While conservative sources seek to absolve guns themselves of any misdoings, liberal indictments of the mentally ill are typically couched as
well-intentioned complaints about the lack of mental health treatment in America. This conception of the mentally ill as potential killers isn’t far afield from that of Thomas Willis, the influential 17th century physician who concluded that the mentally ill were possessed of inhuman strength, and advocated that they be treated with “tortures and torments in a hovel instead of with medicaments” in his 1684 text, “Two Discourses Concerning the Soul of Brutes.”
Outcomes resulting from this kind of “information” include
60 percent of Americans believing that schizophrenia leads to violence, and 32 percent convinced that major depression, a disorder more associated with debilitating inertia, is likely to spur violent acts. But is this even true? Does mental illness necessarily lead to violence? And if not, why do we continue to believe that it does?
* * *
What separates these modern arguments from their Late Baroque roots is that most modern of rhetorical tricks: the relentless and contextless deployment of bogus statistics. In June 2008, Dr. E. Fuller Torrey, founder of the Treatment Advocacy Network, a group that advocates
incarcerating the mentally ill without due process and forcing medicative treatment,
wrote an Op-Ed for the Wall Street Journal, saying that “individuals with serious mental illnesses are responsible for 10 percent of all homicides in Indiana.” Torrey
trotted out the same University of Pennsylvania study in 2011, after Jared Loughner killed six people and injured 14 others in Tucson, Arizona.
In December 2012, shortly after the Sandy Hook Elementary School shooting, Torrey was quoted in a
New York Times Op-Ed. This time, though, his message was slightly different: “Ten percent of homicides are committed by seriously mentally ill people who are not being treated.” Note that Torrey’s claim was elevated from his last. There wasn’t new research, but the state of Indiana now became the entire country and the mentally ill now became the
untreated mentally ill. Torrey repeated his claim again in a
February 2013 Op-Ed for the Wall Street Journal. “
60 Minutes” concluded its September 2013 report, “Untreated Mental Illness: An Imminent Danger?,” with Torrey issuing a threat to the viewer. “We have a grand experiment: what happens when you don’t treat people. But then you’re going to have to accept 10 percent of homicides being killed by untreated, mentally ill people.” That figure was
repeated by CNN in November 2013. and
twice made its way into Mother Jones, where it was
vaguely attributed to the “Justice Department and other studies.” (The actual
Department of Justice number is that 4.3 percent of homicide perpetrators had a history of mental illness. This seems low, given that the Centers for Disease Control
estimates that 25 percent of American adults currently meet the criteria for mental illness and 50 percent of the population will suffer from a disorder at some point in their lives.)
However,
the study Torrey cites, done by Jason Matejkowski at the University of Pennsylvania, says nothing about 10 percent of homicides and comes to an entirely different conclusion: “Nonetheless, it appears that the most severe form of violence is more commonly perpetrated not by the ‘psycho killer’ so often spotlighted in the media, but rather by persons who have a major mood disorder with a long history of substance abuse. Such findings underscore the need to address co-occurring substance abuse among the severely mentally ill and to consider the interaction of substance abuse and other diagnoses when assessing risk for both lethal and nonlethal violence.” So different, in fact, that Matejkowski and his co-authors
published a letter to the editor of the American Journal of Psychiatry objecting to Torrey’s citation and use of their data.
So where does Torrey’s number come from? The number apparently originates from his
own research, which tracked all homicides in the Washington, D.C., area reported in the Washington Post in 1992, and collected the stories involving mentally ill killers. He found 13 stories that met his criteria. Torrey evidently assumed that the Post coverage was representative of the Washington, D.C., murder rate. This is highly unlikely to be correct, given that the Post covers only a fraction of the murders occurring in D.C., and that the reader-grabbing potential of a mentally ill killer would especially invite media coverage.
Torrey then compounds his invalid survey with another reductionist fallacy, assuming that the Washington, D.C., area was representative of the entire country. As his area of coverage was approximately 3 million people (1/85 of the U.S. population at the time), Torrey then multiplied the 13 stories he found by 85 to come up with 1,105 homicides, about 10 percent of the U.S. murder rate at the time, a figure he would go on to cite ubiquitously in the media. By all accounts, Torrey’s claim is based on sensational news reports and bad math, which he then repeats to a credulous media, like an ouroboros of fear-mongering and sloppy scholarship.
* * *
However, the surprising truth is that, Rodger’s issues aside, there’s not necessarily a link between violence and mental illness. The
MacArthur Community Violence Study, a survey of 500 persons, found that someone suffering from mental illness was no more likely to be violent than a person from the same neighborhood who is not (a finding to which Torrey, of course,
objected).
