent crimes.”
Fact: The media does not commit the violent acts. Public perceptions are formed by violent crimes spawned from the dangerous untreated symptoms of mental illness and USPRA should stop trying to intimidate the media into silence.
MY TAKE: The TAC has twisted the USPRA’s statement. Public perceptions are formed by violent crimes spawned from dangerous people. Mentally ill or not. Many defendants of violent crimes try to plead insanity; few of them are actually committed to an asylum as a result. If violent crimes were overwhelmingly committed by those who are mentally ill, asylums would be packed and jails would be barren. (There are issues with mentally ill prisoners not getting required mental health treatment, but that’s another issue.) The media are notorious for taking the truth, twisting it, and hyping the most dramatic result they can get out of it. The USPRA’s statement is not intimidation; it’s a wise word of caution to a sensitive matter that could receive public backlash. The issue here is to attract attention to reaching out to those who are mentally ill, not viewing them negatively. Sheesh.
USPRA: “it is incredibly rare for someone with a mental illness to commit gross acts of violence, especially on such a scale as the Virginia Tech shootings”
Fact: Yes, the scale of the scale of the Va Tech shooting is rare because sadly, this was a record. But, half of all “rampage shootings” such as the one in Blacksburg are committed by mentally ill shooters.
MY TAKE: This might sound sort of callous, but in my opinion, anyone who goes on a “rampage shooting” spree is suffering from a serious mental health problem. However, it doesn’t necessarily mean that person is mentally ill. Many of these shooters have unaddressed issues in their lives that spurs them on to follow through on these acts of violence. And unfortunately, many of these mass shooting sprees are carried out by adolescents. An excerpt from the Harvard Gazette:
“In general, we find that the shooters, they tend to be flying right underneath that radar screen," [Katherine S. Newman, dean of Radcliffe College] said. "They are rarely people who have no history of disciplinary problems, but they are also not the first kid that any teacher or principal would say, 'Oh, yes, I'm not surprised it was Johnny.' They're usually quite surprised it was Johnny.”
“USPRA should be ashamed!”
No, TAC, you should be ashamed. Get your facts straight. And if they’re not, at least cite your sources and make sure they reflect your viewpoint.