People like me who have mental health disorders suffer more violence than we inflict on others, yet we continue to carry the stigma of being unpredictable and aggressive individuals.
In the “events” section of a morning TV program I saw, for example, there was some news with sensationalist overtones. The first was about a son who had killed his father and the second was about an individual who had beaten another and left him in a coma.
The journalistic decisions in the presentation and commentary of both events were as follows: in the first case, the alleged perpetrator must necessarily have “mental disorders” to justify his conduct. But in the second case, it was not “necessary” to jump to that conclusion because the information focused on the bad reputation of the alleged aggressor, nicknamed “The Nazi”.
When there are no factors that can offer an “explanation” for violent behavior, journalists should collect statements from the neighborhood and from family members asking questions such as “did you see him acting strange lately?”, “Did they take any medication?“, and so on. If the statements point to possible “mental health problems” as the cause of the crime but they cannot be confirmed, you usually hear that the subject “had no history of mental illness”.
Societal defense mechanism
Much progress has been made by feminists to point out repeatedly that rapists or abusers are not people with a mental illness, but are “healthy sons of patriarchy.” The latest study carried out Spain’s General Council of the Judiciary (CGPJ) on sentences of sexist violence (published in 2018) shows that psychiatric pathology (which also includes addiction to alcohol or drugs) was only evident in 5.4% of cases.
This data follows a trend that has been observed for a long time: being a person living with a mental health issue is an irrelevant factor in determining an individual’s level of aggressiveness. In fact, in the reports carried out by the same Spanish organization to establish the profiles of both victims and aggressors emphasized that there is insufficient objective data to define “guidelines, patterns of behavior or attributes of the relationship that potentially trigger situations of violence ”.
Madness fulfills a social function.
So, where does this inclination to think that the mentally ill are more violent than the sane come from? For the psychiatrist José Valdecasas, associating madness and violence “is inherent in our capitalist Western civilization.” The people who do not produce enough for the system and do not respect the rules “are really dangerous for the established order in terms of showing the possibility of not accepting that order.”
For Valdecasas, it is also “a defense mechanism for a society that, in the face of terrible events, finds the easy escape valve of ‘madness’ as an explanation of what happened, which avoids further questioning.” Janis Lago, a former psychology student who has a mental illness, says the same thing: “Madness fulfills a social function”… “society, as it defines the construct of madness, needs it.”
Victims, not aggressors
Ana Carralero, a nurse specializing in mental health, adds that when the mental health of the aggressor is addressed to explain their behavior, “we stop looking at the real causes of the problem.”
Varrero, a nurse and professor at the University of Alcalá (UAH), points out the common belief that “people in psychiatric institutions who are violent are [presented as] proof that people with mental illness are violent.” But the institutional violence being inflicted on that person is ignored.
When a psychiatric patient becomes “agitated” in the emergency room, their behavior “is used by the ‘professionals’ to justify acting violently on them, for example, tying them to the bed, administering medication without their consent, etc.,” says Carralero.
Perhaps there is, then, a direct relationship between madness and violence, but not the one we think. Valdecasas also agrees that “people living with a mental health issue can be violent, but not at all in a greater proportion than the general population. Much more frequently, they are victims of mistreatment and aggression in a range of ways.”
The real reasons for violence
There are reasons to think that violence correlates with people’s mental health. This idea is endorsed by both the United Nations (UN) and the World Health Organization (WHO). The UN, in a study on the impact of violent crimes, points out that in countries with the highest homicide rates, the rate of mental health problems associated with them also increases. Mental health suffers both “among those affected by the crime, as well as among the survivors and relatives of the victim,” the agency points out, “which causes a general decrease in the quality of life.”
The latest WHO Mental Health Action Plan (2013-2020) confirms what we already knew: there are factors of structural violence that enhance mental suffering (with greater frequency and incidence) in certain social groups. Among them, the WHO highlights poverty, chronic health problems, child abuse and substance abuse in adolescence.
The main violent act committed by people with a mental health diagnosis is suicide.
It also insists that older people, racialized groups or, in general, “people subjected to discrimination and violations of human rights” are especially vulnerable. Finally, it adds to the list of causes unemployment, marginalization, gender and intra-family violence and “overwork and stress”, especially in the case of women.
When Germanwings Flight 9525 crashed in the French Alps in 2015, many believed it was because of the diagnosis of depression of its co-pilot, Andreas Lubitz. However, there was a 2007 report that contradicted this belief. ‘Time to Change’ was carried out by the British NGO Mind and Rethink Mental Illness.
The results of that study, which was carried out on the population of the United Kingdom, confirm that contrary to popular belief, the incidence of homicides committed by people with psychiatric diagnoses has remained stable since the 1990s. It also shows that people with mental health problems not only commit few crimes but also, comparatively, commit fewer than people with no mental health illnesses.
The report also details that the main violent act committed by a person living with a mental health diagnosis is suicide.
“No psychiatric history”
Why do even experts continue to insist on the relationships between madness and mental health difficulties, if even the big organizations reject this idea in their studies? The term that is almost always used is that of “psychopath“.
“Medical psychopathy already has overtones of ‘disease’ (because medicine deals, or should deal, with ‘diseases’). And in the association between evil and madness comes from this confusion,” explains Valdecasas. “If you are a moral psychopath, then you must be medically a psychopath, which causes a self-fulfilling prophecy.”
In this way, it matters little whether there was a diagnosis at the time of committing a crime. The diagnosis is given as soon as it is emphasized that this particular person “had no psychiatric history”.
