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Psychopaths, Not Psychotics, Part II

Many studies have revealed that when the seriously mentally ill take their medication, they are no more of a threat to anyone than the non-mentally ill.
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A friend of mine from graduate school raised some interesting points regarding one of my previous pieces, titled "Psychopaths, Not Psychotics" ( In that post, I cited two studies, one from the National Institute of Mental Health and the other from the Department of Justice, indicating that the mentally ill, who have no substance abuse problems, commit only 3 to 4% of violent crime.

My friend wanted to know the percentage of the mentally ill in society as a whole.

Here are the statistics. According to the NIMH's Web site, approximately 6 % of people in this country suffer from "serious" mental illness. And according to the National Alliance on Mental Illness' Web site, roughly 50% of people with "severe" mental disorders have substance abuse problems.

I did not include this data in my earlier blog post because of the possible difference between "serious" and "severe" mental illness. Ordinarily, "serious" and "severe" sound as if they are synonyms, but in these statistical studies they may not be.

The definition of "severe" mental illness is quite vague. Sometimes, it seems to refer to "severe and persistent" mental illness; sometimes, it does not.

What I can say more definitively is that if "severe" is indeed synonymous with "serious," then people with severe mental illness constitute roughly 6 % of people in this country. Since about half of them have substance abuse problems, the half who don't abuse drugs represent roughly 3% of the population and thus commit violent crimes at essentially the same frequency as those who are not mentally ill.

I am not trying to say that the mentally ill are never violent. An acquaintance told me about her son, a schizophrenic, who got into an altercation with the police. While there is no excuse for such violence, he did not plan the incident, as a psychopath would have done. Instead, the cops were called when he got unruly. When they showed up, he tangled with them because he misjudged the situation and felt threatened.

This individual had also become addicted to marijuana. As surprising as it may sound, studies, such as one by the Institute of Psychiatry in London, show that cannabis use can lead to increased delusions. Finally, at the time of his altercation with the police, my acquaintance's son had not been taking his medication.

As I noted in my previous piece on this subject, many studies have revealed that when the seriously mentally ill take their medication, they are no more of a threat to anyone than the non-mentally ill.

My friend from graduate school also brought up the issue of political correctness. Are we stifling people by not allowing them to misuse the word "psychotic"?

There is no doubt that many people use a word like "psychotic" in a vernacular sense, as I mentioned before. I do not want to censor them. But my larger point is, Why do we so often assume that a murderer or mass murderer must be mentally ill? How many times have we heard so-called experts on TV, even forensic psychologists, propose, right after a heinous crime has been committed, that the perpetrator probably has a mental health history?

Why don't we ask if the person has a criminal record? Why don't we ask if he (and yes, it is almost always a man) has a history of violence, getting into fights, beating up girlfriends, or forcing them into sex, as Raymond Clark III, charged with murdering Yale grad student, Annie Le, allegedly did to a girl in high school?

To be fair to TV pundits, upon Clark's arrest, no one jumped to the conclusion that he is mentally ill. And some broadcasters over the years have been quite sophisticated and compassionate regarding mental illness.

CNN's Larry King has devoted numerous shows to the subject of depression. He has had guests like Mariette Hartley and Mariel Hemingway talk about their family histories, which, like mine, include multiple suicides. More recently, in a segment on the late Senator Ted Kennedy, Rep. Patrick Kennedy, who admits to suffering from depression and addiction problems, told King how honored he was to pass a bill on mental health parity, a bill he worked on with his father.

Following the murder of a security guard at the U.S. Holocaust Memorial Museum, MSNBC's bulldog commentator, Chris Matthews, said, "You'd like to put it up to mental illness," but then, invoking the Kennedy assassinations, he added that assassins like James von Brunn, a white supremacist charged with the museum killing, usually commit these crimes for a "political" reason.

I agree to a large extent with Matthews, though I was troubled when he said, "You'd like to" blame the mentally ill. Why is it that we'd "like to" associate violent crime with mental illness?

It is important to keep in mind that some of the greatest figures in history were mentally ill. Needless to say, the vast majority of them were no threat to anyone but themselves.

Joshua Wolf Shenk wrote in his book, Lincoln's Melancholy, that Abraham Lincoln, the man many view as our greatest president, likely suffered what we would now call two psychotic breaks. Yet Lincoln tamed his illness and was able to lead a life that continues to inspire humanity.

And what about his namesake, Abraham, founder of three monotheistic religions? He heard a voice that told him to take his family and leave Ur, march through the desert until he reached the land of milk and honey, where his people would be as numerous as the stars. Today, we might refer to Abraham as a schizophrenic, but he was also touched by God.

Some of today's mentally ill are also blessed. People like Nathaniel Ayers, a schizophrenic musician, whom Steve Lopez has written about in the L.A. Times, are part of a group of artists that includes Wordsworth, Coleridge, van Gogh and others, geniuses who have improved all of our lives with their sublimity.