connecting-mental-illness-violence-dataLast night, a poorly researched piece by Steve Kroft appeared on the television news program, 60 Minutes. I say “poorly researched” because it took me all of five minutes to find problems in what some of those interviewed on the program said. While truthy, it wasn’t exactly the whole truth.

The core problem this program displayed is making a post hoc logical fallacy of connecting two seemingly-related things and suggesting a causal relationship exists. Because some of the people who commit mass killings have mental health issues, this is a sign of “a failed mental health system that’s prohibited from intervening until a judge determines that someone presents an “imminent danger to themself or others.”" The two may have little to do with each other (and in fact, according to real research, don’t).

No, the sign your mental health system has failed is when you’re locking up tens of thousands of people with serious mental illness in prison for petty crimes, rather than simply treating them in less restrictive settings.

42 Comments to
60 Minutes: Connecting Mental Illness to Violence with Little Data, Facts

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  1. I truly hope this comment will be posted, because readers need to know how fellow psychiatrists think and react to other “well prominent” psychiatrists who think they speak for the profession being in alleged positions of authority and expertise:

    I think Torrey, like other psychiatrists who have been in positions of academia or other public institutions and have this false sense of authority and accepted spokespersons for the profession, are out of touch with the reality that mental health care can provide in 2013. These doctors don’t provide daily, repetitive mental health care interventions, and think that since they wrote a book, sat on a committee, or have a position in an alleged influential organization like the APA or write for a journal read by more than 1000 doctors, that they speak for the field.

    Well, they don’t when they make absurd statements that Dr Grohol replicates above with “About half of these mass killings are being done by people with severe mental illness, mostly schizophrenia. And if they were being treated, they would’ve been preventable.”

    Really, I don’t remember signing a document or statement after finishing my training that I can identify without error who is a risk to themselves or others, and who is not. And you know, readers, this guy really thinks that, in my opinion. Whether it is well intended, or just the arrogance and lack of accountability that insulated and distant interaction with the general public he most likely has, it is wrong to say that as an alleged spokesperson for psychiatry.

    And here is another “and”, he is probably an emeritus of the APA and they as an organization want this kind of rhetoric said because they want the public to think psychiatry alone can save the day. But boy, does the APA blow it when they use colleagues who are out of touch with the realities of care.

    You as a society want to vilify someone, want accountability and a scapegoat for these shootings, well, you need to start with yourselves. You need to look at what you tolerate, what you glorify, what you consider acceptable norms, and when you want to look the other way and ignore issues or problems that can’t be ignored, well, be ready it might bite you in places you won’t likely tolerate.

    Yes, people who are psychotic can be a threat. So are people who are just antisocial, which by the way, might be considered a DSM diagnosis, but is not a psychiatric illness amenable to treatment over 90% of the time. And, people who use mind altering substances without supervision or regulation are more prone to violence.

    Rule #1 taught to me in training that is still applicable today: people with a history of actual violence are more likely to be a risk for future violence. That overrides a psychiatric diagnosis first and foremost. Maybe it is time to let those who think that violence has no real accountability or consequence realistic reconsideration. I am not advocating we indefinitely incarcerate all who have been violent, but, if one has been violent and been brought to public attention for it, well, 2 strikes might be a profound out.

    It is what it is with these incidents. Overtolerance and minimizing egregious behaviors has to be reconsidered for this culture to not be traumatized repetitively.

    Just the opinion of one psychiatrist. Thank you for the opportunity to comment.

    Joel Hassman, MD
    Board Certified psychiatrist
    practicing now over 20 years.

    • Good points all, Dr. Hassman.

      The quote is especially cringe-worthy because many of these same killers he cites had prior run-ins with the law, the mental health system, or both. If none of these smart professionals saw what Torrey can so clearly see from the Monday-morning quarterbacking position, I’m not sure more laws are going to help.

      We know the best predictor of future criminality is past criminality — by far. Most killers have a previous criminal record, yet we’re not always connecting the dots to form cohesive, fully-formed profiles of these individuals. Given that we already have comprehensive national crime databases, I’m not sure why this is.

      • thanks. glad to be of service. I see us mostly on the same page about broke but disagreeing on the fix and about what can and cant be fixed. its a minefield littered with things like “patients rights”, privacy rights, right to refuse treatment ..which anognosic’s folly I think of as the “right to go howling thru the streets and dying in the alley”… very dignified IMHO. Then there is the spectre of “pre-crime” detainment which has so many of us anguished. We who heard the “nothing we can do about it…” from authorities. nothing they can do until the body bags are needed. there has to be a more humane way. there has to be respect for the rights of all other individuals in the community, not just the Brain Diseased floridly psychotic, or the “I’m feeling great” bipolar. Is there a landmine called “stigma”? yes there is. we should not get all p.c. and not take it on. sometimes this means telling people they cant make their own decisions. the system has to get over this p.c. nonsense. it is a landmine.

        finally to the point of we cant say who when and where the next SMI shooter will appear. that’s just plain lazy resignation in my mind (not my job description). With the biological work being done, we soon will not have to rely on subjective observations,just as we are learning not to use them to name the underlying disease because of its objective symptoms. I suggest here, then, that the DSSM might have to rearrange its old categories of “this disease, not that disease” and base its findings on the lab results just like other Medical specialties do. to bemoan that we are not there, to not speak the promise of getting there…now that’s a landmine too! please, can we sign a treaty?

