Frontpage Forensics

Law and order from the couch

Mental Illness and Violence

Does mental illness cause violence?

Mental illness and violence are not synonymous. News reports and media portrayals continue to perpetuate the stigma that psychiatric disorders make afflicted individuals more prone towards violence.

The recent death of a teen with schizophrenia in North Carolina reminds us, however, that people with psychiatric disabilities are far more likely to be victims than perpetrators of violent crime. According to news reports, Keith Vidal, an 18-year-old with chronic mental illness, was killed on Sunday January 5, 2014. Reportedly he was tased and then shot by a police officer who responded to a call for help from the teen’s family.

The state Bureau of Investigation is looking into the shooting and although I am not involved in this case, it brings attention to many themes of interest including psychosis and violence. Contrary to widespread public opinion, these two issues are not interchangeable.

People are speculating about whether Vidal’s death resulted from an officer’s self-defense or his unnecessary use of force to subdue the reportedly psychotic teen.

One thing is for certain, discrimination and stigma associated with mental illnesses is nothing new. It is perpetuated by portrayals of psychiatric distress and violence in the news and media which greatly influence the minds of the general public. The effects of stigma and discrimination are profound.

Whether Vidal’s shooter was provoked or not is unclear, but we do know that the vast majority of news stories on mental illness either focus on other negative characteristics related to people with the disorder; impulsivity, unpredictability and unsociability. Notably absent are positive stories that highlight the recovery of many persons with even the most serious of mental illnesses. Inaccurate and stereotypical representations of mental illness can strike unnecessary fear in others.

Of course there are times when people with mental illnesses commit acts of violence. Risk factors (i.e. substance abuse or dependence; a history of violence, juvenile detention, or physical abuse; and recent stressors such as being a crime victim, getting divorced, or losing a job) can all precipitate violence.

It will be interesting to learn how the story of Vidal’s death unfolds. In the meantime, this case definitely highlights the need for more understanding and awareness of mental illness.

Helen M. Farrell, M.D., is a psychiatrist with Harvard Medical School. She researches forensic psychiatry and violence.

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