BRATTLEBORO — In her column “High Noon in the OK Corral” [The Commons, Feb. 16], Elayne Clift quite rightly takes our society to task for the ease with which one can buy a vast assortment of weapons. However, in her plea to end the kind of violence that took place in Tucson this past January, she demonizes those who are among the most likely targets of violence themselves: people with serious mental illness.
In decrying the movement toward deinstitutionalization, Clift writes: “The problem was (grossly simplified), states never adequately funded community clinics or mental health services, which no one particularly wanted in their neighborhoods anyway; psychotropic medication trumped long-term care, and before you could say 'criminally insane,' the streets were full of deranged, dangerous individuals for whom one felt compassion while trying not to consider what might be coming down the pike if these poor souls weren't cared for properly.”
The implication is that, in the 1970s, mental hospitals only housed people who were criminally insane people who - in Clift's words - were “deranged, dangerous individuals,” let loose to run amok in the streets. Such was never the case. In addition to holding people with mental illness, state mental hospitals were notorious for warehousing people who were poor, physically disabled, intellectually disabled, and/or autistic. I have a disabled aunt who died in one. She was not mentally ill.
As for the population about whom Clift speaks in such frightening terms, the vast majority of people with serious mental illness are neither deranged nor dangerous. Most are not perpetrators of violence, and are a danger to no one, except perhaps themselves. For schizophrenics, the risk of dying by suicide is greater than the risk of committing a violent act against another person; the risk of being a victim of violence is greater still.
According to the United States Department of Health and Human Services, “people with severe mental illness - schizophrenia, bipolar disorder or psychosis - are 2½ times more likely to be attacked, raped, or mugged than the general population.” A 2003 University of Southern California study found that adults with schizophrenia are 14 times more likely to be victims of a violent crime than to be arrested for one.
As for the danger that schizophrenics pose to society, it is quite small. A 1998 study in the British Journal of Psychiatry found “that 99.97% of those with schizophrenia would not be convicted of serious violence in a given year, and that the probability that any given patient with schizophrenia will commit homicide is tiny (approximate annual risk is 1:3,000 for men and 1:33,000 for women).” The body of evidence does not point to the relative strength of schizophrenia or other serious mental illness as a risk factor for violence.
But stereotypes abound, and the stigma associated with serious mental illness is one of the reasons that most community clinics never got off the ground. Clift is right to point out that these community-based facilities were ones that no one “particularly wanted in their neighborhoods anyway.”
But why did community after community turn down the opportunity to care for people who were seriously ill?
It was a decision that was driven by fear - fear based on stigma and stereotype. Studies indicate that around 75 percent of television shows dealing with mental illness focus on violence, with a notable absence of positive stories showing the recovery of mentally ill people. These types of misrepresentations have a significant impact on our society's attitudes. According to Americans' Views of Mental Health and Illness at Century's End: Continuity and Change, between 1950 and 1996, “the proportion of Americans who describe mental illness in terms consistent with violent or dangerous behavior nearly doubled.”
Is it any wonder that people with serious mental illness end up homeless and victimized?
Stereotyping mental illness as the root cause of violence has a profound impact on the lives of people who live with these illnesses. The stigma alone keeps people from seeking help.
And the antidote is not pity. Mentally ill people are not the “the poor souls” that Clift so patronizingly calls them. They are human beings - our sisters, our brothers, our neighbors, and our fellow travelers.