  2. I’m not sure how to put this exactly. It’s something I have been mulling over for a while. I often wonder if our definition of mental illness isn’t too narrow? I mean, if you can murder an un-armed, non-threatening, defenseless fellow human being, doesn’t that pretty much indicate that your brain is broken? at least temporarily? In other words, aren’t all murderers mentally ill? Taking the life of another is such an incredibly radical, irreversible, devastating act that it seems that one would have to be out of their head to do it. A lot of violent crime happens under the influence of drugs or alcohol, but that doesn’t get classified as mentally ill. However, in my opinion, addiction IS a mental illness. So whether the murderer is drunk, or high, or has poor impulse control, or has been under way too much stress lately , OR IS SCHIZOPHRENIC, seems like splitting hairs. These are all varieties of mental illness. Murder is an insane act, therefore the actor is insane – even if temporarily. And I’m not talking about situations that might seem justifiable like protecting yourself or your family. I’m talking about the deliberate and totally unjustifiable taking of the life of another. It’s INSANE. There is something very wrong with the person who does this. Their wrongness has often been characterized as a character defect. But isn’t a character defect a mental defect? I’m not sure where I am going with this, but it just seems like the arguments over violence and the mentally ill is somehow oxymoronic…

    • Pablo, I respect what you wrote however I would never put addiction in the same category as schizophrenia. Addiction starts with a voluntary choice to indulge in the a substance, often multiple times before becoming addicted. Also, being under the influence of a drug/alcohol is a temporary condition and the high/altered state subsides once the chemical wears off. At this point in time, it still seems we know so little about the development of schizophrenia.

      But Pablo, I am glad that you commented and contributed and that at least 3 people gave a damn about the story on 60 minutes. To me this issue is a national disgrace so I thank you for caring enough to comment.

    • there is a term in law that might have relevance to your question. it is the term “hot blooded murder” the typical example is killing when you find your wife and your best friend in bed…extreme emotion has taken control. temporary situation with a specific emitional event as the trigger. so we dont consider the killer as culpable as some other killers. nor do we get tangled in questions of insanity. we dont often bring the question of insanity into drug murder either. or steroid rage murder. we bring it into the court primarily when a history of mental problems are demonstrable, particularly the SEVERE MENTAL ILLNESSES. these are now being recognized as ORGANIC DISEASES of the Brain. this is quite different than bad attitude, mainly because the ability to know right deed from wrong deed is compromised or completely missing. this is hardly “splitting hairs.” it is also a difference with an established, peer reviewed scientific literature supporting it. this scientific work is more advanced than dr Grohol would have you believe. by itself i would let it go as his opinion based on his understanding. BUT, having read the same statistics as dr Fuller regarding the number of brain diseased among mass killers. ..which are not stats dr Fuller pulled from thin air of created but found from independent sources…i have to take exception to dr Grohol and say i see bias in his argument. i feel a lot of it comes from the position he expresses about “rights” and his calling upon the bogey man of something like “precrime” detention. some of refer to it as “dying with their rights on” and have serious issues ehere the right to refuse trestment by a florifly delusionsl individual trumos the rights of each and all ithers in a community. dr Grohol would have you under the delusion that TAC is not hearing from “the trenches”. that i csn safely say is a lie and nothing less.

      • I didn’t say anything about “the trenches,” so not sure what you’re referring to there.

        I just believe that views like Torrey’s are naive and are ultimately nothing more than a bandaid to the problem of not funding the mental health system in the U.S.

        The “fix” to the system and it has nothing to do with legislation and everything to do with money. Money that society has determined isn’t available to help those most in need in our society.

  3. Dr.Grohol, great piece. I saw the 60 Minutes story and cringed.

    And on another subject, isn’t it time for you to have your own PsychCentral blog, instead of getting subsumed and sometimes buried in the other bloggers of “World of Psychology?” Call it, “World of Psychology: The Grohol View” or something like that. Highlight it in the blog listings at the very end. Make it easy for us who want to read what you, personally, have to say.

    Thanks.

    • Thanks for the kind words… If you go back in the archives all the way to 2001, you’ll see it was indeed “my” blog at one time. Sadly, the demands of running Psych Central take away from my writing time, hence the need for other contributors to our blog. If you want to follow only my contributions to the blog, you can readily do so here: http://psychcentral.com/blog/archives/author/grohol/

  4. It is too bad that this story wasn’t backed-up with scientific facts. But mental illness is clearly a factor in some of these recent shootings, all though it is not perfectly clear that it is the root cause. As someone with two undiagnosed and untreated siblings that are likely full blown schizophrenic and very delusional and who refuse treatment and whose lives are squandered, I firmly believe that there has to be a better way to address mental illness. I believe that we need to change our healthcare system and applicable laws to compel treatment to stabilize folks, if a treatment is available, in an outpatient setting. There also needs to be meaningful support systems in place for families dealing with mentally ill members. In my family, my untreated siblings have severely damaged all the relations within our family and messed up my nephew whose parent is ill, etc. Not to mention the years of stress, worry, trying to find a way to get help, etc all to no avail. My siblings live with my elderly mother and I am sure they will be living on the streets if she pre-deceases them. What a waste, what a stupid healthcare system, what stupid laws we have.

