by Phyllis Vine

Controlling gun violence is welcome. But those who believe it will be accomplished by pinpointing people with a mental illness rest on a false confidence. The reason is simple: Most violence, including 30,700 gun deaths in 2005, is not caused by people with mental illness. Yes there have been conspicuous exceptions. But statistically rare events should not blur reality or drive public policy.

This is what appears to be happening. Take, for example, the headline in Monday’s Washington Post, “Memories Of Va. Tech Permeate Gun Debate.” And an editorial, in the New York Times, applauding a gun control law referred to the “dangerous mentally ill.” It is time to uncouple these incorrect associations.

In some communities guns are as commonplace as bottled water, leading to gang wars, domestic violence and, since 2004 when the concealed weapons law was allowed to expire, deadly weapons in handbags, coat pockets and backpacks. More than 3,500 youngsters were expelled between 1998-99 for bringing guns to school. A study of the Violence Policy Center reported 549 drive-by shootings in a six-month period during 2006.

Explaining violence by pointing to people with mental illness has has been driven by fear -- fear that people with mental illness actually want guns, obtain them, and then use them. And this assertion comes from rare, albeit vivid events, such as Virginia Tech which have been imprinted with repetitious photos, news clips, and tabloid headlines.

Numerous studies in the past decade have shown that, headlines aside, people with mental illness are not more violent. But they are disproportionately cited for violence. Dr. Paul Applebaum, who has studied this issue extensively, notes in a recent article:

the proportion of violence that [people with a mental disorder] account for is relatively small, suggesting that the well-documented public perception of the mentally ill as dangerous persons is substantially exaggerated and that the disproportionate attention given to their acts of violence by the media and by our elected representatives is unwarranted.

This information is routinely reported by watchdogs such as the National Stigma Clearinghouse, or in testimony such as that presented at the New York City Council Hearing in New York City last November. In testimony on behalf of the New York Association of Psychiatric Rehabilitation Services, Teena Brooks reminded officials of the oft-cited 1998 study saying “there was no significant difference between the prevalence of violence by (mental) patients” and their neighbors.

So why do people continue to fall for the trap that a focus on people with a diagnosable mental illness – anxiety disorders, panic disorders, eating disorders, depression, bipolar, schizophrenia, ADHD, alcohol addiction – builds a safety net when the facts indicate otherwise?

In his award-winning book, Crazy, Pete Earley describes how Don Lyle Jaffe, a spokesman for the Treatment Advocacy Center (TAC), suggested posturing around public safety to get people with mental illness into treatment. “Laws change for a single reason – in reaction to highly publicized incidents of violence,” Jaffe explained. He proposed they move the "debate out of the mental health arena and put it in the criminal justice/public safety arena.”

Since then, Jaffe and TAC have been tireless in calling for involuntary commitment. They have directed a fear-based campaign using extreme examples, including the tragic death of Kendra Webdale in 1999, for whom New York’s law for involuntary outpatient treatment was named. They work hard to link mental illness to terror: “For every Seung Hui Cho, thousands with schizophrenia or bipolar disorder don't make headlines,” reads a press release.

Now Jaffe would like to see Kendra's law extended to include inpatient commitment. He says he is attempting to “prevent violence before it occurs.” To link violence to people with a mental illness, in a January 2nd editorial in the New York Daily News, Jaffe recommends we anticipate danger. He appeals to New York's legislature, saying "tragedies are mounting," and asks for laws to "treat potentially dangerous patients."

The actual connection between mental illness and danger was recently addressed in an Australian radio interview, where mental health reform is a top priority. In a radio interview, the co-author of a new study Olav Nielssen tells host Norman Swan (transcripts):

I believe that assessment of dangerousness. . .condemns a lot of patients who may never have been dangerous. . .[T]he prediction of risk is a very weak science and it's well known that doctors aren't able to predict risk with any accuracy, particularly in people in the early phase of illness that we're talking about because they've got no form. They have no previous history of dangerous behaviour. . .

The point I'm making is that having dangerousness as your criteria for involuntary detention. . . leads to false negatives - you know, people wrongly detained who may not need to have been. . .

[T]he most serious violence occurs before any treatment. After a patient has received treatment the risk of violence declines dramatically to somewhere near the community average.

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