Source: JulieFast/Dreamstime used with permission Our mental health community has worked hard to end stigma. My work as a writer, trainer, and coach focuses on educating the world to the true nature of what it's like to have bipolar disorder and/or a form of schizophrenia as I do myself. My books are for those of us with mental health disorders as well as caregivers and health care professionals. My one-on-one work is with parents and partners.
Today, in the media I see a divide opening up that is as big as the Grand Canyon, one that we need to close if we want to stop the tide of public deaths in the United States and around the world caused by people with unstable and quite often, untreated mental illness. To do this, we have to accept that many of us with untreated serious mental illness can be violent.
Currently, there are two messages in the mental health community: The public cry, We are not violent, and at the same time, behind the scenes, Please do something about people with untreated mental illness who are violent, but don't tell the world or we will have more stigma.
We can't have it both ways.
If we do, it's the Emperor's new clothes all over again. In our mental health community, we present the world one image and yet in the homes of scared parents and partners, overworked and overwhelmed mental health workers and police officers who didn't sign up to be mental health police, there are chaos and fear.
My approach is holding the situation in both hands. In one hand, I want the world to know that those of us with serious mental illness absolutely can get better if we say yes to treatment when treatment is available. On the other hand, I feel the ravages of my own mentally ill brain that has violent thoughts and leads me to violent behaviors. This is reinforced by parent and partner clients who tell me first-hand stories of mental illness and violence in their own homes.
We have a mental health violence crisis that no one in the mental health community wants to talk about openly.
- Our jails are full of people, especially men, with untreated mental illness, many of whom have been arrested for dangerous and violent behavior. Currently, there are 10 times more people with mental health disorders in jail than in hospitals. People who go to jail have often done something that is a danger to society. This behavior is often violent or causes them to make violent threats to people in their lives. Police officers are often attacked by people with untreated mental health disorders. I don't want this to be true, but it is.
- We want mental health background checks before a person can buy a gun. Gabby Gifford, who was shot by Jared Loughner when he was experiencing a paranoid episode due to untreated schizophrenia uses this language on her gun control webpage: "With a more comprehensive system for reporting mental illnesses and conducting background checks, we can avoid putting guns in the hands of people who pose threats to themselves or others." This directly says that people with a serious mental health disorder especially if untreated should not have access to a gun. Why? Because the gun might be used in a violent way. People with mental illness should not have access to guns because they are violent. That is the message.
And yet at the same time, our mental health community is spreading the message in the media that there is no violence in the mental health community. Here are a few headlines:
- It's not Mental Illness, It's Hate and Guns (CNN)
- No, Mr. President, Hate is Not a Mental Illness (The Washington Post)
Why does Gabby Gifford, a person directly affected by mental health and gun violence say one thing and then the party line around the U.S. and within mental health organizations says something different? Self preservation.
- Almost all ERs need a security guard for out of control and violent mental health patients.
- Psych hospitals that want to have a community feel can't do so: Patients harm each other. A hospital was created in Portland, Oregon that would be more humane and open to a community feel. I remember thinking, You are going to have a common area called a Living Room in a mental health hospital where people can interact with little supervision? Do you understand dysphoric mania and psychosis? It was closed within a year due to patient-on-patient attacks. ("Violence at Unity Center for Behavioral Health Draws Financial Questions".) I often ask myself, Where is the research before these decisions are made? Who is looking at the actual behavior of people with untreated serious mental illness? We want to end the stigma. I want to end the stigma. But we can't end stigma if we lie about what goes on behind closed doors, on in the case of Unity Hospital, in the setting of a common room.
- We need HIPAA reform and need to change our commitment laws so that parents and partners can be involved in helping loved ones find treatment. This is a widely agreed-on topic in my world of serious mental illness. HIPAA ignores the reality of lack of insight when a person is severely manic or psychotic. But unless we admit that they are a danger to self or others, which often includes violent behavior, how can we make the change? Who will listen to us that change is needed if large mental health organizations say people with mental illness are not violent?
Donald Trump said what so many of us have asked for—that we need to examine our mental health system and make it easier to get people in a mental health crisis to get the help when needed. I am no fan of President Trump in any way, but I can't ignore that he said what we have been asking for. And yet, the mental health community attacked him for saying that mental illness is the cause for mass shootings. So, we agree that Dylan Klebold, James Holmes, Jared Laughner, Seung-Hui Cho, Nikolas Cruz and so many more were experiencing a mental health crisis before they killed so many people, and yet mass shootings are not related to mental illness?
