The Mentally Ill Are Not Dangerous
I’m getting really sick and tired of the media’s portrayl of Cho as a mentally-ill individual and all the following of “leads” from his psychiatric hold and the fact that two girls complained about him to police.
People with mental illness–and that’s 1 in 4 of Americans–are NOT dangerous. Even schizophrenics, those with the classic disorder that comes up when someone says “crazy person”–are NOT dangerous. They are suffering, sick patients. Did you know that the prevalence of schizophrenia in the population is about 1%? That’s 2.2 million Americans. If schizophrenics are so dangerous, we should be expecting to have about 2.2 million more school or workplace shootings sometime soon. (t’s absolutely important that if people need treatment, they get it, and there’s follow-up to make sure they’re getting it.)
Are there exceptions to the rule? Of course. Was Cho a very sick individual? Absolutely. But if we take aggressive, radical steps against every student or person who gets evaluated or placed on a psychiatric hold, we’re going to be hurting a huge number of people based out of fear and ignorance–and wasting a lot of time, money, and energy in the process. Terrible things happen in the world, and I’m sorry World, but there’s not always someone to blame.
Mental illness often reveals itself in the late teens and early 20s, and it’s often genetic. It takes a terrible toll on patients–they go from functioning in the primes of their lives to becoming isolated, lost, and removed from the world that they know. Imagine for one minute that you’re schizophrenic. Voices from inside your own brain tell you things–they’re so real that your brain’s auditory centers actually light up as if they’re hearing things. They tell you terrible, horrible things, 24 hours a day. That you’re a terrible person, that the police are coming for you, that you’ve done something terribly wrong. Want to know why schizophrenics so often are wearing headphones or earplugs, or are singing to themselves? They’re trying to find some way to drown out the voices that speak to them all day long.
These people don’t need our judgment and punishment, they need our compassion and help.
Thank you for this post. This persistent inflation of how dangerous mentally ill people are frustrates and saddens me enormously. The worst is when it comes from people who should know better. As part of our second year psychiatry course, we went in groups to various treatment sites to practice a psychiatric interview. The preparatory lecture to us focused far more than necessary on safety. The psychiatrist actually told a girl that she should wear her hair pulled back so no one could grab it; the possibility that a tie might be used to strangle you was mention. The doctor who took us to the ward told us to stay together and stay close by him. Gah.
I don’t think that’s too excessive, LadyGrey–especially since 2nd years often haven’t had any exposure to patients on a locked ward. Never hurts to be overly cautious–safety, and feeling safe–are incredibly important, but the hype is ridiculous.
But…as you know, there is a subtype of schizophrenia (paranoid) which can become quite dangerous. And yes, you should be careful on the psych wards because you really can get hurt. The media will always blow things up and make them bigger than they are while missing the important facts. That’s why people blog and watch The Daily Show.
Sure, but the vast majority of paranoid schizophrenics aren’t dangerous or threatening.
The media’s reporting of these things may also prevent people from seeking help for fear they will be locked up forever, or seen as a “bad” person.
Stories here in the news are about the criminal background checks that are required by volunteer organizations that work with children. Apparently some police departments are yellow flagging individuals as criminals if police were called for a psychiatric incident (in most cases, a suicide attempt). To think that someone who may or may not have called 911 for help in desperation may forever be barred from volunteering is sad indeed.
In many ways we have changed for the better in our treatment of mentally ill patients, but I still see the need for a lot more progress.
I have to agree with some of the safety precautions on the psych ward. Part of why many (all?) of the folks on a psych ward are there is because they were deemed a danger to themselves or others. Seems reasonable to me to be careful.
As a nurse for 37 years I would recommend to med. students to ask psych techs/nurses on the units where you see pts. Since they care for the pts. in an inpatient setting they can educate you on what safety measures are appropriate.
Cho had mental health issues from an early age. According to his great aunt, whom they interviewed in Korea, he didn’t talk as a child. I think that she said the reason that they moved to the US was for Cho to get care for his problems. She said that he was initially diagnosed as autistic, which is not surprising since that is often an early sign of that disorder.
Our understanding of mental illness is poor at best not only by health care professionals but also the general public. Although I am not a psych. nurse I am very interested in the field and have been attending excellent conf. held in SF sponsored on by the Mass. General Hosp. Psych. Dept. I highly recommend attending their conf. The experts share the latest research on all mental health disorders including updates on the latest pharmocotherapy, psychotherapy,etc.
Many experts have been debating the issues surrounding Cho’s situation. One forensic psychiatrist feels that the tragedy has pointed out the need for everyone to understand paranoid disorders and schizophrenia. Many folks failed Cho along the way in his life. For the judge to tell him to get outpt. mental health treatment showed how inappropriate it is for someone outside the mental health field to deal with a person who is exhibiting the behavior Cho had. Many mentally ill people don’t have insight into their problems so are not going to follow through. Especially the paranoid folks. They are hard to treat because they don’t trust MD’s or medications. I have a first cousin who is apparently paranoid schizophrenic but I am not sure if he has ever seen a psychiatrist. Because he had a large inheritance he is not a homeless person.
Also, not talking is not being “shy”-it’s abnormal! If someone is that “shy” at his age there’s something VERY wrong.
We have to look at how the public good may override the need for civil rights of the ill person. The threshold is too vague and weak. Cho’s writings showed clear signs of a person with a thought disorder. The pendulum has swung way too far towards civil liberties putting the public at risk. The most eloquent and rational speaker so far in this national debate, I feel, is the father of a severely psychotic bipolar son who has written a book called “Crazy”. He exposes the “craziness” of the dysfunctional mental health and judicial systems.
Health plans don’t usually cover long term mental health services. Kaiser used to only pay for 20 visits!! I don’t know what their coverage is now.
Andrea Yates was discharged early from an inpatient setting because her insurance ran out, as I understand. In spite of the nurses warning about the dangers of her early release she was discharged while still very psychotic.
It’s always sad when an important issue is finally brought into the limelight in the aftermath of a preventable tragedy. The father of one of the Columbine victims said that there needs to be more open discussion, detection and appropriate treatment before these disasters happen.
The examples I gave weren’t great, because they would be perfectly reasonable precautions — if put in a context that stressed that not everyone with mental illness is dangerous. Maybe an analogy to the Universal Precautions taken for infectious disease would be appropriate: you protect yourself as a matter of course, but at the same time you know that not every patient you see has hep C or AIDS.