USA Today Publishes Harmful Prejudice, Misinformation About People with Mental Health Concerns

USA Today Publishes Harmful Prejudice, Misinformation About People with Mental Health ConcernsUSA Today on Thursday published an editorial hopefully entitled, Editorial: Fix broken mental health system. Which would be fine as a stand-alone piece advocating more money, focus and resources for our nation’s patchwork system of mental health and recovery care.

Instead, they — like many well-meaning but apparently brain-dead newspapers — tie the need to fix our mental health care system — something others have been advocating for for decades — to recent headline-news grabbing acts of atrocious violence.

Only buried in this hypocritical, two-faced gutter-piece editorial do you find the truth — “Only the tiniest fraction of the mentally ill ever become violent, and then, usually when they fail to get treatment.” It’s even worse than that — statistically speaking, mental illness is a horrible predictor of violence, and nobody who’s read the research would ever suggest otherwise.

I have no problem with you advocating to help people with mental health concerns. I have a big problem if you’re doing so because of violence in America. The two have little to no connection with one another.

People let to get all riled up and angry when something tragic occurs. It’s one way many of us cope and try to figure out such events. But when we respond to tragic events with action, we’re likely to do so in a way that makes little sense in the overall, broader picture.

The fact is people with mental health conditions are no more likely to be violent than is the general population.
~ Wayne Lindstrom

For instance, every year in America, over 12,000 people a year are murdered — most by some sort of gun. Nobody gets upset at that huge number, or that 30,000+ people a year who take their own lives.

Instead, the thing that USA Today wants us to get motivated by are these horrific acts of violence that barely read in the overall number of deaths per year due to gun violence. USA Today doesn’t seem to care about the 30,000+ people each year who, because of untreated depression or other mental health concerns, choose to end their lives.1

Wayne Lindstrom, the CEO of Mental Health America, on the other hand, gets it right in his response to the crummy piece of what passes for “insightful opinion” at USA Today:

The premise that we can predict or prevent violent acts is unsupported. Even in the case of severe mental illnesses, mental health professionals possess no special knowledge or ability to predict future behavior.

The fact is people with mental health conditions are no more likely to be violent than is the general population. Continuing to link violence and mental illness only stigmatizes people and deters them from seeking care.

We whole-heartedly share and endorse these words. We stand proudly with Mental Health America and other organizations who’ve read the research and know that linking mental illness to violence is like linking terrorism to a specific religion — it’s a feel good strategy imbeciles do to make themselves feel better.

USA Today rues the good ole days, when we could lock up anyone society disagreed with or didn’t like the looks of in a mental hospital (nowadays referred to an inpatient psychiatric hospital): “Many states have become so strict that it is almost impossible to get people committed until they are in deep crisis, or try to commit suicide or harm someone.” Awww, what a shame — we actually have a reasonable, humane standard before trying to take someone’s freedom away from them.

USA Today should be ashamed of itself for publishing an editorial that only reinforces the discrimination, stigma and prejudice against people with mental health concerns. They continue to spread misinformation about the link between mental illness and violence,2 and suggest we have some sort of magical powers of foresight that would allow us to predict these kinds of incidents with such accuracy, it would be like the science-fiction story, “Minority Report” (we don’t have such magical powers, sorry).

 

USA Today crap editorial: Editorial: Fix broken mental health system

Wayne Lindstrom’s response: Opposing view: Don’t link violence with mental illness

Footnotes:

  1. Worse, they cite the example of Seung-Hui Cho — who actually had contact with mental health professionals!
  2. There really isn’t much of one, according to you know, the actual research.

Punishing Poets is Not the Way to Stop School Violence

Punishing Poets is Not the Way to Stop School ViolenceAnyone can understand why school authorities would be jumpy, after the recent mass shooting at Newtown, CT.

But the recent suspension — and possible expulsion — of San Francisco high school student, Courtni Webb, is a fine example of how not to deal with suspected school violence.

Ms. Webb was suspended, according to news reports, for writing a poem about the Newtown killings, which apparently violated the school’s policy against threats of violence.

Poets, of course, have been deemed a threat to society ever since Plato banned them from his ideal “Republic.” Poetry, Plato argued, spoke to the heart, not the mind — and thus encouraged rebellion against the natural order of things.

But having heard Ms. Webb read her poem in its entirety, I found little in the way of violent rebellion, and certainly no overt threats to her classmates. Yes, the poem might be called self-absorbed — but isn’t that part of normal adolescence?

When Ms. Webb writes, “When you don’t feel loved/ you hate the world,” she could easily be expressing the feelings of thousands of alienated young people from time immemorial. Most of the poem seems to be an attempt to express her personal frustrations, and to understand the motivation of the Newtown shooter — not to threaten new violence.

