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It is NOT the time to talk about mental illness

21 December 2012

11:31 AM

21 December 2012

11:31 AM

Of all the online reactions to the Newtown horror, the most disturbing was probably the blog post written by Liza Long, the mother of a 13-year-old boy with an autistic spectrum disorder, attention deficit-hyperactivity disorder (ADHD) and oppositional defiant disorder – highly intelligent but given to unpredictable aggression and violent threats. The post is called ‘I am Adam Lanza’s mother’ and its message is discomforting to say the least. Long suspects that her own son is, like Adam Lanza, a potential school massacrist. She thinks he should be incarcerated. ‘It is time to talk about mental illness,’ she concludes.

Inevitably, the blog went ‘viral’. Even more inevitably, there was a backlash. Sarah Kendzior, another mother blogger, did some research into Long (by reading more of her blog) and suggested that perhaps she too suffered from a mental illness .

Finally, Long and Kendzior contacted each other directly, decided that they didn’t want to be part of a ‘mommy war’, and released a joint statement about the urgent need for ‘national conversation’ about mental health.


All’s well, then. Except that, as a psychiatrist, I am alarmed by the idea that Adam Lanza’s atrocious acts should provide the basis for some novel reappraisal of the way we look at mental health. If it is the case that it takes the gunning down of children in their own school to make us talk about mental illness, we are in an even worse state of affairs than might have been imagined. More crucially, it is not and should not be time to talk about mental illness because someone has committed such a heinous crime – that only reinforces an erroneous association of mental illness with violence.

I’ve no doubt that Liza Long faces a very difficult situation with her son, and that should under no circumstances be minimised. It goes without saying that Adam Lanza was a disturbed individual. But the assumptions here are dangerous: that any young person suffering from mental illness is likely to be the next Adam Lanza. As with most generalisations, this does not stand up to scrutiny – mental illness affects one in four people, murder-suicide is committed by less than 1 in every 1000. In Adam Lanza’s case there has been much speculation that he suffered from Asperger’s syndrome – yet nobody seems to have said that this disorder has not previously been associated with acts of violence such as this and its relevance to Lanza’s crime is likely to have been secondary.

Individuals with mental illness are far more likely to be the victims of crime than they are to commit it. Those that do commit acts of violence are far more likely not to have been engaged in treatment. It is the stigmatisation of mental illness that remains the greatest barrier to early identification and treatment.  Stigma stops individuals from seeking and accepting help.

The dialogue on mental health should already have begun: not because we need to protect society against those with mental illness but because we need to protect those with mental illness from the ignorance of society.

Julius Bourke is a clinical lecturer and honorary consultant psychiatrist at St Bartholomew’s Hospital.

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Show comments
  • GAB104

    I agree that mental illness should not be equated with violence. However, in an American context, the Lanza case should be discussed now. For one thing, mental illness is one of the few reasons that ownership of guns can be denied under the Second Amendment. I’m not defending the Amendment; if it were up to me, I’d repeal it now so that at the very least we could make sure people are qualified before they own a gun. Without the Second Amendment making gun ownership a right instead of a privilege, Mrs. Lanza might have been required to keep her guns at the gun club instead of at home, given her son’s diminished capacity to control his emotions (which is a common trait among those with Asperger’s). As it was, there would have been no examination at all of who else lived at her home, or whether they were qualified to handle guns, or whether she was keeping the guns properly secured. The second reason that mental illness should be discussed now is that appropriate long-term care for kids like the blogger’s son and for Lanza is sorely lacking in American society, even if you have good health insurance. My understanding is that Mrs. Lanza knew her son had a mental/neurological condition, so the problem here is not refusal to accept or admit the condition. The problem is that she had so little support, and that once Adam had graduated from high school, there was nothing provided for him (or for her) at that point. I read that she was planning to move across the country to a place where she could have a more independent life and where he could live in a residential program that would serve his needs better. I know that Asperger’s people don’t handle change well, and I wonder whether the prospect of this huge change was what sent Adam Lanza over the edge.

