In my last post, I wrote about why it’s not fair to lump terrorists together with people who mental illness, and a friend of mine replied thus in an email:

I agree with your conclusion just that I really think mentally people are more violent than other people. Not because the mental illness makes them more violent than any random selection of people but because they are lack the incentive (or the support most of us enjoy) to belly our angers. But that doesn’t put them in the same group as terrorists.

I replied his mail, but then I thought it would be good to address it here on the blog, because there are likely many others who are thinking along those lines, and if you’re one of them, the fact is you do have a point.

Like Chimamanda Ngozi Adichie said in her epic TED Talk:

“The single story creates stereotypes, and the problem with stereotypes is not that they are untrue, but that they are incomplete. They make one story become the only story.”

(Hard to believe she gave that talk all the way back in 2009 — her words are simply timeless, aren’t they?)

That’s what my friend’s statement is like: it’s part true, but because it’s incomplete, if you take it by itself without the proper background understanding, it becomes actually untrue.

So, as I replied my friend, he was kind of right and kind of mistaken.

People with serious mental illness are 3 to 4 times more likely to be violent than those who aren’t. But the vast majority of people with mental illness are not violent and never will be. (Dr Jeffrey Swanson, psychiatry professor)

Think of it this way: yes, a person with a serious mental disorder (like schizophrenia) is more likely to be violent than one without.

But then, an angry Lagos driver in rush hour traffic is equally more likely to be aggressive or violent than a pedestrian, but — and this is a very huge “but” — you don’t really expect them to be.

This lack of expectation makes all the difference. You don’t really expect the angry Lagos driver to be violent or aggressive, but many people expect the person with mental illness to be.

Don’t you wonder, though: why is it you don’t fear violence from the driver?

Here’s my thought: you don’t because of a few things you are pretty sure of:

  • You know the chances of actually experiencing this violence are pretty small.
  • You also know the person on the road is not likely to become violent just like that. Road violence is most often provoked, not random.
  • You know, too, that should there be tension for whatever reason, you can minimise the likelihood of any major problems by keeping calm.

Keep Calm and know that Mental Illness ≠ Violence

Guess what, though? Each of those three things is true in mental illness.

1. The chances of actually experiencing this violence are pretty small

Like, really tiny. The chances are so small that if all the violence from mental illness was prevented, you probably wouldn’t notice the difference.

“Most people with SMI are not violent, and most violent acts are not committed by people with SMI.” — Thomas Insel, Director of US National Institute of Mental Health (NIMH)

(“SMI” refers to “serious mental illness.”)

Fact is, chances are you’ll probably never experience violence from someone with mental illness. Violence occurs everyday: people beating people up, criminal violence, war violence and terrorism, sexual abuse. You hear about it, you see it, maybe you’ve experienced it. But most of all this violence is from people with no mental disorder whatever.

Fact — If you remove those who have problems with drug and alcohol use, people with mental illness are no more likely to be violent than anybody else. (But then, drug and alcohol use make anyone more violent, mentally ill or otherwise.)

Not only that, but people with mental disorders are more likely to be victims of violence than to be violent themselves. For real! We’re talking like up to 10 times more, by some statistics! I’ve seen this happen more often than you can imagine.

People with mental illness are more likely to be victims than to be violent

2. A person with mental illness is not likely to just randomly become violent— when there’s violence, it’s often provoked

This is more major than you might imagine. In my personal experience, most violence that occurs from people with mental illness occurs after they were provoked. But when you hear the story, you only hear it told from the part when the person started to react. It’s like the Igbo proverb says (if I have it right), “Until lions have their own historians, tales of the hunt shall always glorify the hunter.” You don’t get to hear the victim’s side of the story.

(Remember, for instance, the video of the househelp who was beating a baby? How many videos of employers beating helps have you seen? I mean, where would the helps even get the phones, much less the mobile data to upload them? On the other hand, which do you think occurs more: helps beating babies or helps being abused? No, don’t look at me, I don’t have the stats on househelp-targeted violence either. But it’s worth thinking about, isn’t it?)

Let me say it again.

3. You know that, should tension actually occur, you can still minimise it

Let me explain. A true Lagos person isn’t really scared of road rage. (Lagosians in the house!) Not because you don’t think it can happen, but because you feel reasonably sure of your ability to sort it out even if it does. A person from the village might not feel so confident, but not the true Lagosian. Right?

It’s similar in mental disorders. The violence (when, occasionally, it does occur) is not uncontrollable. A lot of times, in my experience, it has been not only provoked, but sometimes even deliberately aggravated. (Think about the times you have probably seen a half-clothed man or woman in a market being made fun of and mocked, as people toy with them. As though they were less than human.)

My point? We have little to fear from people with mental disorders. The only reason so many of us still do is a bunch of beliefs carried over from Hollywood, Nollywood, and superstitious and cultural beliefs. If anyone should be afraid of anyone, people with mental disorders should be afraid of us.

One more thing

And this is something I have to keep repeating. I have used the expression “mental illness” and “mental disorders” a lot (I use both to mean the same thing), but I am aware that a lot of people, when they hear that, only think of one or two specific types. I wrote about this in an earlier post: We talk about mental illnesses like whites talk about Africa.

There are a whole bunch of mental and behavioural disorders (the more complete name): over 100 in number, and they include depression, anxiety disorders, sexual disorders and substance use disorders. And for many of these, people struggling with them are as likely to be violent as you or me. Which is not a lot. The risk is only in serious mental disorders, and that’s particularly when those affected aren’t taking their meds, or have problems with alcohol and drug use.

I’ll end with the very wise words of Dr John Grohol, founder of PsychCentral:

“Most people who suffer from a mental disorder are not violent — there is no need to fear them. Embrace them for who they are — normal human beings experiencing a difficult time, who need your open mind, caring attitude, and helpful support.”

Do you see? Or are you still struggling to let go of the idea that mental illness causes violence?

Let me know in the comments!

Published by Doc Ayomide

I’m a medical doctor with specialty training in psychiatry, and I love thinking and writing about what it means to be human.

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  1. Doc what do you say to people who refer to the cases in the U.S. where someone with a known history of mental illness picks up a gun and shoots people at random at a mall or school?

    1. Hi Jagun. There’s more to it than that. It’s kind of like plane crashes. People fear plane crashes because they perceive them as unsafe — despite that all the crashes that you hear of in a single year are probably all the crashes that occur that year — all because the media plays crashes up far more. (You hear about plane crashes for maybe a month, but the daily motor accidents almost never make the news.)
      Another issue: with cars, people feel safer, because they imagine they can always escape or figure a way out somehow. (Never mind that the chances of this happening are much lower than one imagines, as anyone who’s ever experienced a real crash can tell you.) But with planes, the thought of being all those miles up in the air and no land to run to is scary.
      But in the end, planes remain statistically safer.
      Mental illness in the media is similar. We hear more about mental illness-related violence than we do the daily non-related violence. And we feel less capable of handling it if it should occur. So it easily takes up more mental RAM. But that doesn’t necessarily reflect reality.
      You see?

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