Assessing “Mental Illness” in the Aftermath of Sandy Hook
In the weeks that have followed the tragic fatal shootings that took place at Sandy Hook elementary school in Newtown, Connecticut, many people have theorized about the various measures that should take place in order to minimize the odds of future shootings occurring. Among these ideas include improved controls for guns, less violence in movies and video games, and of course, better efforts to assess and treat those suffering from a mental illness.
As a clinician who regularly deals with mental illness and psychopathology, I believe there are a number of important points people should take into consideration before racing to lock up those suffering from a mental illness (as some in the media have casually suggested).
- Keep in mind individuals suffering from “mental illness” (which in itself is an incredibly broad categorization that includes everything from ADHD to schizophrenia) do not generally walk around society in ways that make them easily detectable. Unlike someone suffering from a broken leg walking around with a cast, you really can’t pick out a mentally ill person by his or her “look.”
- Even if someone has been assigned a mental illness disorder, that does not mean they are a threat to others. In fact, of the millions of people worldwide suffering from a mental condition, the vast majority are very safe and no more a threat to society than anyone else.
- “Mental illness” is not easy to find pathologically, as you typically do not see different genetic structures or abnormalities, making it a very subjective science to diagnose mental illness conditions. The DSM is widely accepted and used by clinicians around the world to diagnose mental illness, but even this method is subjective. Furthermore, the DSM does not address the root of the cause, nor is it able to tell a clinician how dangerous a client is to society.
- “Mental illness” is often a transient condition and not always lifelong. For example, if you recently lost a loved one you might easily meet the criteria for a diagnosis of depression, but this diagnosis is really dependent on the death you experienced and will likely fade over time (with or without treatment). My point is that most mental illness conditions will wax and wane over time, and the line between “normal” “abnormal” and “mentally ill” is a very blurry one that has a lot to do with societal norms and clinician subjectivity and bias.
- Regarding mentally ill people, what is the best way to treat them? Years ago great numbers of mentally ill people were institutionalized, but inhumane treatment and incarceration were found to be archaic ways to help these people with their issues. As a result, the de-instutionalization movement took place, resulting in fewer people being hospitalized (and no longer treated like animals), but this resulted in more people left to responsibly live their lives without daily medical supervision and support. The debate about how and where to treat mentally ill people is still alive today, with arguments both for and against institutionalization.
- And finally, is it really mentally ill people we should be worried about — or instead the dangerous medications most are put on that are the real reasons for concern?? Many psychotropic medications used today are unproven and include a great variety of dangerous side effects (just read the black box warnings) – yet increasingly more people are being put on these meds by their doctors! Ironically, these medications often exacerbate conditions instead of correct the problems they are designed to remediate.
The solution to the mass shootings we have witnessed in this country is not to identify, capture, and incarcerate “mentally ill” people. Instead, long-term solutions should focus on all of the variables that likely impact these horrific crimes, including more responsible gun measures, more visible movie and video game warnings, and improved protocols for helping individuals who may be a danger to themselves or society. The reality is that there is no “quick fix” when it comes to tragedies like Sandy Hook, and it is impossible to try and pin all of this on mentally ill people and subsequently “lock them all up” as some are suggesting.