World Mental Health Day (Oct 10th) comes on the heels of a violent attack in Las Vegas which left 59 dead and over 500 injured. As with other shootings, the public’s response is to point at guns and mental illness – and while it remains divided on the issue of guns, the relative agreement on the threat of mental illness is worrying.
The American public has always seemed to lack an understanding of mental illness. Most people know the common names and defining symptoms of a few illnesses (usually bipolar, schizophrenia, and depression), but have no real understanding of what these illnesses entail.
Much of this is the fault of the media. Portrayals of mental illness are dramatized because we see mentally ill characters as “exotic.” Schizophrenia is always shown as full-blown, with the schizophrenic character talking to people that don’t exist and having appallingly delusional beliefs. Dissociative Identity Disorder (formerly Multiple Personality Disorder) is used as an easy twist where the person with DID almost always has a violent or murderous alter. PTSD is depicted as involving vivid and tangible flashbacks, often resulting in violence as the individual tries to defend themselves. But no matter what disorder is portrayed, violence is frequently involved in depictions of mental illness.
Our language misleads us even more – disappointment is “depressing,” being indecisive or moody is “bipolar,” and freaking out for a moment is a “panic attack.” The way we use psychiatric words makes their meaning seem trivial, while at the same time we seem almost incapable of imagining mental illness as anything other than debilitating.
The truth is most people with mental illness look like anyone else. Even those with what the public considers the “worst” mental illnesses, such as DID, PTSD, or schizophrenia, don’t tend to stand out or be obviously sick. Much like with colds or headaches, you can have a somewhat mild mental illness or have one that prevents you from doing almost anything – and every scenario in between. Sadly, our view of mental illness as all or nothing often results in people not getting diagnosed. Some individuals suffering from undiagnosed illness will attribute their symptoms to stress or other factors, failing to seek out help until their illness has progressed to a state where they are forced to. Even those with diagnoses often feel that their illness isn’t “as bad” as it should be, which can lead to feelings of guilt or doubts that their illness is legitimate – both of which can cause them not to pursue the help they need.
This polarization of mental health also creates a profound stigma around most disorders. Admitting to your diagnosis can be socially dangerous, and is rarely pleasant. When you reveal your diagnosis, your actions are from then on analyzed in relationship to your illness, and you are often expected to act a certain way, depending on what diagnosis you have. If you don’t seem ill, some people will think you’re making it up since “you’re obviously functional.” Others will believe you just told them to get attention, and every time someone with your illness does something news-worthy, people will look at you. And some diagnoses can come back to haunt you later, causing you to lose custody, lose a job, or be suspected of a crime. The stigma of mental health can be overwhelming.
Our blindness to the variety and intricacy of mental illnesses is part of why we stereotype them. Every mental illness is distinct, yet many overlap in symptomology and presentation, which often makes diagnosis difficult. Causation varies as well, with some illnesses being hereditary, some caused by life events, others caused by a combination of factors, and still others caused by substance abuse. However, the one similarity almost all mental illnesses have is that individuals with the mental illness are more likely to be the victim of a violent crime than be the aggressor. In fact, mentally ill individuals only account for 4% of violent crimes.
Despite this number, it’s hard for people to shake the association between mental illness and violence. When someone commits a violent attack, our first question is “why?” and mental illness is an easy answer. But even in cases where mental illness is involved, we can’t attribute the entire event to one factor. We cannot dilute a person to one trait. Every individual is impossibly complex, with innumerable factors influencing their behavior and beliefs, and to ascribe someone’s behavior to a single factor can only ever be a vast oversimplification.
While mental illness is not the leading cause of violent attacks, we still need to address it. We cannot adequately prevent, diagnose, and treat mental illness when most of our population has only a passing knowledge of it. It is my hope that through education, outreach, and accurate representation of mental illness, we can move towards becoming a society that recognizes and nurtures all who suffer – not just those who suffer physically.