Sunday, December 18, 2005

Mental Illness and Violence

Mental Illness and Violence

Many people accept without question that the mentally ill are predisposed toward violence. It is probably the primary reason that the public tolerate the psychiatric powers of arbitrary and enforced detention and treatment. But is it true?

Not according to studies which continue to show that people with mental illness are no more violent than the general population.* It is also evident that those violent acts which are committed by the mentally ill are likely to be highly publicized by the media. Violence by the mentally ill tends to be sensationalized to the point where the fact that it is but an insignificant amount of the overall violence in our society is overlooked. **

The injustice created by this unintentional media stigmatization is further compounded by the criminal justice system. More and more the defense of those who commit criminal acts of violence relies on the testimony of a psychiatrist who solemnly pronounces that the perpetrator of the crime is suffering from a mental illness which caused the action.

This process which is wide open to abuse swells the ranks of the mentally ill with criminals who are predisposed toward violence with the result that the genuinely mentally ill tend to become swept up in the same perceptions that categorize the violent criminal.

The boundary encompassing the area of supposed mental ills has increased beyond all credibility. It now ranges from violent criminals, to people who are bereaved or suffering the periodic stresses of life, to people who experience a natural disaster, down to children who fidget in class. All are deemed by modern psychiatry to be mentally ill.

1955 was the start of the era of psychiatric drugs. Prior to that date the number of mentally ill was one in 300 people. By 1987, after 32 years of psychiatric drugging, the number of mentally ill had reached one in every 75 people. In 1987 the 2nd generation of psychotropic drugs such as Prozac went into circulation. The result? By 1994, after only seven further years, the number of mentally ill had risen to one in 50. And now, without so much as a blush, psychiatry informs us that 20% - 25% of the population will become mentally ill... one in four or five people.

Is this appalling deterioration in the mental health figures due to the psychotropic drug regime of 20th century psychiatry not only demonstrably failing to cure the mentally ill, but also apparently seriously exacerbating the situation? Or is it simply a result of the re-branding of criminality and human foibles and emotions into mental diseases? It would appear to be a macabre combination of both.

In 1952 the first edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-the official psychiatric reference book) listed 112 mental disorders. By 1980 that number had increased to 224 mental disorders. By 1994 the number had swelled to 374 mental disorders.

Are these new mental illnesses scientifically based on any standard medical procedure or test? Not at all, in a ‘Ripley’s Believe it or Not’ scenario, they are brought into being by a show of hands at a Mad Hatter’s Tea Party convention of psychiatrists. No blood test, no scan, no etiology, no science of any sort whatsoever. Just opinions.

To quote the bioethicist Carl Elliot: "The way to sell drugs is to sell psychiatric illness.".

No, the genuinely mentally ill are not predisposed toward violence to a greater degree than the rest of society, but they are predisposed to being taken advantage of by the unscrupulous manufacturers and pushers of highly profitable and dangerous psychotropic drugs. They are also predisposed to having their very real individual needs utterly ignored by a mental health system that has expanded beyond the bounds of sanity, and way beyond the bounds of good care.

Philip Barton 11/11/05

* R Gelles, "Violence in the Family: A Review of the Research", Family Violence, Second Edition, Sage, 1987.

** Henry J. Steadman, Edward P. Mulvey, et.al, "Violence by People Discharged From Acute Psychiatric Inpatient Facilities and by Others in the Same Neighborhoods", Archives of General Psychiatry, Vol. 55: 393-401, 1998.

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