Knowledgeable Society Can Bring Hope To Mentally Ill

In light of the recent tragedy at the United States Capitol Building and considering that one in four of us will experience mental illness at some point in our lives, it is important to point out that many myths, fears and questions still surround mental illness and those who are affected by this medical condition.

In any given six-month period, 5.5 million American adults suffer from a major mental illness including major depression, bipolar disorder and schizophrenia.

Lately, several high-profile cases have highlighted the small percentage of situations in which a person with mental illness commits a heinous crime.

I find it troubling that in a July 28 Spokesman-Review article, (by Elizabeth Mehren and Julie Cart of the Los Angeles Times), Dr. Adrian Raine, clinical neuroscientist at the University of Southern California, refers to people with schizophrenia as “scary” and cites a research study from the MacArthur Foundation from which he concludes that as a group, people with schizophrenia are four to six times more likely to commit violence than the general population.

Schizophrenia is one of the most common and least understood of mental illnesses. The use of such words and the generalization about individuals with schizophrenia only perpetuate the misperceptions, stereotypes and stigma associated with mental illness.

The MacArthur Foundation study Dr. Raine cited reports that people with a major mental disorder and no substance abuse had an 8.9 percent rate of violence in the 10 weeks prior to hospitalization compared with 22.6 percent of individuals who are mentally ill with co-occurring substance abuse.

Also, the study indicates a significant reduction in violence over the year following a psychiatric hospitalization with appropriate outpatient follow-up.

What this demonstrates is that treatment is of critical importance in reducing violence. It also points out the necessity for better coordination between mental health and chemical dependency treatment providers.

The study reports that the presence of substance abuse increases the likelihood of violent acts in people with schizophrenia, but it also reports that patients discharged from psychiatric facilities who do not abuse alcohol and drugs have a rate of violence no different from that of the neighborhoods in which they live.

What most people don’t realize is that many persons who have schizophrenia are often passive, vulnerable and more likely to be a crime victim than to commit a crime.

It is important to recognize that treatment does work - although it is difficult when individuals move from state to state or refuse medication or care. According to the National Institute of Mental Health, only one-third or fewer of people with major mental illness experience a relapse within one year following active treatment.

Unfortunately however, many individuals in need of mental health services do not always seek treatment. Studies show that several factors influence this: cost, lack of geographic accessibility to services and lack of health-care insurance.

In addition to these factors, stigma is still one of the most troubling of all. Nearly 75 percent of Americans believe mental illness carries a stigma while 85 percent of Americans believe the stigma associated with mental illness affects the number of people who need help (Parade Magazine, 1993), by thwarting them from seeking treatment or delaying their getting help.

To date, nearly every current study indicates that public fears are way out of proportion to reality.

The issue of parity coverage for mental health treatment should be at the forefront with all of us as it is with national organizations such as the American Psychological Association, National Council for Community Behavioral Healthcare, National Alliance for the Mentally Ill and the National Mental Health Association. We must recognize that improved funding for treatment through parity legislation would increase accessibility and would contribute to greater understanding of mental illness thus reducing the stigma associated with this debilitating disease.

Without treatment, mental illness, substance abuse and emotional problems rob individuals and their loved ones of pleasures at home, school and work.

Advances in treatment, though, give hope to millions of Americans. So too, does a knowledgeable society - one with a greater understanding of the connection between mental health and the overall safety and well-being of people in our communities.