James Holmes, accused of opening fire in a crowded movie theater in Aurora, Colorado, last summer, had no criminal history, but was seeing a psychiatrist prior to the incident. Adam Lanza, suspected of murdering his mother and gunning down 20 children and six adult staff members at a Connecticut elementary school before taking his own life, had never been in legal trouble, but had been diagnosed with a “personality disorder,” as well as the developmental disorder Asperger syndrome. Anders Behring Breivik in Norway, Jared Lee Loughner in Arizona, Cho Seung-hui in Virginia — the list of mass murderers defined according to their mental illnesses goes on.
The fact is that deciding to murder, at random, a large number of innocent people reflects deeply disturbed thinking, which might reflect a mental illness. However, contrary to popular belief, this does not mean that people with mental illnesses are likely to be dangerous or violent. The belief that they are — and the reporting that feeds it — is reinforcing widespread stigmatization of those with mental illness, increasing their suffering and preventing them from participating fully in society.
Public perceptions of the risk of violence associated with mental illness are at odds with the facts. In the US, for example, roughly 42 percent of adults believe that a depressed child is likely to be dangerous. And 70 percent of Americans believe that patients hospitalized for a mental illness may be dangerous. However, according to the American Psychiatric Association, people with mental disorders, who account for roughly one-quarter of the population in a given year, commit only 4 percent to 5 percent of violent crimes. Indeed, while mentally ill people may be more likely to commit violent acts if they are not treated, or are misusing alcohol or drugs, the risk is small.
Personal experience usually refutes the link between mental illness and violence. A survey of the American public found that, while 68 percent of adults knew at least one person who had been hospitalized with a mental illness and 10 percent knew five or more people, only 9 percent had ever been threatened or physically harmed by such a person. People in close contact with the mentally ill, such as mental-health professionals and family members of people affected, are the least likely to believe that they are dangerous.
The discrepancy between experience and perception is largely caused by the media, which frequently link mental illness with acts of violence. One study of American newspaper reports found that 39 percent of reports concerning mental illness were focused on violence or danger. In Germany, extensive reports on violent attacks against prominent politicians by two people suffering from schizophrenia in 1990 bolstered the German public’s belief that mentally ill people are dangerous.
Coverage of violent acts that result in multiple deaths is particularly extensive. The public inevitably seeks some explanation, and the media will explore any potential link to mental illness to provide one — for example, acquaintances’ reports of “odd” behavior and social withdrawal or accounts of previous interactions with mental health professionals.
Meanwhile, defense attorneys may try to lessen their client’s culpability by claiming insanity, as Breivik’s lawyers attempted to do after he killed 77 people to protest the multiculturalism that he claims threatens Norway. Although this approach is rarely successful — Breivik received a 21-year sentence — it is widely reported, linking crime to mental illness in the minds of the public.