Mental illness is a term that is frequently used in all types of conversations. It is being discussed as it relates to politics, funding and service area gaps, employment and homelessness, and it spans socioeconomics and all populations, youth to seniors. Yet there may be confusion about what it is everyone is talking about.
Webster’s Dictionary defines mental illness as “medical conditions (such as major depression, schizophrenia, obsessive compulsive disorder, or panic disorder) that are marked primarily by sufficient disorganization of personality, mind, or emotions to impair normal psychological functioning and cause marked distress or disability and that are typically associated with a disruption in normal thinking, feeling, mood, behavior, interpersonal interactions, or daily functioning.”
The reality is that mental illness is a broad continuum of diagnosis and severity. Awareness is increasing and perceptions are changing along one side of the spectrum. There appears to be more acceptance of depression, anxiety and trauma-related issues. However, judgment and misinformation tend to increase along the continuum regarding more serious problems such as bipolar disorder or schizophrenia and psychosis.
Some of the attention to the issue is being driven by mass shootings in the news, causing policymakers and the public to pair “mental illness” with violence and assign blame. Implying that the risk of violence comes from individuals with serious mental illness is not supported by evidence. Research indicates that people with a serious mental illness account for only 4% of violent events, according to the National Institute of Mental Health. National statistics also show that people with serious mental illnesses are over 10 times more likely to be the victim of a violent crime than the general population.
There is a difference between serious mental illness and severe emotional distress. Using the broad term can have a great impact on those who are dealing with a diagnosed mental illness such as depression or anxiety. It perpetuates an incorrect assumption that individuals with mental illness are dangerous. That can create a dynamic in which those who need treatment the most avoid it.
It is hard to imagine that a mentally healthy person might intentionally kill multiple strangers. It is true that mental illness may play a limited role in mass violence. The National Council on Behavioral Health notes in a report from August 2019 that there is evidence of a serious mental illness in roughly 60% of individuals who perpetrate mass violence.
It is also true that the common characteristics and environmental factors of perpetrators should be considered. Those that occur most often are male, history of childhood abuse, feelings of isolation and hopelessness, substance use and possibly the harboring of grievances related to work or school. They may also be having trouble with finances and interpersonal relationships, be involved in domestic violence, have a sense of being victimized and feel indifferent to life. They often die by suicide. However, correlation is not causation, and any one of these factors alone is not to blame.
Again, mental illness is a broad spectrum, and when fingers are pointed at an entire population, the attached shame becomes a barrier to seeking treatment and further marginalizes individuals who are already struggling.
Also, keep in mind that mental illness is common. One in 5 individuals struggles with some sort of mental health problem, and 4.5% of adults in the U.S. experience a more severe mental illness. But the more mental illness is paired with being dangerous or violent, the less likely individuals are to seek treatment.
Early intervention for many of the characteristics I’ve talked about here can be effective in preventing violence. In addition to increasing access to treatment for mental illness, we should be focusing on identifying factors that contribute to the common characteristics listed here.
Solutions could include increasing social connection for those at risk, along with promoting resources and community education related to mental illness. In addition, there should be continued discussions of red flag laws to reduce easy access to firearms for those at risk for violence.
The bottom line is that the issue is more complicated than just one factor. That means that an effective solution will need to be multifaceted.