The mentally ill are more likely to be victims of violence – not perpetrators

One of the common misconceptions of mental illness is that the mentally ill are a monolithic group of lunatics, running around, committing violent acts.  This is perpetuated in a variety of ways, including popular culture and the media, who tend to highlight and sensationalize the unfortunate incidents when someone when is mentally ill commits an act of terrible violence.

Of course, that isn’t the case at all.

Let me address this stigma in two parts.  First, as has long since been established, mental illness, like most physical disorders, exists over a spectrum.  Nearly 1 in 5 American adults has some form of mental illness.  Breaking that down further, however, reveals a far more nuanced picture.

First of all, I vehemently object to the idea that “mental illness” is a big block.  It comes in a variety of symptoms, severity and specific diseases.  As noted above, nearly 1 in 5 American adults have some sort of diagnosable mental illness over the course of a year.  Roughly the same number of 13-18 year olds fall into the same category.  Over the same time period, 1 in 25 adults suffers from a mental illness that is severe enough to qualify as a “functional impairment.”  At the same time, roughly 100,000 people, per year, have their first episode of psychosis.

So, first and foremost, let’s dispatch the idea that all mental illnesses are the same.  They  vary in a variety of respects.

Second, it’s important to keep this in mind: Being mentally ill makes someone far more likely to be a victim of crime, not a perpetrator of it.  I get that the popular stereotype of the mentally ill has led people to believe that this isn’t the case, but again, reality is very different than perception, and when you think about it, this makes sense.  Someone who is mentally ill is far more likely to lack complete control over their faculties, health, finances, etc.  As a result, they are vulnerable to society’s criminal elements.

Let’s take a look at the research.  According to a 2014 study by North Carolina State, roughly 24% of the mentally ill who were surveyed (out of 4,480) had committed an act of violence over the past six months – but 31% had been a victim of it.  Breaking it down further, of those who had committed an act of violence, 63.5% had done so in a residential setting, while only 2.6% had done so at school or the workplace.  This doesn’t make the act of violence any less important or tragic, but it does mean that the mentally ill are rarely a danger to the general public.  Unfortunately, it may mean that family members can be.

Taking this research a step further: According to governmental surveys, only 3-5% of violent acts come from someone living with a serious mental illness.  And this, again, makes an important distinction: A serious mental illness is more than just someone who gets periodically anxious.  It is defined as:

a condition that affects “persons aged 18 or older who currently or at any time in the past year have had a diagnosable mental, behavioral, or emotional disorder (excluding developmental and substance use disorders) of sufficient duration to meet diagnostic criteria specified within DSM-IV (APA, 1994) that has resulted in serious functional impairment, which substantially interferes with or limits one or more major life activities”

As a study from Washington notes, this leads to exaggerated views of the connection between mental illness and the general public.  This, in turn, leads to widespread stigma, discrimination, treatment avoidance and a lower quality of life for those who suffer from mental illness.

I suppose, ultimately, it comes down to this.  The mentally ill – from a mildly anxious teenager to the most severely schizophrenic homeless senior – deserve to be treated with basic human dignity and respect.  Stigma is so dangerous because it is pervasive, and any broad-based, inaccurate characterization of mental illness dehumanizes those who suffer and forces them to keep their illness in the dark.  Violence among the mentally ill is rare – tragically, becoming a victim of violence is a far more likely scenario.  It is vitally important to the destigmatization movement that we continue to fight back against all inaccurate portrayals of mental illness, including this one.