    • When you use the word, “clearly,” in this context, that’s where you lose me.

      What if we were to determine that, upon autopsy, each one of these killers had a small brain tumor in an area of their brain that affects judgment?

      What if we looked into their family histories and found all of them were missing involved fathers in their lives? Or all of them had grandfathers who died of asbestos or lead poisoning?

      There are literally a thousand third-factor explanations that could account for their criminality and behavior. Without a careful study and access to their family histories, medical and mental health records, etc., you simply cannot say.

      Just because two things are associated doesn’t mean they share any type of causal relationship. This is one of the first things researchers in psychology learn, but it is also sadly one of the first things researchers later forget (or ignore).

      A simple example… Every time I look out my window, I see a bird fly from one tree branch to another. Is my looking out the window causing the bird to fly from branch to branch? Of course not. The bird is just engaging in their everyday activities, some of which I happen to catch while looking out the window.

      • Great observations. I honestly do not know the exact “ills” of my siblings, not being a medical doctor. I do know what I have observed over multiple decades, and what they have shared with me. I watched my brother go from being a little paranoid to extremely paranoid, to hearing voices and believing there are invisible people always surrounding him and to watching him speak with these invisible people. He does share with me his latest theories of why this is happening to him. I watched him cry when he confided in me when this first started to happen years ago and not understanding why and to saying he felt like he was going crazy. I encouraged him to seek medical help to rule out brain issues. He did not do so.

        As far as my sister goes, she has always had some degree of delusions of grandeur that have only increased exponentially over the years along with disordered thoughts and speech and so many other issues indicating some sort of problem. Now it seems she has trouble distinguishing between what she sees on the TV news and what is happening in her life. I only had one semester of psychology and am a big believer in science and facts over conjecture. There must be a something going on in their brains at this point. My sister has had CT scans and MRI’s of her brain to rule out issues from a somewhat recent car accident. She did not share with me if there were any findings of mental illness. Her ego would never allow her to admit that to anyone.

        So regardless of the root cause, my siblings live unhappy and unfulfilling lives and I cannot compel them to seek answers from the medical community. Instead they hunt down various conspiracy theories on the internet, unable to look within.

    • I agree, and I think “clearly” was an appropriate term to use. I’m not a psychiatrist, but I am an RN with 30 years of experience, mostly in ER and Management. MRIs’ and PET scans CLEARLY showed the differences in the the brains of mentally ill people, not all, but some do. The first school school shooting occurred the early 1980′s, in a neighboring county. It is rarely mentioned, probably because the boy killed a teacher and a janitor but no students. It was widely discussed that this 12 year old child lived in poverty , was abused at home and picked on at school, which was a new one for him The teacher he shot had bought him a pair of glasses the week before he shot her, and obviously told everyone she worked with about it. I heard it at work the night of the shooting by another teacher at that school. To me, that was totally unnecessary and embarrassing for the boy. I have a problem with a system that still uses the term “mental hygiene.” Hygiene means cleanliness in my world, so are mentally ill people “dirty minded”? A large number of seriously mentally ill people ARE in jail or living on the streets. They have no other alternatives. If psychiatrists can’t see the U.S. system is broken, they are a huge part of the problem. Also just reporting the problem to the police is inadequate. Do they follow up and make sure their patients are monitored? I highly doubt it. Good post Sammy, no matter what words you used. And doctors, if you don’t like my choice of words, which is typical of many doctors in all fields, too bad. I make no apologies for them.

  5. I’m glad that someone thought enough to comment on the “60 Minutes” segment on mental illness. It seemed logical and possibly true, but it left me empty. I am a person with dysthymia, a lesser form of depression that lasts for years. I Have tried to keep up with mental health issues, but I’ve also been terribly mentally ill at times in my life, currently taking what is commonly called a “coctail” of medicines.

    Yes, I’m aware of Dr. Torree’s views on mandatory out-patient committment. I think this is a slippery slope that some states are doing or considering. In South Dakota the 2012 legislature passed new laws on out-patient committment. I had talked to the executive director of NAMI South Dakota and a local legislature, both at the same NAMI meeting, and was assured that adequate funding for this would be part of the process. Much to my dismay I found out the legislature didn’t provide any new funding for this proceedure. They in a draft part of the bill said that this was going to “help” those with a mental illness, and streamline the proceedure, plus of course, save money for the taxpayer. Talking to a state employee of the Dept. of Health, I believe, at a NAMI State convention that year I pointedly asked about this–I was assured that money from a special funding source was to be used for this.

    Sorry for going into such detail, but there seemed to be lack of understanding re: this. It hasn’t really made me comfortable yet, as I can just see state legislatures across the country taking this direction to “help” the consumer and save valuable tax dollars, thus possibly lowering funding for their mental health systems even more.

