Sage Words about Violence and Mental Illness

One of the blogs that I highlight down of the left-hand side of this one is attached to schizophrenia.com.

They have a particularly good entry for April 20th, that discusses not just the tragedy in Virginia and its possible relationship to mental illness, but also some broader social questions. Having been born and raised in the UK, and then worked there and in the United States in both medicine and psychiatry I can really relate to many of the points made in the article. It really should be disseminated as widely as possible, so I am going to do something that I usually do not, and quote the article in full:

The Loss of Life in Virginia, and How it Could Have Been Prevented

Read more… Schizophrenia, Poverty & Crime

Whenever a tragedy happens such as the recent shootings in Virginia,
the question inevitably turns to why did it happen, and how could it
have been prevented.

While some reports (such as here, here and here)
have suggested the shooter in this tragedy – Cho Seung Hui – might have
suffered from psychotic depression, schizophrenia or bipolar disorder –
its impossible to know with the limited amount of evidence available,
and even after all the evidence is reviewed it will never be known for
sure.

From what has been reported it does, however, seem obvious that he
was seriously depressed and socially withdrawn, and had some
significant delusions of persecution and paranoia. Whether these
symptoms add up to a serious mental illness or some type of sociopathic
disorder is unknown. Some factors don’t seem to point towards
schizophrenia – as Cho Seung Hui did not seem to suffer from the lack
of motivation (called avolition) that is so common with schizophrenia.
He was able to attend college and, from the sounds of things, was
attending classes regularly and finishing his assignments. Typically
when a person develops schizophrenia schoolwork and personal hygiene
the first thing that suffers, and an inability to complete schoolwork
is common.

With regard to the question of why did it happen – it is of course
impossible to know for sure. But at the same time research into mental
illness and brain disorders does point to some possible answers.

The path towards mental illness (any mental illness) is a complex
one with many different factors – from genetic predisposition and
pregnancy factors, to early life stresses and environmental factors, to
social stresses. We have more information on this in our “Preventing Schizophrenia”
– but fundamentally the factors that nudge people towards mental
illness are many and varied. The factors that have been conveyed about
the life of Cho Seung Hui suggest that early life experiences could
have been factors. Here are some of the relevant points that have been
discussed in the news:

1. A Difficult Early Life – news on the family has suggested that
they had a difficult (low-income) family life in Korea which prompted
the move to the US when the parents had a young family. A low income
life that motivates a young family to leave a country – is likely to be
a high stress environment – a factor that could contribute to mental illness.

2. Social stresses of immigration to the US (many studies out of the
UK have indicated that immigrants frequently face extremely difficult
social challenges in new countries due to a lack of understanding of
social norms (as well as racism) – which causes a great deal of social stress and significantly higher rates of mental illness.

3. Cho Seung Hui’s Father worked in a Dry Cleaning company – and the family may have been exposed to higher levels of dry cleaning chemicals – which are linked to neurological damage.

Additionally, on a related topic, Dr. Michael Merzenich, the Neuroscientist at UCSF – comments in his blog
on the important issues related to the general social environment that
is also a factor in the extremely high levels of gun violence and
deaths in America – typically 300% to 600% higher than in other
developed countries:

“Our jurisprudence is based on
the principle of “blame” for behaviors that should by hypothetically
controlled by our “free will”. Alas, human observers and psychologists
(and with increasing clarity, we brain scientists) have understood from
the beginning of time that your or my “will” is not entirely “free”.
The boundaries of “good judgment” are defined by a combination of the
inherited factors governing our brain function, by our physical brain
status (2 million head injuries/annum in the US alone!), and the
brain’s own plasticity-embedded experiences. For most of us, our
genetics combined with fortuitously not busting our skull in the wrong
place and with our particular plastic, experientially-driven brain
‘history’ adequately protects us from serious transgression. At the
same time, in our (and other) contemporary society(ies), we tolerate
conditions that result in millions of young men and women being reared
with an experiential history that is NOT adequate to keep THEM safe
from offending. THIS IS THE PART OF THE EQUATION THAT IS UNDER OUR
(SOCIETY’S) CONTROL. We’re doing a bad job with it. In fact:

1) We live in a violent society chock full of models of behavior (a
violence & fear-obsessed media, violent films, gangsta rap, et
alia) that are well outside any rational societal norms. The mass
murder of children on school campuses is one our MANY rather
spectacular modern American-violence inventions with little historical
precedent.

2) We tolerate the hardening of young brains to
otherwise-not-tolerable bloody, shoot-em-/slash-em-up violence as an
acceptable source of intensive training “fun” in the heavily-rewarded
game-play of millions of our children. All that intensive training is
somehow supposed to be just fine for the child and their brain?! Those
tens or hundreds of thousands of violent repetitions in rewarded
behaviors just don’t matter a whit? Stuff and utter nonsense.

3) We continue, collectively, to find innumerable ways to shame
children in their young lives as “failures”, “weaklings”, “misfits” or
“oddballs” in school and in life.

4) We send juveniles and young adults off to crime school (prison) at an extraordinarily high (and growing) rate.

Sometimes I think that we could hardly be doing a better job of
training young people to misbehave. When they do, we hold them to a
universal high standard of acceptable behavior that they may actually
have had little experience with, in their own path through life, in our
very own society.”

Lastly – there is the issue of easy access to guns in the US – which
when combined with all the above factors makes for an extremely toxic
mixture. Easy access to guns results in high death rates in shootings;
death rates that are typically 500% to 1,000% higher in the US than in
other civilized countries, as can be seen in the diagram below.

National Comparisons for Selected Countries Homicide Rates Per 100,000 Population

Source: Corrections Service Canada

As New Scientist Magazine notes
“Scientific studies have demonstrated over and over that owning a gun
makes it significantly more likely that you will be shot. The US has
the highest rate of firearms-related homicide in the industrialized
world – Americans are literally sacrificing hundreds of innocent
citizens each year upon the altar of the Second Amendment.”

Are any of these factors preventable? Yes – of course they are – but
the actions are costly and complex. To prevent these types of tragedies
takes:

1. Better education of the public about how to achieve mental health for their children,
2. Early and easy treatment for mental disorders with early testing and screening in schools,
3. Good insurance coverage
so that people can actually get their mental health problems addressed.
The US is the only developed country in the world that severely limits
coverage of mental health problems. Better and easier access to high
quality mental health treatments is a great need in the US.
4. Laws that make it possible for mentally ill people to get treatment, even though they may not understand the need.
5. A reduction in the culture of violence in the US (a movement to reduce violence in movies, on TV, and in video games). Read: In denial about on-screen violence for more information.
6. Strict gun controls
that take the millions of hand guns off US streets, and that will make
it more difficult for the people who become mentally ill or who have
psychiatric disorders – to obtain guns. Approximately 29,000 US
citizens are killed by their fellow citizens each year, by hand guns.
(see Statistics, Gun Control Issues, and Safety for more information)

The answers are relatively clear – but whether we actually do anything about it is up to you.

Related Reading:

Mental Health, the Law and Predicting Violence (NPR)

America’s tragedy – Its politicians are still running away from a debate about guns (The Economist)

Mayors urge Bush to tighten gun control laws

Stricter gun control after shootings at U.S. university – not going anywhere fast

Relationship of US gun culture to violence ill-understood

Violence may be a ‘socially infectious disease’

Fewer cheap guns = fewer criminals with guns

Posted by szadmin at April 20, 2007 08:45 AM