We would be fortunate, as a society, if more lonely and alienated young people expressed their feelings in poetry, and fewer, through acts of violence.

We have yet to create a well-validated “profile” of those who carry out acts of so-called targeted violence, such as school shootings. The evidence to date suggests that perpetrators of such attacks tend to have very low self-esteem, a “persecutory/paranoid” outlook, depressive symptoms, narcissistic traits, and feelings of rejection. Perhaps one can find intimations of a few of these characteristics in Ms. Webb’s poem.

But as my colleague, Dr. James Knoll, has pointed out, focusing too heavily on these factors by “profiling” students would deluge school officials with “false positives.” Profiling alone — in the absence of careful, on-site assessment — casts far too broad a net to be useful.

Furthermore, as Prof. Eric Madfis of the University of Washington at Tacoma has pointed out, “zero tolerance” policies with mandatory arrests, suspensions and expulsions appear to do little to thwart targeted violence in schools.

Rather, schools do best by heeding the early warning signs of planned, targeted violence, such as when a would-be perpetrator “leaks” elements of the plan to another classmate, or posts threats on a website. Indeed, research from Finland found that adolescents aged 3-18 who expressed “massacre threats” online were a riskier group than adolescents who expressed the threats offline — for example, those who made online threats had often begun making actual preparations for the attack.

Of course, utilizing these early warning signs presupposes that knowledgeable peers or family members are willing to come forward to school authorities or police — and this happens all too rarely. As Prof. Madfis has noted, there is often a “code of silence” among adolescents that discourages coming forward with such information — which is widely regarded as “snitching.”

Nevertheless, the recent case of Blaec Lammers, in Bolivar, Missouri, shows that timely, personal intervention can make a huge difference. The young man’s plans for an Aurora-style movie theater massacre were thwarted when his mother reported him to local police.

Perhaps the most sensible recommendations for preventing targeted violence in schools come from the Interdisciplinary Group on Preventing School and Community Violence, writing in the aftermath of the Newtown, CT shootings. Among their conclusions was that the most effective way of preventing violence targeted at schools is by

“…maintaining close communication and trust with students and others in the community, so that threats will be reported and can be investigated by responsible authorities.”

The group did not endorse the use of “profiling” or checklists of personality traits. Rather, they urged the use of trained staff members who would investigate specific instances of apparent threats. Of course, schools strapped for funding will find it hard to implement such staff training — yet arguably, this may be more effective in preventing violence than posting armed guards at all our schools.

I also believe that greater cooperation between school health personnel and outside mental health specialists is sorely needed. For example, the school nurse or school psychologist could meet periodically with family physicians and psychiatrists in the community, to discuss students believed to be at high risk for targeted violence. This could be done via anonymous case presentations that would protect the privacy of potentially innocent students — and without simplistic “profiling.”

Some of these adolescents might be tugged off the path of violence through appropriate, voluntary counseling or mental health intervention. In cases of extreme or imminent threats of violence, involuntary treatment might be required, via appropriate judicial processes.

What will not help, in my judgment, is targeting students like Courtni Webb, who engage in acts of poetic expression, rather than savage violence.

 

References and Further reading    

Sankin A:  Courtni Webb, San Francisco High School Senior, Suspended For Writing Poem About Sandy Hook Shooting. Accessed at: http://www.huffingtonpost.com/2012/12/28/courtni-webb_n_2376833.html

Dibble L: 3Qs: Analyzing and preventing school shootings. Accessed at: http://www.northeastern.edu/news/2012/03/madfis/

Zarembo A: Plotters of school killings tend to tip off someone in advance. Los Angeles Times, Dec. 23, 2012. Accessed at: http://articles.latimes.com/2012/dec/23/nation/la-na-massacre-prevention-2012122

Interdisciplinary Group on Preventing School and Community Violence.  Accessed 12/20/12: http://curry.virginia.edu/articles/sandyhookshooting

Knoll JL: Mass Shootings: Research & Lessons. Psychiatric Times (in press).

Knoll J: Mass Shootings and the Ethic of the Open Heart. Medscape Psychiatry Dec 20, 2012. Accessed at: http://www.medscape.com/viewarticle/776427

Nina L, Atte O, Eila S, Riittakerttu KH: Adolescents expressing school massacre threats online: something to be extremely worried about? Child Adolesc Psychiatry Ment Health., 2012; 6(1):39.

Are You a Hero in Waiting?

Are You a Hero in Waiting?This is a true story.

Imagine that you are at a Wal-Mart around midnight. Dark parking lot. Little security and yet a number of random people wandering around. A man with a little boy thrown over his shoulder passes you. The little boy is screaming and kicking and crying and yelling for his mama.

