Monday, January 17, 2011

Violence and Mental Illness, Again

Yes, most mentally ill people are not violent. Thanks to the USPRA for such a wonderful professional reflection on the violent attack in Arizona.


USPRA Issues Statement on Tucson Shooting      January 13, 2011

The US Psychiatric Rehabilitation Association released the following statement in reaction to Saturday’s Tucson shooting in Arizona:

In wake of Tucson’s tragic shooting that shook America over the past weekend, we wish Congresswoman Giffords and the 13 other wounded individuals a speedy recovery, and our thoughts and prayers go out to all of those whose lives were impacted by this act of horrific violence.

With such senseless acts, we often search for someone or something to blame. The assassination attempt on Congresswoman Giffords has generated considerable speculation around the mental condition of the suspected shooter, which has heightened the stigma associated with mental illness. We must remember that there is a weak link between mental illness and violence. According to SAHMSA, nearly five percent of the US population suffers from a mental illness resulting in serious functional impairment, but only a very small group of individuals with mental health issues shows any violent behavior. Most people with mental illnesses are not violent, and most people who are violent are not mentally ill.

While we have no way of knowing whether or not our nation’s mental health system failed this individual, the Tucson tragedy should spotlight mental health policy & the provision of mental health services as a national priority.  The best strategy to providing individuals with mental illnesses the assistance they need is to have an accessible system of care that is easy to use. However, because the majority of mental health services are delivered through public systems, these are usually the first programs to be cut in a state budget when money runs short. More socially accepted diseases like diabetes, heart disease, high blood pressure and other physical illnesses don’t experience the same inconsistencies, yet funding for mental health programs seems to fall to the cutting room floor year after year.

In light of the Tucson shooting, we must also increase awareness of the need for mental health services within schools and colleges. The Mental Health on Campus Improvement Act attempted to increase accessibility to a range of mental and behavioral health services for students—including a focus on prevention, identification and treatment of students in college and university settings—but failed to gain any traction in the last two Congresses. We must realize that only by providing resources for prevention and outreach programs, can we ensure that students can obtain the support they need in order to recover and re-establish themselves in the community.

USPRA hopes that this tragic event brings the essential mental health system reforms that we so need in our nation and we will continue our responsibility to urge legislators to effectively address the needs of individuals with mental illness.


Resource: (Friedman, R.A. (2006). Violence and mental illness—How strong is the link? New England Journal of Medicine, 355(20), 2064-2066. )

Sunday, January 9, 2011

Violence and Mental Illness

Today I pray, along with so many others for the victims of the Arizona shooting yesterday: six dead, at least 12 others injured, including Congresswoman Rep. Gabrielle Giffords. The man in custody for this violence is now being held on multiple counts of murder, and his background searched for clues to his destructiveness. The county sheriff says the young man has mental issues. I say No Kidding.

Most of us who suffer from issues of behavior, emotion and thinking have what are called mental disorders. In other words, we as individuals have problems. Problems we know as something a part of ourselves but distinct from ourselves as a people. Those who suffer mental illness are people whose disorders have them. Major mental illness (MMI) like schizophrenia or psychosis so distorts the mind, mood, perception and behavior that we have commonly called these people "out of their mind." They behave as if they don't have two normal thoughts to rub together. Often, they don't.

American courts have long recognized this distinction, with what most of us know as the insanity defense. Someone may be considered guilty of an action but not punishable, not sent to prison, because they were "out of their mind" when committing a crime. Instead, they are committed to a psychiatric hospital in a locked ward. Prison for the insane. Most never get out, because it's pretty hard to get your mind back once you're out of it.

Our current cultural political and religious speech, so out of control with hatred, divisiveness and extremism, is like gasoline to MMI's fire. Words do have that kind of power, to inflame emotions and create sides where there needs to be common cause. Shame on those who, like former Alaskan governor Sarah Palin, have used their political power to incite violence with website images of a gun's cross-hairs on an picture of a political opponent. Her ignorance of how her words can hurt people is mind boggling.

Internet technology gives hate speech a world-wide audience. When politicians stir up hate in the name of partisanship, it is no wonder those whose minds are disturbed and distorted by illness take their rhetoric for truth. And occasionally act on it.

Mental illness is the next great medical frontier. Just as MRIs, blood tests, CT scans and Xrays have given us astonishingly detailed windows into our bodies, I pray for increasingly clear windows of understanding into the most mysterious of all our organs, our brains. One day we may be more able to anticipate and treat MMI before individuals become violent to themselves or to others. It won't save us from our stupidity and ignorance, though. So far, there's no cure for that, save education, humility and self control. Something, at least right now, is in dangerously short supply amongst many in politics, media and self promotion. 

Thursday, January 6, 2011

No scientific backing to bracelet of stars | StarTribune.com

While all kinds of remedies have no "scientific backing," the Placebo effect, the power of the mind to effect healing with hope and expectation, is certainly a fact of science.

No scientific backing to bracelet of stars | StarTribune.com

Saturday, January 1, 2011

Disorders of the Will : Happy New Year?!

On this day when so many of us are glad for the blank sheet of paper, the turn of the calendar, the new year's fresh start, I continue to wonder about how people change. That, after all, is what people are really after when they seek therapy. Some relationship, some turn of mind, a problem beyond their experience to avoid or help draws them to consider the time apart, the confidential help that therapy provides.

After years of reading, debating, writing and anguishing with others about this human problem, I believe that change requires a combination of pain, hope and resources. Personal pain to want to create difference, hope that will pull us forward even when we continue to fail, and the resources that help us act against habit, behavior, will, environment and even genetics. One of those resources is imagination; another, time; yet another, self control.

It's that self control that is such a stinker for us all. And to that point, I was reading an online excerpt today on the NY Times book review from a new book I may have to purchase soon. This paragraph really stood out; it's commenting on why disorders like anorexia or ADHD are such common diagnoses now. We have such a wide-open, tolerant culture, that restraints against human desire are fewer and fewer to find:
Maybe this is one reason disorders of the will are so much more common than they used to be. Anorexia nervosa and obsessive-compulsive disorder, both still relatively rare, are nonetheless much more common today than they were fifty years ago, not to mention the explosive growth of attention deficit disorder and addictions of all kinds. Some of this boom is just more frequent diagnosis, but it also reflects changing circumstances. That it’s now possible to be addicted to cocaine, shopping, or sex is evidence of how far we’ve moved beyond the constraints of budget, custom, and embarrassment. There aren’t many compulsive eaters, video game addicts, or — God knows — anorexics — in sub-Saharan Africa, but in the West men and women can be consumed with almost anything, including not eating, because here you can get or do almost anything. Opportunities for obsession abound. 
          from the new book, "We Have Met the Enemy" by Daniel Akst  (Penguin Press, c. 2011)

So, good luck with those resolutions. One of mine is going to continue to be curious about human will (I think Martin Luther may be right: he wrote that our wills are in bondage....) and what to do about those wills when they stubbornly, dangerously, get us into trouble. Happy New Year!