  • Wilhelm


  • Wilhelm


  • eeore

    Given the link between wheat allergy and autistim, I find it amusing that those pushing the anti-human green agenda so often refer to the wheat price and use it as a bench mark of wealth.

    Equally I find it odd that a psychiatrist should be defending those with mental illness, given the immense damage that such a diagnosis does to an individual’s life, and the willingness of these diagnoses to be handed out.

  • The Elderking

    Well this society needs to start by listening to families when they say their loved ones need help.

    Every time my wife has a Bipolar episode it follows the same path. She needs immediate treatment, medication and safety. Yet every time she is allowed to run around, causing herself and others misery, places herself at risk and breaks our hearts. Only when she is very ill, at risk of immediate harm or gets in trouble with the police do the “professionals” stop hiding behind her “human rights” get off their superannuated arses and take her in. So, instead of a week or two’s treatment she runs about for weeks or months, engages the police, doctors in fact all and sundry and causes acute worry and then has to have 6 – 12 weeks in hospital and comes out looking like someone from a death camp..

    How is that humane? How is that even Cost Efficient?,

  • Lee Moore

    Hmm. We have a mass killing perpetrated by someone with (a) mental problems and (b) guns. We immediately have 3,987,264 pundits, newspaper articles, editorials, and TV programmes taking the opportunity to demand a change in the law relating to guns. But when a single person suggests a change to the law in relation to people with mental problems, that’s a no-no. I wonder if Mr Bourke thinks that this is not the time to be leaping to conclusions on gun laws. OK, I don’t wonder at all.

    • Fergus Pickering

      What change would you suggest? Banging them up for ever? Executing them? What do you have in mind. Incidentally, the fellow’s mother was as mad as he.

      • Lee Moore

        You misunderstand me, Fergus. I don’t have any particular proposal in relation to laws about people with mental problems. I’m just laughing at Mr Bourke’s article and in particular the headline (It’s not the time etc.)
        Without worrying about what particular view you have on laws relating to guns, or laws relating to people with mental problems, don’t you find it funny that one little blog post about the latter, provoked by the massacre, attracts Mr B’s horror, and a slot in the Speccie to write about it, while millions of examples of people taking the opportunity of the massacre to talk about the former attracts no horror and no slot in the Speccie. The point is, of course, that it is ALWAYS the time to talk about things that are PC (gun control) and NEVER the time to talk about things that are un PC (mental problem people control.) Even in an allegedly right wing magazine. And just after a massacre with a gun is a particularly good time to talk about gun control, because the plebs have got their emotions properly aligned. But just after a massacre by a person with mental problems is a particularly disgraceful time to talk about mental problem person control…. because the plebs have got their emotions improperly aligned.

        • Fergus Pickering

          But you see, making it difficult for people to purchase guns is easy and brings good results, whereas doing stuff about mad people is hard and the results are difficult to foresee. So it is not PC to act on the gun thing but common sense. In the USA everybody has a gun and an awful lot of people get shot. On the other hand I have no idea whether Americans are madder than we are or whether banging up people we think are mad would be beneficent. Besides, I am a bit mad myself and I expect you are too. I don’t think I should go to jail for what I may do but for what I have demonstrably done..Is voting UKIP sufficient grounds for committal? .

          • Lee Moore

            I’m sure we can all sign on to that as a general proposition – ie “What I think is common sense, but what you think is dangerous insanity.” Traditionally the problem comes in translating this into a set of laws that applies to everyone equally. But ” Hey You – Obey Me Now !” is certainly attractive as a governing system, so long as one is the Me rather than the You.

  • CraigStrachan

    Autism is not a mental illness.

    • Fergus Pickering

      Quite right. It is not. But that won’t stop people sounding off.

  • mikewaller

    Do we know if such perpetrators have any regard to the way in which posterity will view them, or is what they do merely an expression of anger and resentment? I ask because I wonder, if the former were an issue, could memory of them be treated in a way that they would find discouraging e.g. dropping their real name from the record and substituting another. Very much a long shot, but it is infuriating that somewhat like, say, Manson, achieves a kind of immortality denied to millions of people who actually do good.