    I don’t want to sound cynical but with the countrys obession with entertainment of sex, volience, and nilhism, I don’t see much hope for the disabled in our society, as we can easily be dismissed as “unnessary”, or of not “contributing” to society.

    I’ll throw this much in, we need the faith communities to take on a stronger role to help those with a mental illness. I am a person of the Christian faith and believe that God will provide, even if society doesn’t.

    • Good points all, and I appreciate that point — that often these mandated treatment laws are being implemented with no or few new resources given to them. Which is pretty much the worse of all possible worlds, because it means the ultimate penalty someone with mental illness will pay is going to prison.

      For instance, in New York state, they funded AOT (assisted outpatient treatment, which is the marketing term for mandated outpatient treatment) well the first year to help its implementation. But it was nowhere near enough money, and so people continued to be treated by underpaid, undertrained community mental health staffers (depending on where exactly you lived in the state, you may or may not have received quality services under the AOT law). They may help a person from being homeless, but they don’t actually do much to help the person recover from their mental illness. They’re given a case manager, whose workload is usually 3x or 4x the standard of care they’re supposed to be working under. Which means the patient is again getting shafted from receiving quality, dignified care.

  6. I watched 60 Minutes and think it was good that they had a segment on that showed that there is a real problem with the criminalizing of the seriously mentally ill. I worked in a large county mental health system where we tried to treat the people with more serious problems who didn’t always take their meds and many had no insight into their brain dysfunction. Half our county jail inmates were being given psych meds and most were antipsychotics. A lot of the violence we saw was on family members such as beating a Mom to death with a baseball bat. Yes some were using street drugs but others were too dysfunctional to even get those. Many were homeless living under the freeways. None of this was happening when I was growing up in the 50′s and 60′s. Society should ask why that was not happening then. I think we all know that the commitment laws are not working and there need to be some changes made or more senseless violence is going to happen with more people who are out of touch with reality in jail. The most effective treatment for the real seriously mentally ill was a long acting injectable medication with supported supervised community housing or long term rehab housing with supports in the community like Clubhouses. I am on the board of a non profit that is providing permanent supported housing in central Florida called Dave’s House. The link is http://www.brainfoundationofflorida.org. There needs to be a lot more funding for housing, research and changes in the laws to solve this huge problem. I have seen major success stories but also many tragedies both in California and also in Florida.

    • I totally agree with all you have to say! I pray all our states put this in place! I live in Indiana and remember what it was like in the 60′s even here in Indiana. So many people are alive and thrived back then! Thank You!

  7. My personal suspicion about the _60 Minutes_ piece is that Steve Kroft has fallen into the popular fallacy _post hoc, ergo propter hoc._ Post hoc conclusions that someone who perpetrated some horrific crime may have had an undiagnosed mental illness do not justify the propter hoc contention that all persons with mental illness should be locked away for the safety of the public. Moreover, the main reason why this Canadian believes in gun control laws comes down to the choice between policing the means of violent crime or policing the people. And the United States has effectively accepted the enormous political and financial burden associated with policing the people.

  8. For some background, read how ‘untreated’ become a meme – no science, determined focus and lots and lots of money.

    http://fair.org/extra-online-articles/mindless-and-deadly/

  9. O.K., I’m kind of conflicted about this issue and am trying to choose the right words not to give the wrong impression. I have had mental health problems for most of my life, and while I am functional and productive, have had to rely on a good deal of medication and therapy to stay that way (as well as keeping my life much more simple and predictable than I would prefer).

    I am not violent or aggressve at all, and am likely to become extremely passive and withdrawn if my symptoms are worse. From what I’ve read about statistics on mental illness and violence, this is pretty typical even for people a lot worse off than me.

    However, it is not contradictory to believe the following statements.
    A. The majority of the large, diverse population of the mentally ill are no more violent (or perhaps even less violent) than the average person.

    B. At the same time, those suffering from certain conditions may be an exception to the general rule. For example, someone with delusions of persecution may be motivated to “defend” themselves from imagined enemies. Some may also have delusions in which they expect a violent act to be rewarded, like the guy who tried to kill President Reagan and thought this would make Jodi Foster fall in love with him.

    So it is possible to entertain the possibility of danger from a small sub-group of the mentally ill without promoting fear of the mentally ill as such. The concern wouldn’t even apply to most people with serious psychotic disorders. But when you have a situation of delusions with violent content + a history of violence, aggressive personality traits, threats, weapon ownership or high levels of impulsivity, there is reason for concern.

    Another thing is that even if “mentally ill” is not the correct term for most of the recent mass killers, there still could be mental health problems associated with their actions. Personality disorders and/or anger management and impulse control issues, for example.

    People with these types of behavioral issues come in contact with the mental health system as well as the mentally ill, and professionals should be better trained in seeing and responding to the signs of danger.

  10. The problem of murder started with Cain and Able. Back then it was considered sin. I don’t things have changed much since then.

  11. I think the Doctor interviewed on 60 Minutes made a good point. To many of our mentally ill are in jail or prison. This indicates to that our society is still in the dark ages when it comes to the handling and care of our mentally ill. I think that was the basic message he was trying to get across.

