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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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