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Home: Articles: Dallas Morning News: Violence Disputed

Association Between Violence, Mental Illness Disputed

By Tom Siegfried and Sue Goetinck

When an ex-mental patient commits a crime, headline writers always notice.

News accounts rarely say if a murder suspect has diabetes or cancer, is a vegetarian or Episcopalian. But any sign of mental illness - say, a bottle of antidepressants in the Unabomber suspects cabin - jumps to the top of the story.

High-profile crimes involving mental patients - from John Hinckleys attempted assassination of President Ronald Reagan in 1981 to the murder of two nuns this year in Maine - reinforce the notion that mental illness equals violence.

But some studies show that people with mental illness are no more violent than people in general. And studies that do show an elevated risk of violence find an increase no greater than the difference in violent tendencies between men and women, or teen-agers and adults.

"If you want to protect yourself from violence, you would do just as well to avoid men and teenagers as you would to avoid people with mental illness," says Bruce Link, a psychiatric epidemiologist at the Columbia University School of Public Health in New York.

Drug and alcohol abuse are much more likely than other mental illnesses to be linked with violence, new data indicate. Furthermore, research shows that aggressive community treatment-prevention programs result in low repeat offense rates for mental patients who do commit crimes. Such programs require additional funds for social service agencies up front, but far less than the money spent to process repeat offenders through the criminal justice system, says psychologist Sheilagh Hodgins.

"Mental health professionals do know what to do in order to prevent violence, but they have to have the resources to be able to do that," she says.

Yet, mental health advocates say, the misperception of the mentally ill as violent and dangerous diminishes support for such social services.

"There's only so much of the social service pie, and the stigma and misunderstanding about mental illnesses...enables a lot of neglect," says Michael Faenza, president of the National Mental Health Association, based in Alexandria, Va.

Impressions from headlines contribute to the stigma and neglect, Faenza believes. But research tells a different story, showing that major mental illnesses add little to the nations violence problem.

"Mental illness is a very small contributor to overall levels of violence," Link said in Baltimore at a recent meeting of the American Association for the Advancement of Science. "It is sensationalized and vastly overemphasized in media reports."

Link and colleagues recently conducted a large-scale study of mental disorders and violent behavior in Israel. Nearly 5,000 citizens were interviewed to determine psychiatric data and the incidence of violence. The findings there were similar to those in a previous study in urban areas of the United States: Somewhat higher rates of violent behavior, such as fights or weapon use, among people who have been treated for or diagnosed with mental disorders.

The study found rates of such violence for people with mental illness to be about three to four times the rate for people generally.

"I have a concern that findings like that can be taken as ammunition for people who want to stigmatize or reject people with mental illness," Link said.

"The point is that three to four times higher is similar to how much higher men are than women, or how much higher 18-year-olds than 50-year-olds. So it's not a rational basis for rejecting or discriminating against people with mental illness."

The elevated level of violence, Links research suggests, occurs mainly in a subset of patients, those with symptoms involving feelings of threat or loss of self-control.

"Believing that others are out to harm you - or the experience of having your mind controlled by external forces...are the types of symptoms that will lead to violence," he said.

"If you believe others intend to harm you, you may act on that belief in such a way that you initiate violence."

©1996, Dallas Morning News

Modified December 25, 2002

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