The students in my undergraduate Community Partnership course – Brent Chandler, Marta Conant, Jacqueline Cormier, John Durham, Levi Krajewski, Jenna Libby, Nick Tolbert and Kate Wypyski – and I have been heatedly discussing the broad use of the term “mental illness” of late, and here are our thoughts.
“Mental illness” is currently a media buzzword, especially with regard to recent tragedies that have rattled the nation. Countless articles make not just an association between mental illness and violent acts, but also suggest it as the root cause. We consider such generalizations to be irresponsible and unproductive.
ABOUT THE AUTHOR
Marcia Goldenberg, MS, R.N., is a member of the faculty at the University of Southern Maine School of Nursing.
The media encourage us to think in generalizations by using this term as a catch-all phrase to describe a broad range of disorders, which castigates the many people living with mental health diagnoses and can distort society’s view of them, essentially making them into boogeymen. Readers can fall prey to human nature, to “err on the side of caution” and walk away with a general association between mental illness and violence. Thus, stigma is born.
Imagine a successful executive whose extreme mood swings are now well managed by medication; a nursing student with a history of chronic depression who was named to the dean’s list for the fourth consecutive term; and a young man with a history of hallucinations and delusions who is not receiving treatment and hears voices telling him that he is a worthless person. What do these individuals have in common? Each is living with a mental health condition, but that does not mean that each poses a threat to the community.
Very few people with severe mental illness are dangerous to others. Using this umbrella term does a disservice to those in recovery or struggling to reach out for help, and does not address the root of the recent school shootings and other tragedies.
Research has shown that the best predictor of violence among those with schizophrenia is the same as it is in the general population: a history of experiencing or perpetrating violence. Similarly, just as with the general population, substance abuse plays a significant role. Environment and context are just as important, if not more so, than “mental illness” in determining a person’s likelihood to perpetrate violence.
The average reader may not distinguish between depression, anxiety, schizophrenia, obsessive-compulsive disorder, personality disorders or sociopathy. Often, several different diagnoses can be made within the overarching category of any particular disorder. Additionally, people with a given condition fall on a spectrum with regard to the severity of that condition.
Instead of glibly explaining away a person’s behavior by labeling them “mentally ill,” why not instead look into the specific behaviors or traits of the individual? When an individual dies in a single-car crash and it’s reported that the individual suffered a “medical event,” we rarely consider that a sufficient explanation. Was it cardiac, neurological or suicide? Were there drugs and/or alcohol involved?
Living with a mental health condition is more common than some know. Nearly one in five Americans is living with a mental health condition, the National Institute of Mental Health has found. According to the World Health Organization, the average American has a 50 percent chance of having a mental health disorder, not including eating disorders, personality disorders or schizophrenia. Furthermore, in any given year, nearly one in 10 adults will suffer from a mood disorder (such as depression or bipolar disorder), according to NIMH, while almost one in five will suffer from an anxiety disorder.
Many people who are affected by mental health disorders live successful lives and manage their diagnosis well. Yet more than 60 percent do not receive treatment, whether it’s from a lack of resources or an unwillingness to seek treatment for fear of stigmatization.
We need to talk more about whether or not there were warning signs when we discuss those few within a community who do commit acts of violence. And we need better treatment opportunities. People need to feel safe when seeking out resources, and we need to foster that environment. We need to support all people across the continuum of mental illness and recovery who read this seemingly constant stream of stigmatizing language that fails to explain the conditions in question.
As student nurses and working nurses, we have a unique opportunity to see people living every facet of the human condition, and we are hoping that we can destigmatize through our care, but we are only part of the equation. The media have a responsibility to present accurate information about mental health diagnoses to foster understanding, reduce ignorance and minimize fear by explaining the unknown, rather than further deepening it.