Ending the 'US' versus 'THEM' mentality

Research indicates that people with mental illness are ten times more likely to be the victims of violent crime than the perpetrators, but when instances of violence are covered in the media the accused are often referred to with phrases like ‘madman’, ‘insane gunman’, ‘psycho killer’ in an attempt to explain the unexplainable. We want to draw a line between those who partake in everyday society and those who commit violent crime because it is more comfortable to live in a reality where there is a separation between ‘us’ and ‘them’. It is also more comfortable to believe that people who commit violent acts are biologically programed to do so because it removes the burden of greater cultural context or social responsibility.

Reporting on mental illness is a perfect example of the media saying ‘if it bleeds it leads’. A study conducted by the Mental Health Commission of Canada found that 15 percent of articles covered mental illness in the context of recovery, only 16 percent actually quoted a person with lived experience, but a full 40 percent referred to mental illness in the context of violence and crime.

The really awful and ironic part of this type of coverage is that it increases stigma due to misinformation. , Increased stigma leads to fewer people seeking treatment, and lack of treatment increases the risk of poor outcomes which in some rare cases can be violence.

It’s not just the media that is confused though. I am a person with a mental illness and I am not violent nor have I ever been violent, but throughout every hospital admission or assessment I’ve been to I have been asked early on and repeatedly “Do you have thoughts of harming others? Do you plan to harm someone?” Obviously it’s important to screen people for violent tendencies, but statistically you may as well ask that very question of any member of the population and get just as many honest answers. It’s not the exact question that bothers me (it has to be asked) so much as the immediate and constant implication that I am mentally ill therefore I might be dangerous. That implication wears at an already frail psyche; it makes it even harder to trust oneself. I remember upon my first admission being asked that question by every health care professional I spoke to in the ER (the triage nurse, the medical resident, the social worker, the medical doctor, the on call psychiatrist) before receiving a two guard security escort to the children’s mental health ward. I was 16, I was admitted for depression, and the most real trouble I’d ever gotten into was detention for not doing my homework.

Treatment centres and hospitals are not impervious to the ‘us’ verses ‘them’ mind set that occurs within the media. That is why I believe in more open concept inpatient spaces instead of wards where the majority of the staff sit in an enclosed area separated from the patients by a wall of plexiglass because it enforces that mentality. The patients on the outside think “they’re watching us; they’re watching us; they’re watching us” while I suspect some of the staff on the inside think “they’re up to something; they’re up to something; they’re up to something”. This breeds mistrust, which leads to tension and hostility, which in itself leads to acting out.

Spending quite a bit of time observing people in psychiatric wards both as a patient and later as an advocate has led me to the philosophy that if you treat a person like a criminal they are more likely to act like one. I have watched people who were initially passive become increasingly agitated and hostile when they are treated in a suspicious and contentious manner. So while screening for violent or paranoid tendencies is in fact necessary perhaps it would be more effective to do so in a way that doesn’t make the patient feel like they are dangerous or under persecution.

If mental health consumers are treated with trust and integrity instead of suspicion and hostility they will be more open, more receptive, and more likely to return for help if they experience recurring symptoms that could potentially lead to violence.