Before the shock at yet another horrifying mass shooting in America even begins to fade, two things reliably occur.
First, arguments about guns and gun control rise quickly to a fever pitch, offering much heat but little new light on a much-debated topic.
Then, just as reflexively, we start hearing a lot of “crazy” talk: Barely considered assertions that because someone like Holmes did something deranged he (virtually never “she”) must then be, de facto, mentally ill. This soon segues into policy debates about whether better mental health services (or — seriously — magical human-nature detection technology) could somehow identify all these crazy killers before the fact (as in Philip K. Dick’s mind-bending story, “The Minority Report”).
It’s no different this time, following James Holmes’ frenzied attack, in which he shot 70 people at a midnight showing of “The Dark Knight Rises” in Aurora, killing 12.
Even smart, compassionate friends are prone to say things like, “This young shooter’s mental illness wouldn’t necessarily be known to the public because of privacy laws” and “If only he’d gotten help.”
But just because someone does something deranged (a better, less-loaded word than “crazy”) does not mean he or she has a mental illness.
Mental illness is just that, an illness. It has discrete symptoms, it can be diagnosed, and it is often treated quite successfully through a variety of means, including medication and therapy. There are many flavors of mental illness, none easy for the sufferer to bear, from depression to bipolar, schizophrenia to panic disorder, borderline personality disorder to PTSD.
“Mental illnesses are medical conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others and daily functioning,” according to the National Alliance on Mental Illness. “Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life.”
The idea that someone who does something deranged must be mentally ill is utterly false. Perfectly “normal” people — think Anders Breivik, the right-wing terrorist who systematically slaughtered 77 of his fellow Norwegians or Pol Pot, the brutal dictator who murdered millions of Cambodians — do horrific things.
But here’s what’s even more important: Mentally ill people generally are no more violent than those without a diagnosis. Unfortunately, part of the stigma surrounding mental illness has led many Americans to believe otherwise.
According to a January 2011 article in the Harvard Mental Health Letter, a 2006 national survey found that 60 percent of Americans “thought that people with schizophrenia were likely to act violently toward someone else, while 32 percent thought that people with major depression were likely to do so.”
A deep, wide-ranging “violence risk assessment study” done in 2005 by the MacArthur Research Network for Mental Health and the Law found that 18 percent of people with a psychiatric disorder committed at least one act of violence a year.
Whoa! That’s no trifle.
However, the study also found that 31 percent of people with “dual diagnosis” of substance abuse and psychiatric disorder committed violence at least once a year. “This confirmed other research that substance abuse is a key contributor to violent behavior.”
But wait! There’s more:
The study “found no significant difference in the rates of violence among people with mental illness and other people living in the same neighborhood. In other words, after controlling for substance use, rates of violence reported in the study may reflect factors common to a particular neighborhood rather than the symptoms of a psychiatric disorder.”
In fact, people with mental illness really aren’t any more dangerous than anyone else. But substance abusers, whether there is concurrent mental illness or not, are a very serious threat.
This is not a petty matter of semantics. The stigmatization of mental illness actually can cause great suffering. Stigma can keep people from seeking out professional help and community. When we assume that the latest mass killer is or must be mentally ill, we’re contributing to the problem.
But on a psychological level, snapping to such labels probably allows the rest of us to turn an alleged killer like Holmes into The Other, safely tucked away into a category of human that’s Not Us or Anybody We Know.
There is an interesting image floating around Facebook that brings this to a fine and damning point: If Holmes had been a Muslim, he would have been labeled a terrorist; if black, a thug and criminal; but because he’s white, the quick-and-easy tag is mental illness.
People do horrible things. All the time. That doesn’t make them mentally ill. We should never fool ourselves into thinking that the universe is so obliging as to provide convenient labels and excuses to explain away all such suffering.