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Research — the kind reported after there is violence in a mass shooting—strongly points to people with untreated mental illness as the perpetrators of the majority of mass shootings in the U.S. In many cases, family members tried for years to get help for the child.
Child-on-parent violence in common in the mental health community. For over 20 years, I've worked with parents who have children who are violent due to untreated mental illness. Society doesn't want to know about these kids. How can a child attack a parent? That goes against the law of nature. But in my work, I see it weekly. There is very little help for these families and now, with the rhetoric coming from the main mental health organizations that people with mental health disorders are not violent, the families will experience even more shame and fear: Wait, people with mental illness are not violent, but my child is? Am I doing something wrong?
It is time for people in the mental health community to stop pushing the agenda that people with mental illness are more likely to be harmed than to harm. When it comes to serious mental illnesses on the bipolar and schizophrenia spectrum, I don't believe this to be true. We can cause harm when ill.
We need a balanced discussion. The majority of people with mental health disorders have depression and anxiety. They are not known to be violent. Those of us with SMI or SPMI on the serious mental illness scale who have a form of bipolar or a psychotic disorder? We are the ones in jail and in hospitals. We are on the streets. We are the one who needs a health check before buying a gun. No, not all people with serious mental illness are violent, but I can honestly say I have never met someone who is in a dysphoric manic episode with psychosis who is not violent to some extent. Even if it's just throwing a cup at a wall. Ultimately, suicide by gun is the most violent act a person can commit.
Violent and criminal are not the same thing. Violence is violence.
We can't end stigma while simultaneously giving the opposite message that none of us are violent. It sends a mixed message and, in my opinion, will lead to more killings.
Families and partners who live with a loved one who is violent will not tell you what is going on if they are told there is no violence in mental illness. They will suffer in silence due to the very community that is supposed to help them. Police officers will not take their calls seriously if the message is that there is no violence in mental illness. People also fear suicide by cop. Think of the position we put our law enforcement in when we say there is no violence in mental illness?
The police are in an impossible situation. This past weekend, two clients of mine called the police due to a child making threats to parents. Both children voiced the idea that their parents should be dead and both had physically harmed a parent in the past. The parent's calls for help were completely ignored. One police officer said, "Until she actually harms you, we can't do anything."
One 911 operator said, "Does he have a knife to your neck right now?" No? He said you would be better off dead? That is not a real threat. "We can't come out."
I have thousands of stories like these. It is not the fault of 911 operators or the police. It is in how they are trained. If large mental health organizations keep saying, "People with mental health disorders are not violent," police officers hear this message and will not respond with the urgency needed to help families who are in potential danger.
Why Do Mentally Ill Killers Seek Out Hate Groups?
When a person becomes more mentally ill, they will seek groups that share their hatred. A white man will find a white nationalist group, a Muslim will find an anti-Jewish group, an African-American will find a militant black rights group. This is the nature of the illness and when the full story of the killer comes out in the news, in many cases, people will say, "He wasn't racist until he got so sick. His hatred started when his brain wasn't working correctly."
As the mental illness progresses, the person will look for a group that is filled with as much angst, hate, and rage as he feels and usually right before a terrible situation, this person will join that group where he feels safe. If you hate it that women don't look at you, 8chan and the incel community are there to serve your needs. This is then called racism or hate. FBI behavior specialist John Douglas has the best writing on this topic in my opinion. He has many books on how racist and hate-driven behavior escalates before a mass killing.
Can We Find Balance?
Our current discussion isn't scientific. It is based on wishful research. Jail, gun use, domestic violence, and children who harm parents are daily experiences in the mental health community. These are terrible things to think about and to talk about. But ignoring this in the mental health community will not make it go away.
The mom of one of the recent shooters in El Paso tried to tell the police she was scared. They ignored her. "The kid is 21 and has a right to have an AK47," the police said. The young man opened fire at Walmart and killed innocent people. It is being called domestic terrorism. Once again, this will fit the agenda that mentally ill people are not violent and push the focus to gun control and hate.
This is not a gun problem. This is not a hate problem. This is a mental health problem. If we leave our ethnocentric American bubble, we will see individuals with untreated serious mental illness use knives and swords in the same way we use guns here in the U.S.
If we want to reduce the number killed, yes, we must ban these guns. But if we want to stop the killings, we must face the fact that some of us with serious mental illness are violent. This needs to be discussed openly and honestly or the killing will continue.