  12. I’m not a mental health professional, but I am someone who has lived with the stigma of mental illness.
    Mental illness only comes to light when you have a James Holmes or someone of that nature do something awful. The majority of people with mental illness are not violent and are more likely to be victims than victimizers. We tend to suffer in silence.
    A fair number of us hold jobs, but much of the time these are not high paying jobs. Many of us cannot afford counseling. The county mental health systems are overwhelmed, and their first line of treatment tends to be putting a person on medications. I personally do not tolerate most medications, and I find that most of the counselors are not used to dealing with higher functioning individuals such as myself. They are used to dealing with people who are severely compromised.
    I have long thought that I could benefit from cognitive behavioral therapy, but I could never afford it.
    Yes, the mental health system in the United States fails overall. But it doesn’t simply fail to weed out and incarcerate the violent mentally ill minority. It fails the non-violent mentally ill majority by not having affordable, accessible treatment available to us. This treatment would include counseling, not just putting us on drugs and sweeping us under the rug.

  13. Dr. Grohol has opened up a major concern, not just in America, but the basic issue of how we can prevent human violence toward self AND others. When I wrote my book focusing on the series of school shootings in the mid to late 90′s, I distanced myself from the professional squabbling and media indifference about why do most persons perpetrate massacres against innocent youth and adults. As an emotional health educator, I have focused on an aspect rarely discussed: Those kids and adults who want to harm others, and often themselves, suffer from unbearable emotional pain, which keeps them collecting and hiding it unside until it explodes. We must know that it is hurt people who hurt people. Yet we need widespread preventative coping skills education to explain this no-fault dynamic tortures so many pre-teens and teens.

    So, what can we do about it? First, we should be developing practical brain-based coping skills programs in communities and our elementary achools. Preventative public health requires that, since no one else knows what a person’s experience is in their inability to identify one’s “Four Core Emotionally Wounding Experiences”: Losses, rejections, betrayals and humiliations.

    To explain why the human brain coping process is sensitive to, and essential for dealing with one’s emotional wounding experiences we need free education programs which I’ve been advocating for nearly 20-years starting in pre-teen years in elementary school.

    Having demonstrated a practical, basic “no-fault” educational program that removes BLAME & SHAME, I began first introducing and evaluating a Brain Works & Coping Skills for Kids project with over 700 4-6 grade classes. Results from that demonstration program in California and Arizona led me to offer a FREE, open-access online educational resource so any educator, mental health professional, parent or pre-teen/teen to learn practical ways of getting over hurt feelings in a “no-fault” process. Now, nearly 6 yrs. later, I’m surprised that this exploratory website, http://www.copingsklls4kids.net, is the leading resource in the world on the subject of brain-based coping skills. I’m amazed that among the half-million visitors to our site, many of whom hear about it via social media, are youth and adults from every state in the U.S., plus 192 other countries.

  14. I agree with the individual above. I have experience with the mental health system. I entered after a nervous breakdown after too many assaults and overwhelming discomfort with life. The psychiatrist told me I was bipolar and I complied wanting relief and help. I took antipsychotics, ssri, benzos, lithium, Depakote, ambien..and I became void and suicidal. The type of help offered was condescending to me as a human. I have had several jobs before, and lived an independent life. I became non compliant to their dismay and anger..then withdrew with no help which felt like torture. I was on one medication in the end and got healthy enough to start doing small things again. Then, I went to a counselor. I had to pay, as the system only offers nurses and half hearted case workers that talk to you like a child. The counselor helped through EMDR and diagnosed as PTSD. How did this happen? I’m left dumbfounded with suicide scars and the memory of condescending arrogant medical professionals that disregarded my experiences and looked down on my humanity. Perhaps sometimes the “treatment” offered is not helpful??? I’m sure sometimes it is, however if this happened to me,i’m sure it could happen to another individual and I do not wish it upon anyone. doctors also prescribe irresponsibly, I know someone with a TBI that was on 4 SSRI drugs and gabapentin. I was shocked. He is now dead. These stories are from real life, not the DSM 5.

  15. The fact that mental health professionals cannot agree on the problem or how to approach it is a disservice to society. Academic arguing over whose methods, theories, statistics and treatment approaches are correct is great for the classroom, but offers nothing for the good of the public. Ask the man on the street what the problem is and they will tell you these violent acts were committed by mentally ill young men. A result of a broken mental health system. An observation that doesn’t even require a high school education. So while those with the knowledge and skills to fix the problem continue to argue about who is right, the rest of society sits and waits for another violent act to be committed by individuals who needed help but couldn’t get it.

    • Did you miss the part where the vast majority of murders in the U.S. are NOT committed by people with a mental illness?

      Or the part where a person with mental illness is far more likely to be victim of a violent crime, than a perpetrator of one??

      Because what’s “obvious” to you is far less obvious when you take two minutes to look at the data. Or we can just continue painting those with a mental illness with a nice broad brush, and continue to discriminate against anyone with such mental illnesses in society.

      That’s much easier than having a nuanced and careful discussion about this issue.