  • Rhoda Klapp

    Elsewhere many have commented on the effect of the drugs used to treat the mentally-ill. I have no idea of the truth of it, but have the long-term effects been studied? Are the drugs which enable some to take a part in society having the effect on a few of causing depression or suicidal thoughts or angry acts? It is always time to talk about long-term drug therapy.

    • Chris

      It is not just medications. Jared Loughner shooter of Gabrielle Gifford allegededly used a cocktail of drugs. The US preoccupation with both psychoactive drugs and with guns, is a very dangerous mix. The gun is a neutral metal object until a mentally disturbed person gets hold of it.

      Drug and alcohol use for loughner (from Wikepedia)
      Zach Osler, a high school classmate of Loughner’s, and his closest
      friend, indicated that Loughner’s life began to unravel after his high
      school girlfriend broke up with him, and he then began to abuse alcohol and other drugs, specifically Salvia divinorum (a natural hallucinogen illegal in some states).[16] Another longtime friend, Kylie Smith, added that he had used cannabis (marijuana), psychedelic mushrooms, and LSD around that same time.[17]
      Loughner quit using marijuana (as well as alcohol and tobacco) in late
      2008 and has not used it since, according to one of his longtime
      friends.[18] The U.S. Army confirmed that Loughner had been rejected as “unqualified” for service in 2008.[19][20][21] According to military sources, Loughner admitted to marijuana use on numerous occasions during the application process.[9]

  • Randy McDonald

    “But the assumptions here are dangerous: that any young person suffering from mental illness is likely to be the next Adam Lanza.”

    Reading Long’s post, she wasn’t talking about mental illness generally but about mental illness predisposing people to act violently specifically. She began her essay by recounting her son’s anger with her at his school dress code, then describing how her son threatened to kill her then himself over overdue library books, his siblings making use of their evacuation plan during this incident.

    • telemachus

      Yes Randy
      The toxic mix of School Anger, Repeater Guns and American If-you-are-not-a-success-you-are-a-failure psyche led to this.
      Forget remediation the Revanchist American Right will block all attempts to provide affordable adequate health care for these unfortunates and it goes without saying that they will block any gun control.
      They will remain wedded to the success at all costs American Dream.
      They all watched too many Westerns in their formative years

      • TomTom

        How does School Anger, Mental Illness, and ASsorted Problems manifest iself in this country Tel-Boy ? Do tell us about your personal experience

        • telemachus

          We have the crade to the grave free National Health Servce nd unessGove wrecks it a slendd liason between the School authorities and the Health Authorities
          Further unlke the States we d not require all our children to be winners
          You know the gun bit

  • Charlie the Chump

    Lanza’s mental health problems were combined with access to 5 weapons.
    That was the problem.

    • HooksLaw

      As I understand it the first person he shot was his mother. This does seem to indicate some exceptional problem.
      As Tom Tom states below the availability of guns to someone with a mental condition seems unwise. But equally the exact nature of the boys mental problems are not known to us.

    • commonsenseobserver

      Obviously, parents must take reasonable precautions.

      But it is ridiculous to assert that because mental illness is accompanied by stigma and public ignorance, we should do nothing to improve access to the needed care on the patients’ side.

  • TomTom

    I do wonder if it is appropriate for a single mother with a child with serious mental impairment to be considered suitable to hold AT HOME any firearms as opposed to depositing them at a gun club in a safe. Had Mrs Lanza lived she would no doubt be wondering if lawsuits would have cost her her home…….

    • commonsenseobserver

      It’s pretty impossible for such comprehensive background checks to be conducted on a federal level.

      • TomTom

        Yes. But there must be an element of Parental ie Adult Responsibility – it is a matter for Adults applying for permits to have to consider and carry sufficient Liability Insurance – since Mrs Lanza had a $1.5 million home she might have considered insurance

        • commonsenseobserver

          Of course, there must be safeguards on all levels, and especially in the home, and those who refuse to take reasonable precautions ought to be penalised by the rule of law.

    • Jack Dawson

      Many people in England have their shotgun licences revoked because of mental illness, usually to prevent suicide. It’s a hell of a job to regain a licence, even if they get better and are no longer considered risky.