April 19, 2007

Mental Illness and Violence

Ken Duckworth, MD, Medical Director of the National Alliance on Mental Illness (NAMI) has released the following statement on this week's tragedy at Virginia Technological Institute (VTI). We have also included information from the Treatment Advocacy Center - an advocacy group the works for greater availability of treatment options for people who are mentally ill.

NAMI extends its sympathy to all the families who have lost loved ones in the terrible tragedy at the Virginia Polytechnic Institute and State University. We are an organization of individuals and families whose lives have been affected by serious mental illnesses.

Despite media reports, Cho Seung Hui, the shooter in the tragedy, may not actually have had a serious mental illness relative to other diagnoses.

The U.S. Surgeon General has reported that the likelihood of violence by people with mental illness is low. In fact, "the overall contribution of mental disorders to the total level of violence in society is exceptionally small." More often, people living with mental illness are the victims of violence. Acts of violence are exceptional. Treatment works, but only if a person gets it.

Questions must be answered about whether the mental health care system responded appropriately in this case. We know that Cho Seung Hui was referred to a mental health facility for assessment. Did he receive the right treatment and follow-up? If not, why not?

Are people with mental disorders truly more violent? Research supports some public concerns, but the overall likelihood of violence is low.

The greatest risk of violence is from those who have dual diagnoses, i.e., individuals who have a mental disorder as well as a substance abuse disorder. There is a small elevation in risk of violence from individuals with severe mental disorders (e.g., psychosis), especially if they are noncompliant with their medication...Yet to put this all in perspective, the overall contribution of mental disorders to the total level of violence in society is exceptionally small.

A study of adults with schizophrenia showed that symptoms of losing contact with reality, such as delusions and hallucinations, increased the odds of serious violence nearly threefold. The odds were only about one-fourth as high in patients with symptoms of reduced emotions and behaviors, such as flat facial expression, social withdrawal, and infrequent speaking.

The researchers found that the odds of violence also varied with factors other than psychotic symptoms. For example, serious violence was associated with depressive symptoms, conduct problems in childhood, and having been victimized, physically or sexually; minor violence was associated with co- occurring substance abuse.

Information from the Treatment Advocacy Center:

Warning signs from VA Tech shooter

Lucinda Roy, Virginia Tech English Department, told Neal Conan on Talk of the Nation that the Virginia Tech shooter was a disturbed young man ... and that she had tried to get him some help to no avail. read more.

Questions in Virginia
As details become known from Virginia, questions will grow more specific. "All too frequently, it is easier for a disturbed person, even a psychopath, to get a firearm than to get sound treatment for mental illness."

Read the Boston Globe Editorial: At a loss in Virginia

Hiding from warnings at VA Tech

Related Reading:

The Loss of Life in Virginia, and How it Could Have Been Prevented

The Virginia Tech Tragedy: Distinguishing Mental Illness from Violence


I wish you would send a copy of your findings to all the media to set them straight that all patients who suffer from schizophrenia do not become violent!

Posted by: Janet Kuhn at April 19, 2007 10:37 AM

I really wish that Hollywood would get on the ball and stop making movies that show people with mental illness as either dangerous and psychotic or mentally challenged. Either way it is wrong and people are brainwashed into believing this is the truth.

Posted by: Paula Fillion at April 19, 2007 01:06 PM

If most schizophrenics are peaceable then the word must get out! Who is in charge of our propaganda!!!??

Posted by: Al at April 19, 2007 05:52 PM

Elsewhere on schizophrenia.com I learned that people with schizophrenia are 4 times more likely to be homocidal. I was surprised by that because I remember reading we are also exactly 4 times more likely to suffer from alcoholism. Alcohol causes people to be violent and I think it is unfair, even libel, to blame psychotics.

Posted by: Wade Gielzecki at April 19, 2007 07:13 PM

Seem that everybody is now on about how the Virginia Tech gunman had psychological problems. But, they seem to forget that he killed using guns (few guns it seems). Everybody can go "crazy" - that is in a human nautre - but not everyone should posses a gun!!! It was directly the state who granted power of killing to this person - by letting him posses guns!

Posted by: Marija at April 20, 2007 03:37 AM

The state did not grant a person the power to kill by allowing possession of a gun anymore than they "grant" that power by allowing us to possess cars and alcohol which kill many more people each day than the guns. Illegal is illegal, and people will break laws and do horrible things. A million people have guns and never go on some rampage. Same with a car. Once in a while, it happens, and the focus should be on the individual and how collectively we can help people.

I notice that more people each day are killed by homemade bombs in one city alone - Baghdad - than this one time thing in Va., yet we are horrified by Va., and feel for the loss of each of their families, and we are simply numb about Iraq. Each one of those people in Baghdad have families that are in just as much grief.

Violenece is violence.

I would sleep a lot better knowing that millions of law-abiding, non-military, non-police, non-government citizens have guns than JUST the military and police. That is what's called a dictatorship or a monarchy. That is not what the American constitution is about.

