"Come, Let Us Reason Together" The Second in a Series Addressing Public Violence

            Within the problem of public violence, no issue raises us to the heights of passion, pro or con, as does gun control, which was addressed last week. There is one facet of the problem that has the opposite effect. Shhh! I don't want to hear it, or talk about it. Go away, mental health.

            Years ago, the mentally ill were warehoused, put away from society; out of sight, out of mind. "I don't want to see it, so I will put my head in the sand, or better yet, make the crazy people go away," was society's attitude. Things have improved, yet this attitude is still prevalent. We fear what we don't understand, and for centuries, man has struggled to understand and deal with mental illness, to understand those who are, and how to treat them.

            This fear has caused us to stereotype the mentally ill as being prone to violence where the opposite is true. Quoting from a study by Mental Health Reporting, "Although studies suggest a link between mental illnesses and violence, the contribution of people with mental illnesses to overall rates of violence is small, and further, the magnitude of the relationship is greatly exaggerated in the minds of the general population." Further, "People with psychiatric disabilities are far more likely to be victims than perpetrators of violent crime. People with severe mental illnesses, schizophrenia, bipolar disorder or psychosis, are 2 ½ times more likely to be attacked, raped, or mugged than the general population."

            So where does this perception come from? Quoting again from the same study; "Characters in prime time television portrayed as having a mental illness are depicted as the most dangerous of all demographic groups: 60 percent were shown to be involved in crime or violence. The vast majority of news stories on mental illness focus on other negative characteristics related to people with the disorder. Notably absent are positive stories that highlight recovery of many persons with even the most serious of mental illnesses"  

            There are many among us who have a mental disorder, who are being treated, and no one will ever know them from another. They have families, hold jobs, function in civic and church activities, and are solid citizens. Still, there are many who go undiagnosed and untreated, some of whom are violent. 

            Other studies have shown that the majority of the perpetrators of public acts of violence resulting in mass killings have described their planned actions to a mental health professional, parent, or friend. These same studies have identified behaviors that MIGHT be precursors to violence, but warn that they just as likely are not.

            August 1, 1966, Charles Whitman, a former Marine, and engineering student at the University of Texas at Austin, went to the top of the 28-story tower in the center of the campus, and at noon began an assault on anyone below. Before his rampage was over, Whitman had killed 14 and wounded 32. The mass shooting touched my life, I was there, and changed the consciousness of the country. 

            Whitman had confessed, only days before, to a University psychiatrist that he had fantasized about "going up on the Tower with a deer rifle and shooting people." This event caused legislation to be written in Texas requiring health and education professionals to report any individual who made such remarks that they thought were a danger to themselves or others. It is a judgment call for psychiatrist and others, and is flawed. Some argue that it has the effect of causing those truly sick and having violent thoughts to avoid seeking help.

            Another contributing factor to the mental health problem is a shortage of care. My son is a psychiatrist about to enter the Navy. He was heavily recruited by the service and was told that there are only sixty psychiatrists on active duty at any one time. These are serving the 750,000 comprising the Navy and Marine Corps. Care for the civilian populace is equally inadequate.  According to the Bureau of Labor Statistics, there are 23,140 psychiatrists practicing in the United States, in Alabama, only 290.

            The reason so few choose psychiatry is money. Most other doctors are paid on a per procedure basis, whereas, psychiatry is more a flat rate, if insurance pays at all. Submitting an insurance claim creates a permanent record of having sought help for a mental problem, which brings us to the stigma of mental illness.

            We have come a long way from how it was when I served in the military and came home with PTSD issues. Talking to a counselor was unmanly, and job threatening. A retired U.S. Customs Agent related to me how it was unspoken, but known, that if you sought counseling after a shooting incident, you were taken out of the field, and given a desk job.

            The stigma has diminished, but it is still there. Mental illness makes us uncomfortable. We 
understand, and are tolerant of all but the most infectious diseases, but of mental health, there is confusion and fear. Before we can identify those prone to violence, and treat them, we have to create an environment where all feel safe when seeking help with mental problems.         
             I hope you are beginning to see how the problem of public violence is a Rubik's Cube within a Rubik's Cube. Before the issue is solved, and legislation won't do it, all the colors have to be lined up, and there are many, many of them. We will twist the Cube again next week.