Schizophrenia and Violence

The XX Factor
What Women Really Think
Jan. 10 2011 3:48 PM

Schizophrenia and Violence

Emily B. , I agree with you that the portrait of Jared Loughner is one of someone sinking ever deeper into untreated mental illness. A community college professor of his worried that Loughner might " pull out a weapon ." The school couldn’t force him to get help because he didn’t "self-identify" as needing help. Getting treatment for people who have psychosis is a huge problem; often their illness prevents them from recognizing they are ill. Frequently the family is essentially helpless to intervene because our laws are so skewed toward protecting the rights of the mentally ill. But wandering untreated is itself like being sentenced to hard time.

Vaughan Bell does argue that schizophrenics are no more likely to commit violent crime than the average person. A large Swedish study purportedly backs this up, showing that while 5 percent of the non-schizophrenic population has been convicted of a violent crime, 8 percent of those with schizophrenia have been convicted. In absolute terms that is small, but normally studies that find a 60 percent increase tout that difference. However, the study also found that 28 percent of people with schizophrenia who also were substance abusers had been convicted of violent crime. That’s about six times the general population-an incidence that’s hard to write off. Loughner’s friends describe-as is very typical for schizophrenics-his descent from nice kid to confused, addled pothead. Drug use, especially marijuana, is exceedingly common among people developing schizophrenia, a desperate attempt to self-medicate the demons that are taking over their minds. The authors of the Swedish study, published in the Journal of the American Medical Association, dismiss the mental illness as the cause of violence among this 28 percent group of schizophrenic drug abusers, and ascribe it to the drugs. This strikes me as ludicrous. What it more clearly seems to say is that untreated psychosis can lead to violent behavior. That is why society needs more ability to get desperately sick people the treatment they need-even if they don't necessarily want it.  I agree with Bell that people with mental illness suffer under a terrible stigma and we should do everything possible to ameliorate that. But pretending that people who say strange and alarming things are no more likely to do something anti-social than the rest of us just makes it easier to turn away from people who need help.

Emily Yoffe is a regular Slate contributor. She writes the Dear Prudence column.