Every time someone abuses a freedom, we want to strip a million other people of freedom. I'm sorry - I would rather have freedom AND responsibility. The problem is not our freedom, but our lack of responsibility - both for our own actions, and responsibility for the care of each other. This particular individual should not have had the guns, but my focus is not on what he should not have had - but what he SHOULD have had - proper medical care for a disorder affecting his thought processes.

Now that he is dead, we will never know what that condition was. For all we know - it could have been undiagnosed hypothyroidism which was causing his severe depression. Last I read, Depression was what he was diagnosed with. And Millions of people have some amount of depression and go on to live just fine without need for restrictions and mointoring. Heck - even our military and police and presidents sometimes suffer from this malady. Cho's obviously was an extreme. Maybe a lot more was going on.

Just my opinion.


Posted by: Naomi at April 20, 2007 08:28 AM

This might not be the place to discuss this kind of issues, I will just add one more comment, no more.

Cars, alcohol and other things that can be abused were made to bring more confort or fun, but guns (or bombs) are made with one only purpose - to kill or to severaly wound. We can easily live without them.

Society should fight for non-killing types of weapons and ban the guns completelly. That would hurt no one except maybe the industry that makes profit on them now a days.

Posted by: Marija at April 20, 2007 08:48 AM

Guns are used for hunting and for self-defence. It helps with survival and in the event of chaos, such as during hurricanes & their aftermath, they can be used to defend home and family against roving gangs. This happened in Florida, and in some neighborhoods, people did stay behind with guns after their families evacuated. Those are the neighborhoods that were NOT looted.

A woman alone may have little defence against a big strong male predator, but again - a gun levels the playing field and can PREVENT violence. It is a tool.

Banning guns can only work if ALL guns world-wide suddenly disappeared - and that means from the hands of all governments, all police, all military, and all criminals. Poof. Otherwise, we once again will give up freedom for an illusion of safety. Still, it would not prevent deaths from mob violence. I'd rather go down fighting then just be a sitting duck for some mob racial hysteria or whatever.

Posted by: Naomi at April 20, 2007 12:03 PM

Whatever the pros and cons of gun
control(I would be pro more gun control if i lived in the US)the question should be
why was this person not picked up
as being someone unsuitable to be in possession of a firearm.

Certainly screening procedures need to be improved to lessen the
probability of further such sales of firearms to unsuitable individuals.

Posted by: Tim at April 20, 2007 01:51 PM

"screening procedures need to be improved to lessen the probability of further such sales of firearms to unsuitable individuals."

There-in lies another danger - the danger of yet another registration in the U.S. like the sex-offender registry, registration as a felon, etc... I can just see the stigma-propagation machine and the witch-hunts for anyone with a "mental-illness".

Who would voluntarily go to a doctor for depression, mania, OCD, hearing voices, what might be a brain tumour, thyroid problems, schizophrenia or anything else if they would run the risk of forever after being on some kind of national registry that would flag them as being a "risk" for gun ownership? Or maybe driving a car... taking care of children... where would we draw the line? Cho's diagnosis was depression.

It is really complicated, which is why it hasn't been done.

It is medical teatment which is imperative, and follow-up care.
Hopefully, without the threat of being "labelled" forever after.

Posted by: Naomi at April 20, 2007 02:37 PM

I agree with Marija,

Hand guns are designed to be effective at one task - killing people - and I would suggest that they have no role in a civilized country. In most developed countries the ownership and use of these weapons is extremely controlled for the simple reason that if you don't people have a tendancy to use them, and typically with very little provocation. This tendancy for gun use make the average citizen much more likely to get shot. Most people think being shot is a bad thing. Research clearly shows that if there are more handguns in a given population, there are also more deaths by handguns - i.e. you're not safer with more handguns - you're less safe. Look at other developed countries and you can clearly see this.

In the US approximately 29,000 people a year are killed by hand guns - or approximately 10 per 100,000 citizens. In Canada - an equaly wealthy and diverse country - has approximately 792 gun deaths per year (or about 2.5 per 100,000 population) - or about 1/4 of what the death rate in the US is. European countries have an even lower death rate by hand guns. So - if we use this as a rough guide - an extra 20,000 people in the US are being sacrificed each year because of very loose gun control measures in the US. I don't think too many people - if they really thought about it - would judge 20,000 people killed each year as a reasonable trade off for the "added security" of protecting themselves (as Naomi suggests) from the federal government.

A bigger question is how could anyone judge theselves safe when they have the highest death rate per capita of any developed country?

Each decade this totals about 290,000 people killed by handguns - our own citizens against our own citizens. The number of US citizens killed in Iraq or the World Trade Center is miniscule compared to the number of people who kill each other in the US each year.

If people are willing to sacrifice 29,000 of their fellow citizens a year because they think they are "safer" this way (with plenty of guns) - I would suggest they really need to re-evaluate the facts, and their thinking.

Posted by: SzAdministrator at April 20, 2007 03:17 PM

''Who would voluntarily go to a doctor for depression, mania, OCD, hearing voices, what might be a brain tumour, thyroid problems, schizophrenia or anything else if they would run the risk of forever after being on some kind of national registry that would flag them as being a "risk" for gun ownership?''