A
2009 University of Oxford study on schizophrenia and violence found that any link between the disorder and violence was mediated by substance abuse and that schizophrenics were no more likely to be violent than their siblings without mental illness. The same authors examined
bipolar disorder in 2010 and came to the same conclusion. Substance abusers without co-occurring mental illness were six to eight times more likely to commit a violent crime than the general population. Persons with bipolar disorder and substance abuse issues were six to seven times more likely. Consistent with Matejkowski’s findings, the mental illness is a red herring (these aren’t mentally ill offenders — they’re substance abusers who happen to be mentally ill).
The 2009
National Epidemiologic Survey on Alcohol and Related Conditions, a longitudinal study of nearly 35,000 people, found that violent behavior is only significantly higher in the mentally ill when there is co-occurring substance abuse. A
2012 re-analysis of the NESARC data came to the same conclusion. As a
2010 study about the role of violent behavior in mental illness concluded, “Substance abuse is central to the explanatory model because it is often intertwined, in various ways, with all of these vectors of violence; accordingly, its treatment should be a component of risk management in individuals with serious mental illness.” What this means is that mental illness, substance abuse and violence may have common roots — poverty, child abuse, environmental stress — or even, as several recent economic and epidemiological studies have concluded, the income inequality in a
given state or
country, which may explain as much as 74 percent of the difference in murder rates between U.S. states. What this does not mean is that mental illness,
ipso facto, causes violence.
In fact, the National Crime Victimization Survey shows that people with severe mental illness are
nearly 10 times more likely to be violently
victimized than the general population, and more than 16 times more likely to be raped. For those who argue that the ostensible purpose of firearm ownership is the right of self-defense, it’s not particularly consistent to propose to deny that right to an intensely vulnerable population.
But this has nothing to do with self-defense. Firearms are, after all, an industry. An industry that, last fall,
asked the Supreme Court to overturn a federal law banning teenagers from purchasing handguns in order to expand its market base. An industry that willingly spreads fear among the American populace in order to drive sales. Just look at Wayne LaPierre’s eschatological
speech at the 2014 Conservative Political Action Conference last month:
We know, in the world that surrounds us, there are terrorists and home invaders and drug cartels and car-jackers and knock-out gamers and rapers, haters, campus killers, airport killers, shopping mall killers, road-rage killers, and killers who scheme to destroy our country with massive storms of violence against our power grids, or vicious waves of chemicals or disease that could collapse the society that sustains us all.
Though it may seem implausible that LaPierre left anything
off from his list of reasons to be scared, there is one curious elision– alcohol. A Bureau of Justice Statistics survey found that in
64.4 percent of homicides, the perpetrator was under the influence of alcohol. A
2011 study found that 57 percent of homicides in the United States could be attributed to alcohol. Going by the
FBI’s estimate of 14,827 homicides in 2012, that’s 8,451 people per year. A 2006 study found that alcohol-related homicides cost the United States just over
$11 billion per year. By comparison, the same study found that DUI-related deaths cost the U.S. slightly under $18 billion annually.
So why don’t we approach handling guns while intoxicated the same way we treat drunk driving? Where are the massive public health campaigns informing our citizenry about the dangers of mixing firearms with drinking? Why don’t police pursue those who are intoxicated and possibly armed with the same ferocity as impaired drivers? And why have Arizona, Georgia, Tennessee and Virginia recently
passed laws explicitly allowing patrons to carry loaded guns in bars?
Too often in American politics, corporate interests such as the gun and alcohol industries are able to displace their costs onto people unrepresented by lobbyists and super PACs — people like the mentally ill. If we continue to scapegoat them with the convenient myth of the “psycho killer,” we are precluded from recognizing which factors
do contribute to homicides in the United States. Until we recognize and treat both substance abuse and violence as serious issues of public health, we, as a society, will continue to suffer their consequences.
We don’t yet know what role, if any, alcohol or drugs played in Rodger’s massacre. But we do know that, no matter what, the media will likely continue focusing on mental illness as the key cause (as if there aren’t huge numbers of mentally ill people who do not engage in mass shootings). And the NRA will be really glad they did.
2 comments:
Question: If we purport to be a "civilized" society, why (other than for sport) do we need guns?
Steve - Excellent logical question. But the subject of guns appears to have a more emotional than rational basis. They have become a totem of a mythical bygone age - when most Americans were white, well off and happy. Gun ownership is the last vestige of that illusion and the NRA has done a masterful job of converting anything to do with guns from a sensible safety issue into an assault on liberty and tradition. The reality is that gun ownership as defined by purchases by people who didnt previously own one is declining. Those who already own one or more are doing most of the buying. Hopefully, like most such movements, it will eventually fade away.
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