Mental Illness, Violence, And Family Homicides

The topic of mental illness and violence is complicated enough in its own right, but also gets badly distorted by the misleading propaganda generated by the shameless National Rifle Association. The NRA attempts to distract attention from its role in gun murders by unfairly blaming the mentally ill. Their story line is that when murderers kill, it's not because guns are so readily available in the general population (courtesy of the NRA and the gun industry that supports it); but rather it's because all the shooters must have been crazy. But here's the hypocrisy. Only after the murder does the NRA claim the the murderer was crazy, whereas before the murder, the NRA would have fought to the death to allow him all the weaponry money can buy.

This is trying to have it both ways. The NRA argues that it is sane societal policy to have everyone armed with guns, at all times and in all places. Then it blames the tragedies that inevitably occur on the insanity of the individuals, not on the societal craziness and greed that has promoted the ubiquity of the guns.

This is nonsense. The vast majority of the mentally ill are not violent and the vast majority of violent acts are not committed by the mentally ill. Mass murders are a US specialty not because we have more crazy people per capita than other countries (we don't), but because we have the world's craziest policy allowing the accumulation of guns.

But we should not be naively politically correct in the other direction- and act as if untreated mental illness isn't a risk factor for violence. It is, and family members are often the victims.
Fuller Torrey has compiled statistics to put this issue into perspective. Dr. Torrey is founder of the Treatment Advocacy Center, a national nonprofit dedicated to eliminating barriers to timely and effective treatment of serious mental illness. 

Dr. Torrey writes:

"This is the first study of the role of serious mental illness in all family homicides.

There are approximately 4,000 family homicides in the United States each year. Individuals with serious mental illness are responsible for 29% of these, or approximately 1,150 homicides. This is 7% of all homicides in the U.S.

The role of serious mental illness varies depending on the family relationships.  Approximately 67% of children who kill their parents are seriously mentally ill, but only 10% of spouses who kill their spouses,

Although total homicides have decreased markedly in the US in recent years, there has been no decrease in the number of children killing parents or parents killing children, the two types of family homicides most closely associated with serious mental illness.

Women are responsible for 11% of all homicides in the US but 26% of family homicides.
Elderly family members, especially women, are disproportionately victimized.  Among all homicides in the US, only 2.2% of victims are ages 75 and older.  In a sample of 2015 family homicides, 9.2% of the victims were age 75 and older.

Guns are used as the weapon in less than half of family homicides.

The failure of individuals with serious mental illness to take their medication and their abuse of alcohol and drugs are risk factors for family homicides. The majority of family homicides are preceded by warnings and threats that are often ignored. The adequate treatment of individuals with serious mental illness would prevent the majority of family homicides associated with serious mental illness."

Thanks, Dr. Torrey. The full study is available here.

There is nothing more terrifying than living with the constant worry that your family member will harm you- particularly if there is no treatment available for him/her or if he/she refuses whatever treatment is available.

Family violence is the canary in the coal mine of our neglect of the severely ill- just the most extreme manifestation of the many forms of suffering we inflict on them and their families by failing to provide adequate housing, treatment, and social services.

I have observed first hand the mental health systems for, and the housing of, the mentally ill in most of the developed countries in the world and have concluded that the US today is perhaps the worst place and worst time to be mentally ill.

The defunding and privatization of services has led to 350,000 mentally ill inappropriately imprisoned, 250,000 homeless, and to the tragedies of family violence reported here.

There are two necessary solutions. First, and uncontroversial, is better housing and access to treatment. Our country has badly neglected the severely ill- and we, they, and their families are paying the price. Legislation now before Congress may finally help to reform our mental health nonsystem.

Second, and more controversial, is the need for involuntary treatment for those most obviously in need of treatment and most unwilling to participate in it. For a common sense approach that attempts to balance the two crucial values of civil rights and safety, see 'When Is It Justified to Force Treatment on Someone.'

We mustn't blame our uniquely US gun violence problem on the mentally ill. Most are decent, well behaved people who do no harm. If we want to reduce gun violence, we have to tighten ridiculously loose gun laws.

But we also must not neglect the need to treat mental illness when it is a clear risk factor for violence.