Problem
People with serious mental illness account for a disproportionate share of suicides, homelessness, violence, and incarceration.
- 2 million mentally ill go untreated
- One-third of mentally ill go homeless (200,000)
- 16% of incarcerated (300,000) have mental illness
- 1,000 homicides a year are committed by mentally ill
- 10-17% of seriously mentally ill kill themselves
- $15 billion is spent incarcerating mentally ill
- Random acts of violence by minority are tarring the majority.
Five Policies that Save Money, Improve Care, and Keep Public and Patients Safer
- Spend smarter: Spend on mental "illness" not mental "health".
- Use Assisted Outpatient Treatment (court ordered outpatient treatment) for those with a history of violence dangerousness or multiple rehospitalizations due to noncompliance.
- Reform involuntary commitment laws so they prevent violence, rather than require it.
- Reform Medicaid law to preserve psychiatric hospitals (eliminate the IMD Exclusion)
- People found Not Guilty By Reason of Insanity and unfit to stand trial should receive mandated treatment
Are people with mental illness more violent?
If you are talking about the 40-50% of Americans who may have a "diagnosable mental disorder", then 'no', the mentally ill are not more violent than others.
If you are talking about the 5% of Americans with the most serious mental illnesses--primarily schizophrenia and treatment-resistant bipolar disorder, then 'no', the mentally ill are not more violent than others.
If you are talking about members of the 5% group who go off treatment that has previously prevented them from being psychotic, hospitalized, or violent, then 'yes' the mentally ill are more violent than others. This higher than normal rate of violence increases even more when these groups abuse substances. When people ask, "Are the mentally ill more violent", they are usually asking about this group, the most seriously mentally ill.
What can make people with serious mental illness become violent?
Violence is almost always associated with going off treatment and becoming delusional or psychotic. There are many reasons people with serious mental illness go off treatment. Some reasons are not unique to mental illness while others are.
The ability to regulate behavior is compromised because the brain is the organ affected.
Anosognosia: Up to 50% of people with schizophrenia and many with bipolar lack insight: they are so sick they don't know they are sick (anosognosia).
Costs/Side Effects: Some refuse treatment because of costs, side effects, lack of support, etc.
Civil Liberties: A misunderstanding of civil liberties, the nature of mental illness, combined with misinformation prevents us from mandating violence preventing treatments.
Reaction to hallucinations and delusions. When people with serious mental illness act out, they are often doing so as a logical reaction to their delusions, hallucinations, and paranoia. If you think someone is the Devil and trying to kill you, you will try to hurt them first.
Misplaced Funding: Most money spent goes to mental 'health' not mental "illness". People with serious mental illness are usually sent to the end of the line, rather than the front. The ability to get services is inversely related to need, therefore people with serious mental illness find it difficult to get services. Mental health providers often discriminate against highly symptomatic people with serious mental illnesses.
Discussion
Almost everyone has issues with involuntary commitment and involuntary treatment. This site rather than saying "it's a difficult issue" and dropping it, attempts to study the science and law to come up with policies that balance the right of patients to have freedom, their right to receive treatment, the public's right to safety, and sound fiscal policy.
Please Read Uncivil Liberties |