The man slaps and spanks the boy and is telling him to shut up. He never uses the boy’s name. There is no woman near them and the man is moving faster. Also, imagine the boy is blond and the man has dark hair. Onlookers shake their heads but do nothing.

What would you do? Would you watch and not do anything? Or would you intervene? Social psychologists tell us there is a very good likelihood we will do nothing.

But this is the story of a woman, Pam, who did.

Pam asked the security to go check on the boy. The security man did, and then turned away. Pam asked the security guard what transpired. As she does the man screams at her: “The little shit is crying for his mother like a pansy-ass.”

“At that moment,” said Pam as she recalled her ordeal, “I forgot to be scared.”

The man shoved the boy into the back set of the car all the while cursing and screaming at him. He got in the car and backed up. Pam stood behind the car and blocked the man from going. She walked over to the driver, told him to roll down his window and then asked the boy if the man was his dad. The boy said nothing.

The man pushed Pam back from the window and threw open the door. He swore at her, stumbled and fell onto the car next to his. He was drunk. Very drunk. As this was happening Pam went over to the boy and asked again if the man was his dad. She tells him she knows he is very good at telling the truth, and that she is just there to see what is the matter for all those tears. The man is quiet and never moves but mutters something and then laughs.

Pam faces the man, apologizes for inconveniencing him and tells him she knows how unpredictable children who are tired can be. But given the circumstances she was pretty sure a good dad like him would want people to care that no child was being abducted in their presence. She said she hopes she is wrong in her suspicion.

Pam’s powerful display of courage, acting to help a victim while others are not responding is a correction for one of the most replicable effects in social psychology. The bystander effect, or Genovese syndrome, is the name given to the phenomenon where the presence of bystanders decreases the likelihood that someone will intervene. In fact, there is an inverse relationship between the number of witnesses and the likelihood someone will help: The greater the number of bystanders, the less likely someone is to respond.

Researchers John Darley and Bibb Latene were interested in the 1964 murder of Kitty Genovese in New York City where witnesses to the murder did not respond. While there is controversy about the reports on the number of witnesses and their reasons for not responding, the newspaper reports of the murder and apathy inspired the researchers to conduct experiments to demonstrate the effect.

But there is more to Pam’s story than just speaking up.

Pam introduces herself to the boy and asks him again if the man is his dad. He nods and is able to tell her his daddy’s name. She then asks the man to show her his driver’s license. By then the security guard has returned to check the license, which is expired. The security guard hands the license back to the man and walks away.

He walks away.

Pam says in a very loud voice that she will be happy to wait until the police arrive so this little boy doesn’t have to drive in a car with a drunk driver who has an expired license. She then dials 911, asks the security guard to stay with her and she talks to the boy. The father is furious. He curses and kicks a can at Pam. It hits her in the shoulder and Pam is unmoved as she continues to talk to the boy, asking him about his mama. He tells Pam about her, his sister, and his grandpa.

When the police arrived Pam gave a statement and they arrested the man for public intoxication. Pam waited with the little boy, another policeman, and the security guard until the boy’s grandpa came to get him.

Pam has done more than challenge the bystander effect. She is an everyday hero. Research on the Genovese syndrome has resulted in three processes that are important for people to respond to others in distress. The first is to actually notice the situation. When there are many other people around we may narrow our awareness – so the first thing Pam did was realize something was happening with the man and the boy. In other words, she paid attention to her surroundings.

Second, those who respond interpret the situation as an emergency. Pam did this the moment she saw the boy being hit. The best response I have ever heard for an intervention came from a woman who witnessed another woman hit her child several times at a park. The witness told her to stop and the abusive parent said, “It is none of your business.” The woman who intervened said: “If you do this in public it makes it my business.”

Pam made it her business, which is the final point the researchers formulated. Once you notice, and interpret the situation as an emergency, then you finally take responsibility for helping.

This is an area Phil Zimbardo, another leading social psychologist, is studying: What it takes to be a hero. His latest endeavor involves fostering heroic imagination. He has noted that heroes are never going to conform to group norms and highlights the two core principles of heroism:

  1. Heroes act when others are passive.
  2. Heroes act sociocentrically, not egocentrically.

They act alone, and for the good of others. It also seems they don’t like to boast about their deeds. That is why we need to honor their stories and retell them when we hear about them. That is why Pam’s story appears here.

Dr. Zimbardo calls it Heroes in Waiting, and we need to be prepared. In his own words, we need to be “waiting for the right situation to come along, to put heroic imagination into action. Because it may only happen once in your life, and when you pass it by you’ll always know, I could have been a hero and I let it pass me by. So the point is thinking it and then doing it.”

Pam is an inspiration because she didn’t let her opportunity pass her by. I hope we can all do the same when it is our turn.