The question inevitably follows the carnage at Virginia Tech: Are individuals with severe mental illnesses more dangerous than the general population? Since the 1960s, when the emptying of public mental hospitals went on fast forward, this question has recurred with each publicized psychiatric tragedy. And each time, mental health organizations have replied with an identical mantra: Psychiatric patients are not more dangerous than the general population.
This answer may be politically correct, but it is factually incorrect. To be precise, mentally ill individuals who are taking medication to control the symptoms of their illness are not more dangerous. But on any given day, approximately half of severely mentally ill individuals are not taking medication. The evidence is clear that a portion of these individuals are significantly more dangerous....
All of this is known but assiduously ignored by most mental health organizations. The reason usually given is that to talk publicly about violence increases stigma against all individuals with mental illness. The problem with such reasoning is that the violent episodes themselves are the main source of stigma -- until the issue of violence is addressed the stigma will remain. This was illustrated by a 1996 survey that found that 31% of Americans associated mental illness with violence, an unexpected increase from a similar survey in 1950 that had reported that only 13% did. The general public apparently bases its opinion on actual events, not on mythology fashioned by mental health organizations.
The most remarkable aspect of psychiatrically related tragedies is that most of them can be avoided. Studies suggest that problems of violence are associated with a small percentage -- approximately 10% -- of all individuals with serious mental illnesses. These are often the same individuals who are intermittently homeless, incarcerated and rehospitalized. Because of their brain disease, these individuals have little or no awareness of their illness and will not voluntarily take medication, because they believe there is nothing wrong with them.
Dr. Torrey is the President of the Treatment Advocacy Center. Visit their site here.