I very much doubt there would be a mass of people thinking 'i won't go the doc in case i'm not allowed to own a gun'

In fact it could be argued that anyone with the above problems who chose not to do so for fear of not being allowed to own a gun would be too foolish to be trusted with a gun.

Posted by: Tim at April 20, 2007 11:17 PM

I distrust national registries. I have watched the corruption of Megan's Law (sex-offender registry)- something that started out as a good idea, and then over the years spiraled into something like a witch hunt with all the hysteria - with kids urinating in public on the registry, and children themselves getting labelled as pedophiles, and the entire country ostracizing people who are not predators - along with the people who really are. It makes no difference - once on the registry, the stigma is enormous regardless of how petty the offence. So, after seeing that good idea spiral into ever increasing sanctions without the application of common sense, I see what can happen once we create a national database.

Then there are felons and another data base... even if it is a juvenile taking a parents car without permission - stupid - but they have restrictions for life because of the stupid thing they did 40 years ago - like never voting again (if the crime was in some states), and being restricted from some jobs?

The repercussions go far beyond simple gun ownership - and that's not so simple either. I come from a state which is big on hunting, target shooting, etc. About 3/4 the adults I know shoot. It is recreational and a hobby. A few hunt. Many are also Ham radio operators, fly model airplanes, etc. It is a lifestyle that I guess people from big cities and crowded states would not understand.

But back to repercussion of this national database.... Because of our "Homeland Security" - our databases are now shared with other countries and even if a person has a DUI 40 years ago as a teen, they are being barred from crossing the boarder into Canada which they may have been doing because they have a summer home there, and have been doing so for the past 20 years!

So - I would hesitate to do anything that would put a depressed teen on any kind of governement database being flagged as a "risk" because that same teen who is depressed might otherwise have grown-up to have a job travelling to different countries, or be governor, or whatever.

Once we create a database... it gets used for all kinds of things that we had no idea would be used for .... such as barring people from crossing borders, restricting job opportunities, and even restricting where they can live.... even if it was some small event as a juvenile. That's my observation of events in the U.S.A.

Posted by: Naomi at April 21, 2007 07:11 AM

Dear Chuck Heston Fans (9 comments )


Dear Chuck Heston fans:

I thought now was the sickest time in our history, It just got sicker.

CHO fired 100 bullets from an automatic weapon he had just bought by mail. He had been a mental patient but the power of the NRA prohibited including that information as part of his only one minute gun clearance allowed by the NRA.

He got one of his brand new guns on the internet ($580 on a credit card) but the power of the NRA prohibited more than a one minute back ground check, so he got his clearance, and his shinny new GUNs.

I cannot believe the discussions that are now going on with the NRA Nutzies

Hey I have another idea that the NRA Wackos will love.

Get rid of these pesky regulations, let's go ahead and arm the kids but don't stop there. Let every man, woman, and CHILD carry concealed weapons. They actually said that if only one kid in that classroom was "packing," that student could have stopped CHO

John Wayne Lives. No LAWS about mandatory training and no restrictions on what guns or how many... and no restrictions on armor piecing amo or what quantity. NO RULES will make the NRA really happy... and PROUD.

THE NRA (with offices in the White House) has always stopped your president (any president ) from any restrictions on their GAWD given RIGHTS... just so they can hunt unarmed birds, deers and "varmints."

Maybe we should arm the teachers and the coaches and the school boards too and perhaps put gun towers in the school yard and armed guards in the hallways... just like in San Quinton. What the hell. It works there... usually.

Remember we did not need to shoot the Korean. He shot himself but he was not the only crazy person out there. With the new NRA plan our well armed children can shoot any more Crazies who show up on the school grounds or in the class rooms or on the street... or even at home... Let them decide.

Not sarcasm, or Hyperbole...

Just an extension of the thinking of your NRA pundits who want no restrictions of any kind on guns or amo.

If we can have one moment of reality remember that it was the NRA's beloved Ronnie Reagan and the Republicans who closed the mental hospitals in 1983 and put all of the crazies out on the streets. I know they will find some way to blame all of this on Nancy Pelosi or the Clintons, or Jane Fonda.

We could use this monumental tragedy to come together and establish some real rules but the NRA has dug in even deeper and will never budge. Any restrictions takes away their constitutional right to form a Militia. Remember... that was with Muskets.

NOW this truly IS the sickest time in our history. It just got sicker. The border guards are still in prison, and this week Bush's friend and the most important lawyer in the world said UNDER OATH "I can't remember" 74 times.

How bad could the Dems possibly be? GAWD bless.

Posted by: James at April 22, 2007 04:12 PM

I'm quite tired of there being stories of schiz.'s that are tormented by their disease and then commit crimes and people like NAMI feel the need to come out and NOT support that person and their family but rather try to explain that most mentally ill persons are never violent.

It's time that an orgnization is started and takes a strong stance of supporting the growing need to decriminalize the severally mentally ill.

There needs to be help for the families going through such pain with their schiz. loved ones sitting in jails and prisons.

The prisons need to be better eqipped to handle and treat the mentally ill in prisons. I'm really tired of orginizations turning their backs on this need in the community!

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