      • I am aware that the majority of violent crimes are not committed by people with mental illness. Which is why we should be more concerned when they do happen. It is obvious to me the system is broken because: 1. Mental health parity laws have not been followed by insurance companies. 2. Lack of treatment facilities. 3. The difficulties family and friends experience when trying to find services or offer information about their loved ones with mental illness. 4. Stigma, caused by lack of education and information. 5. Confused patients when they see 5 different mental health professionals and receive five different diagnosis or methods of treatment. 6. The time consuming difficulties created for physicians trying to commit involuntarily. 7. Advocates with their own agendas and interest that do not take into account the needs of the individual situation. These are practical matters not requiring scientific data to solve.

  16. We are a culture of scapegoats and blame. When this magical drug that improves insight and judgment is released and mass produced at a reasonable cost, America will be cured.

    Wish there was a sarcastic font for that last sentence. But, it is was psychiatry sells as a whole, what the public clamors for these days as a whole, and, common sense is the exception in problem solving. Cue Congress in illustrating that dearth of common sense

    Quick fixes, folks, that is society today. And what is a firearm?

  17. Hi, Our Mental Health care in this Country is proably one of the worst in the World! First off Insurances don’t want to pay… Why? If your diabetic you see a specialist…. why not the same for someone who has emotional issues? No you see we want to put everyone in a room (Group) and pay one therapist to oversee… I have experienced first hand “Unethical and Unprofessional Therapist” anyone care to discuss these issues… please feel free to let me know.

  18. Speaking as a retired Probation and Parole Officer, having some experience with treating violent offenders I am amazed to read the little concern with one of the major factors in the mass killings occurring in America (I am an Australian).
    America is the land where any citizen can obtain weapons of mass destruction. Thus any person with a slightly unbalanced brain, can execute their fellow citizens at the spur of the moment. The gun lobby is more powerful than any democratic government!
    Treatment of mental illness is usually based on the administration of drugs and/or psychotherapy, that by studies have shown to be fairly ineffective. This may leave about 60 percent of patients with treatment resistant depression or mood disorders. (http://www.hypoglycemia.asn.au/2011/research-evidence-for-hypoglycemia-part-4/#SSRIs)
    It should be realized that that about 75 percent of all your prisoners have drug addiction as a comorbid condition to their offenses. These addiction are due to “mental illness” where drugs and chemicals give some relief to the debilitating symptoms of mood disorders. A small minority of these drug addicts may graduate to more serious violent offenses, and yet the professions in the mental Health Industry have a poor record of even curing addiction. I believe this may be due to the fact that most psychologists are trained to believe that “Mental illness is an illness of primarily the mind” (by neurolinguistic influences), whereas in fact most people with mood disorders suffer from an underlying physiological illness that causes them to have “mental symptoms”. Having some experience in nutritional psychotherapy I have been able to help many violent offenders with a combination of nutrition- and psychotherapy to overcome their metabolic illnesses – mostly regarded as “silent diseases” – that have contributed to the dysfunctional personalities.
    For instance, one of the many metabolic disorders that contribute to mood disorders is reactive hypoglycemia – a pre-diabetic condition. It interferes with the production of biological energy (called ATP) so essential in the manufacture of feel-good neurotransmitters, such as serotonin and many others. It can be treated without recourse to drugs by the adoption of the hypoglycemic diet (similar to a diabetic diet). Of course there a host of other treatable illnesses that can be treated such as most of the digestive disorders – Crohn’s Disease, Irritable Bowel Syndrome, Celiac disease and so on – that interfere with the absorption of vital nutrients that the body requires to manufacture feel-good neurotransmitters. In psychonutritional treatment it is essential that these physiological factors be treated FIRST, before embarking on talk-therapy which remains ineffective so long the biological aspect of personality is ignored!
    What is needed is to get rid guns in the community and and reform the Mental Health Industry with a greater emphasis on non-drug treatment in the direction of nutritional biochemistry and followed up with psychotherapy. It needs a team of specialists of psychiatrists, psychologists, Nutritional psychotherapists, nutritionally trained nurses and counsellors, family therapists an so on to bring this about.

  19. Ah, the leader of the APA does not disappoint: here is Dr Lieberman’s post at http://www.thehealthcareblog.com he did last Friday:

    http://thehealthcareblog.com/blog/2013/09/27/after-the-navy-yard-shooting-a-call-to-action/#more-65913

    Interestingly at the end, he wrote this, which to me sounds eerily similar to what Torrey was quoted in Dr G’s post at the top:

    “In his recent book, American Psychosis, the mental health advocate E. Fuller Torrey writes that “at least one third of the homeless and 20% of the incarcerated” are mentally ill and that “our public (mental health) facilities are overrun by untreated individuals”. The recent spate of mass shootings is a tragic and preventable consequence of our failed policy.”

    It is amazing these guys say with such certainty that these shootings are preventable consequences.

    Can I get one of their crystal balls for my office?

  20. We must fight the stigma to keep the “old way” the thing of the past; that being the way of the permanent commitment in a psych ward full of abuse and neglect. Thanks to the wonderful headline on MSN this morning, the masses are being force-fed the idea that the mentally ill are coming for them, much like a zombie horde… “Woman in DC Shooting May have Thought Obama was Stalking Her, Sources Say.” http://usnews.nbcnews.com/_news/2013/10/04/20816675-woman-in-dc-chase-may-have-thought-obama-was-stalking-her-sources-say#comments

    It goes one to say she has a history of mental health trouble.

