On Mental Health and Poverty: Replacing Fear with Understanding

“Why does it always take a tragedy for people to show an interest in mental health?”

That’s the question a colleague posed earlier this week when a television reporter arrived to interview our CEO, Pete Zevenbergen, about the shooting in Newtown, Conn. — an act so senseless and horrific that it has left the nation shocked and groping for answers.

My colleague was concerned that connecting mental health issues to tragedies like this plays into the stigma associated with mental illness. By asking, for example, what the mental health community might do to prevent mass shootings, the media assumes that a mental illness played a role, that people with mental illness are inherently violent

Having worked as a news reporter, I understand the need to try to get quick answers, even to complicated problems. I also understand why the media turn to mental health professionals for those answers; troubled people who commit horrible crimes are bound to raise questions about what our society can do to prevent those crimes.

But the truth is, we don’t know what role, if any, mental illness might have played in this latest mass shooting. We don’t even know if the shooter had a mental illness. (The latest reports suggest he had Asperger’s syndrome, a developmental disorder that, unfortunately, comes with a different kind of stigma.)

What’s more, speculation like this is largely unproductive – and is probably counterproductive for the very reason my colleague suggests. That’s because, stereotypes to the contrary, mental illness is not a strong predictor of violence. A 2003 review of studies on the association of violence and mental illness concluded that people living with mental illness are “more often victims than perpetrators of violence.”

The review, published in World Psychiatry, found that whether someone has a mental illness or not, the primary factors contributing to the individual’s violent behavior are gender, age, poverty and substance abuse. The profile of a violent criminal hasn’t changed for decades: single, young men of low socio-economic status.

Substance abuse also plays a role. The review noted one study that said people with substance abuse disorders contributed to 34 percent of all violent crimes, a much larger figure than the 4.3 percent of people with a major mental health disorder. And those with mental illness who do commit violent crimes typically do so against people they know, not random strangers: 87 percent of their victims are family or friends.

My point here is simple: We will do little to help the cause of building a strong mental health system in this country if we allow headlines from the latest mass shooting to perpetuate stereotypes about mental illness. None of this is to say that the people who commit horrible crimes aren’t seriously troubled, that they haven’t experienced trauma in their lives, or even that they don’t have a mental illness.

But rather than using these heart-wrenching and high-profile crimes to sow more fear toward people living with mental illness, we should do our best to understand their lives and the challenges their illnesses create. We should make it a point to increase our mental health literacy through programs like Mental Health First Aid, programs that give people the skills and confidence they need to reach out to someone experiencing a mental health crisis. We should not be afraid to show those with mental illness that we care, that we’re there to listen, to help if we can, and encourage them to seek treatment. Just as important, we should make sure that such treatment is timely, effective and easy to access. Of course, offering that treatment requires money – money that’s in short supply these days as many states, including Kansas, cut their mental health budgets.

One of the worst things that can happen to someone who lives with a mental illness is for that person to become isolated from friends, family and community. The review I mentioned earlier cited one study that’s relevant to this point: “The public’s desire to maintain social distance from the mentally ill increased markedly after each publicized attack, never returning to initial values. Further, these incidents corresponded with increases in public perceptions of the mentally ill as unpredictable and dangerous.”

How sad would it be if last week’s tragedy increased our fear toward people living with mental illness? If it pushed them further into isolation and loneliness? Our instinct as fellow humans should be to embrace them and show them we care, not push them away. Our responsibility as a community should be to fund the mental health services that will help them recover and thrive.

Contact Mark at wiebe_m@wmhci.org.

This post originally appeared in the December 2012 eNewsletter from Wyandot Inc., republished with permission.


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HCF's Local Health Buzz Blog aims to discuss health and health policy issues that impact the uninsured and underserved in our service area. To submit a blog, please contact HCF Communications Officers, Jennifer Sykes, at jsykes@hcfgkc.org.

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