I found the May 12th Pantagraph “Our View” article “The Mental Health Debate Needs Improvement” helpful. I would like to expand on several aspects of the article. First, I think it is important to recognize that the terms “mental illness” and “mental disorder” refer to specific professional designations that meet diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD). These diagnoses not only have legal implications but also serve treatment purposes. Mental health professionals often use the terms “life problems” or “mental problems” when an individual’s psychiatric history is unknown and does not meet clinical criteria for a mental illness. Continuing to use the terms mental illness or mental disorder to prematurely explain an individual’s behavior when no formal evaluation has been performed may further stigmatize those individuals. Additionally, using the phrase “history of mental illness” to describe the behavior of someone who has committed a life-threatening violent crime against another person is vague, often lacking confirmation by the DSM or ICD, and may misrepresent an individual’s actual psychiatric history.
Anyone else reading this…
Only highlighting and reporting a history of mental illness when we are just beginning to investigate all possible motives is “bringing” mental illness to the forefront and further perpetuating the impression that mental illness is, subtly or indirectly, the primary cause or contributing factor to a person’s violent behavior. It is unfortunate to accept such a (well-worn) conclusion before fully evaluating all possible motives. There are many reasons other than mental illness that lead individuals to resort to violence. These include example by others, access to weapons, peer pressure, low tolerance for abuse, revenge, notoriety, a history of discrimination, poor impulse control, and even deliberately creating the possibility that the perpetrator is engaging in such extreme violent acts as a way to prompt his or her own death. I think it is best to consider that such extreme behavior probably stems from multiple reasons. One way to reduce the impact of stigmatizing a suspect is to not mention any potential motives, including the individual’s mental state, until an investigation of all potential motives has been completed.
The Pantagraph article also notes that “…schools are implementing programs to teach children the basics of techniques such as mindfulness and cognitive behavioral therapy.” While these techniques may seem harmless, they can evoke negative images and feelings in some people. When such programs are used, it is reasonable for school officials to consider screening for pre-existing conditions, having trained adults oversee the programs, and examining research findings on the effectiveness of these interventions.
The final comment in the Pantagraph article is worth repeating: “Blame everything on mental health issues can oversimplify a complex situation.” Referring to mental illness without identifying other possible motivations for violent acts before a full evaluation is another way of negatively stigmatizing an individual.
Douglas Lamb, Bloomington