    The comments are especially infuriating with gems like:
    “The federals have just defunded a mental hospital in Maine. We need to transport these ill people to Washington to live there. More mentals will be shooting up schools. Close and do away with mental health and see the chaos spread. Our government is dysfunctional and we need a new form of government that will not allow the wealthy to take over.”

    And:
    “This is really sad. I feel bad for this lady’s family and her kid. We need to seriously re-think our mental health programs in America. It’s not gun control that will stop mass shootings it’s mental health reform. We have to setup a better system to have people exhibiting mental instability put into custody in a mental health facility (instead of jail like they are now). Florida’s Baker Act is a small step in the right direction.”

    I just love knowing that some people call us “Mentals.” Wow. What a lovely term. I know that the current system doesn’t work for everyone, and our entire healthcare system is not that great with the cost of insurance, etc. But this type of hatred and ignorance is going to start spreading. We need to fight this stigma. The media is turning against us. The hated mentally ill against the beloved guns; here comes the discrimination!

  21. I agree with Sammy the Cat; it just seems obvious that a person who commits a spree murder or a mass murder, or a person who commits serial murders, or even someone who kills their spouse and maybe their kids then maybe their own self… is mentally ill!

    The publication “Mother Jones” did a huge, very thoroughly researched article about all the spree killings and mass murders (MJ differentiates these) done in the USA *over the last 30 years* and when the info was available they included the mental illness diagnosis of the perpetrator(s).

    “… A majority were mentally troubled—and many displayed signs of it before setting out to kill. Explore the map for further details—we do not consider it to be all-inclusive, but based on the criteria we used we believe that we’ve produced the most comprehensive rundown available on this particular type of violence.”

    This article continues to be updated as new spree-killing or mass-murder incidents occur. Here is the link to “A Guide To Mass Shootings In America”

    http://www.motherjones.com/politics/2012/07/mass-shootings-map

    I agree that *something* is broken and needs fixing. Probably mutually interconnecting things about our culture, our laws, or our mental health care system are broken and need fixing. Or at least, improving. A better, more workable balance between individual rights and the right of the public to expect safety in public places needs to be found. Somehow.

    • Funny thing here is… when in America somebody mass kills, conclusions go straight to mental illness. In Europe, usually socio-political aspects are discussed first (although some tried to pass off Breivik as mentally ill… but probably for political issues, so they can swept neatly under carpet).

      One needs to look at the cultural and social aspects. Like it or not, in the USA violence is somewhat glorified, guns are glorified… so of course there is gonna be more violence. Don’t sweep it under carpet as “they are crazy”. You can screen the whole population and medicate everybody who ever shown an intrusive or anti-social *thought*. But violence is still gonna happen if current attitude prevails.

  22. As a research Biopsychologist I only need to bring up one important point that others have noted but I’d like to emphasize further that shuts down the whole idea that mental health related issues cause mass murderers. It is the issue of correlation vs. causality.

    People these days are out to look for “scapegoats” because they can not accept the fact that they have little control over such incidents as Newtown. Without this control they need to somehow come up with ideas/actions that will explain how such events can happen and act on them so that they are not helpless.

    So they pick the folks with mental disorders (the ‘Them” vs. “Us” mentality) and a group of people who can’t / don’t advocate for themselves. it’s the same idea that somehow gun control will really prevent these horrible events.

    So…let’s first look at gun control….It is true that one thing in common in gun deaths is that all those who committed these crimes have guns. But does that mean that all people who have guns are to be treated the same way as those who commit crimes with guns?

    Just so in these mass murders. Yes…it may be that a % of these folks have mental “illness” but given the very large number of folks with mental health issues who don’t commit crimes we can’t really talk about causation.

    In the recent CT gun control law the Dept of mental health and addiction services has been given the job of gathering information about those who have been hospitalized for psych problems and create a database. I shutter to think how those data might be used in other ways (background checks, landlord inquiries, etc.).

    It is interesting to note that many folks who consider suicide are not “ill” per se but just are overwhelmed with stresses in their life and or catch 22′s of life that they feel are unsolvable and very painful.

  23. What this amounts to is psychiatric Naziism & elitism. The problem with this lazy-minded “get ‘em into treatment” philosophy & is unforgivably missed is violation of free will & criminalizing the mentally ill. It is Un-American “soccer mom” hysteria, ignorance, & violates the spirit of civil rights legislation for the disabled. Less than 1% of violent crime is committed by the mentally ill. Gosh, 60 Minutes, what if you don’t want treatment? Did you forget patient’s rights in this dialogue? What this paradigm in America creates are “Montag”‘s & dissidents. In situations where medication is refused, patients are hit, assaulted, threatened & brutalized, & activists are persecuted, “leaned-on” by the system, & subjected to Russian, “Conquest of the Planet of the Apes” & “1984″ style public harassment & shaming. The dangers of anti-psychotic medication are crookedly covered up & concealed with literal Soviet tactics. Psychotropic medication is, for all intents & purposes, diluted insecticide/nerve gas (side-effects are essentially insecticide poisoning). John Nash (“A Beautiful Mind”) was a schizophrenic awarded the Nobel Peace Prize for the mathematical game theory & had been off of medication for 10 years when he was awarded it. Any know-it-all comments on him, CBS? Is he a threat, CBS?

  24. Terrible.

  25. I am a Mother of 4 sons, our third son took his life in 2002. He was 20 years old and tried everything! Psychiatrists would prescribe one drug after another! We saw 3 psychiatrists, one saw him for a month and moved out of state, the next wouldn’t even look at him, he looked at us his parents. The last one was too busy the night before our son took his life and sent us to another clinic and our son had to tell what he was going through All Over Again!! He then said” I don’t think anyone can help me!” We sought out psychologists and therapists and yes, he went to the Emergency at the hospital and only stayed 72 hours. What is wrong with you people in the psychiatric field? Our son had Major Depression and OCD in Scrupolosity and not one gave us the signs of suicide even after his stay at the hospital! Quit bickering about what all you saw wrong in this 60 minute piece! It’s been LONG overdue! And you professionals are worse than lay people as far as the stigma of mental illness goes. This is a father who tried to help his son to no avail and put the message out there! … Change the Laws so these kids can get Real Help instead of a revolving door! … What are you psychiatrists doing? What are YOU doing about it?!Why aren’t YOU screaming to the public and the politicians & using the media? No, you’d rather criticize! Our family will never recover and I pray in my lifetime I never have to go through that hell again with such a passive broken down system! .. You know how bad the system is! Make a Change instead of going in circles – kids are dying and families are suffering every single day!…Missing My Son- Deborah Sheets – Indiana

  26. Ask any mother of a seriously mentally ill child turned adult when danger is coming…we will let you know…and it doesn’t take a crystal ball to know it.

    My son was institutionalized his entire life “for safety” because medicine has left treatment of psych “issues” to behaviorists who could care less about finding a CURE….instead his young life was flushed down the toilet like all his peers the day he aged into adulthood in a county who’s civil liberties groups protect your right to live in the street until you die in the gutter…or batman playing movie theater (his mom knew) or elementary school classroom (Adams mom WANTED to have him committed but our LPS Laws made sure that didn’t happen….whew to think what an awful think it would be to Pass Leguslation helping families in crisis keep their sick disabled adult child safe and possibly just prevent the next Isla Vista…cuz Ethan’s parents… did they know he was sick?? oh that’s right they were AT THE POLICE STATION begging for help that very night…crystal balls…u have some nerve acting like kids like my son and his peers do not cause the chaos calamity and confusion in the world that society is feeling with MOST of our “acts of violence”…you know the ones I am talking about …the ones that have some young kid acting out in a delusional state his disorganized intentions…. the give away bleed to lead headline will certainly have the words “madman”…”lunatic” and generally “monster”…oh ya and the police… well they keep “looking for the motive”…. acts involving our kids hit society pretty hard…much harder then when our kids simply kill themselves…then no one cares…it sure seems like you are ok with the 5% being left to self destruct because not one word in your long winded attempt to dissuade folks from believing that severe mi has No Corralaton to TRAGEDY offers the suggestion that some folks might actually need Long Term INVOLUNTARY care because they LACK insight….there is a wonderful federal mental health bill that YOU and your peers should be supporting …instead you are helping to create more confusion in the eyes of the public by acting like mi and violence have NO correlation whatsoever…because of Misinformation spewed by groups like yours the bill is being chopped up by the GOP into bits that are “non controversial”and lack any assistance for Families with Adams, Elliot’s and Jared’s….we could save these children from the death sentence of the age 18 cliff if we had major reform of our civil commitment laws.
    Instead I ur children are allowed to roam free after 18 with County funded case managers “protecting” their clients “choice of housing”….that while our boy was HOMELESS and thinking he found his “new family” on the streets of Santa Ana Civic Center…four arrests three hospitalizations four group homes evicted from….all before he turned 19. Now he rots in prison with crazy boy tattooed (literally) across his beautiful face…pepper sprayed three times …keeps “reoffending” while in ISOLATION 23 hours a day…but NO MEDS because he “is fine”…according to the correctional facility our child will spend the next 15 years in he is NOT SICK ENOUGH for psych meds…see it’s not illegal to tattoo stuff all over your face but it is a problem if you are a seriously mentally ill young guy who gets drunk one day while homeless and decides to go into a bank with a sticky note demanding one thousand dollars…..our county promised that once matthew “got in trouble with the law” they could help him….they failed to mention all that help was voluntary only….God forbid we force meds into someone who is as “fine and healthy” as our boy. Families alone watch as children are left to self destruct after 18 all while carrying 400 pages of psych hospitalizations and medical records dating back to age 5 to Board of Supervisor meetings begging for AOT services.
    Not every tragic act is preventable but it is discourteous of you to assume that boys like ours don’t exist…many families have begged for help while predicting the exact collateral damage you claim has no association to the illness that has robbed them of the very ability to fight back and recover…no insight equates to tragedy.
    Personally Speaking of Course

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