Violence and Mental Illness

youth violence
youth violence

The following short article explores the role of interpersonal violence in establishing power over those with whom we disagree, get one’s needs met, and solve problems.

Using negotiation and interpersonal discourse instead of violence to meet our personal needs or achieve a goal is a skill learned and practiced from the ages of 2-5.  Trembly, et al. In 2005 in their book, Developmental Origins of Aggression, stated that when persons above the age of 5 use aggression toward others to get their needs met, they have not mastered the skills of communication cooperation, and negotiation needed to be used in their interpersonal engagements. The children that have not accomplished these skills are often the victims of childhood abuse and neglect (ACEs, CDC.GOV). What they learn in childhood is that violence is a legitimate means to solve problems and get one’s needs met. Dr. Moffitt established with her research that externalities behavior problems among youth can have a lifelong trajectory (2019).  The research of other research also established that the trajectory can be interrupted through family and youth interventions and effective treatment.

Interpersonal violence accounts for 180,000 deaths and 16 million non-lethal traumatic injuries in emergency departments over the last decade.  In an  introduction to a group of articles in the Harvard Review of Psychiatry, 1/2/21, Issue 1, Pages 1-5 by Jeffery Swanson proposes that the available data indicates that only 3-5% of those committing interpersonal violence are “mentally Ill.” This introduction uses only 3 major mental illnesses, Bipolar Disorder, Schizophrenia, and Major depression to describe the complexity of mental illness and the need to reassess our understanding of what is mental health and what is mental illness.

The siloing of mental health, addictions, developmental issues, neurodiversity, trauma, criminal justice, child abuse and neglect over the last century have hidden the complexity of the roots of interpersonal violence.  It is in the interactions of mental illnesses and brain disorders that scientists will discover the complexity of the origins of acts of interpersonal violence.

The new terminology which we should be examining and using is relationship and behavioral heath which encompasses mental illness and substance abuse.  It also includes the concepts of conduct disorder in youth and personality disorders in adulthood. These very outdated terms are pejorative misnomers for the effects of childhood trauma on the brains and development of children which last a lifetime when not sufficiently treated.  These misnomers influence us to miss the point when looking at the need for treatment and legal and social interventions to stop the abuse and neglect of children in our society.  Untreated childhood abuse and neglect is where we will find answers to the origins of interpersonal violence.

 

 

 

 

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drkathy

I am a psychologist and I own 6 mental health clinics in Maryland, ESPSMD.com. We specialize in working with troubled youth and their families. I have written 2 books and 1 assessment about youth violence and I lecture internationally on bullying and youth and family violence. View all posts by drkathy

3 thoughts on “Violence and Mental Illness”

  1. Great Article, this is such an important issue.

    An issue that I have been very interested in is similar, when mass shootings occur, why does the media often attributes mental illness to the perpetrators. Obviously, people who commit mass shootings are mentally disturbed and disconnected with reality in some way. However, the term mental illness is often either not defined or connoted with bipolar or schizophrenia. This can give the public the impression that people with bipolar or schizophrenia are inherently dangerous and to be avoided at all costs.

    This contributes to the stigma against those with mental illness, many of whom already feel isolated, judged and unwanted. It is categorically untrue that the mentally ill commit most of the acts of interpersonal violence. As you state in your article, Jeffrey Swanson, in the Harvard Review of Psychiatry 1/2/21, Issue 1, pages 3-5, points out that the available data indicates that only 3-5 % of mentally ill commit acts of interpersonal violence.

    Most people with mental illness are not any more likely to be violent than others. There are, of course, some noted exceptions, as there are in any population group that has been studied. But, by and large, they are not any more violent than any other group.

    Most of those who commit mass shootings have characteristics that indicate sociopathy. They are sociopaths. Many of these acts are perpetrated by people who have thought through intricate plans and had strategies to kill as many people as possible. Some even publish their plans in a manifesto online with a desire to be famous for their heinous acts. Sociopathy is connected with a mental health disorder called Antisocial Personality Disorder. On a continuum of Antisocial Personality Disorder, sociopathy would be on the extreme end. At least, that is my understanding from my reading on sociopathy.

    1. drkathy – Salisbury, MD – I am a psychologist and I own 6 mental health clinics in Maryland, ESPSMD.com. We specialize in working with troubled youth and their families. I have written 2 books and 1 assessment about youth violence and I lecture internationally on bullying and youth and family violence.
      drkathy says:

      Dear Laura, Thank you for your comments. Stigma about Mental illness is certainly part of the problem, Another factor is a primitive need to punish rather than treat those youth with “acting out” behaviors many of which arise out of child maltreatment. I think it is Scotland that has combined the Departments of Juvenile services and Departments of social services with great success by treating the entire family rather than punishing the individual youth rather than applying trauma informed care to treat the entire family. They also work with families from the time the family is first seen because of a child maltreatment event and continue with the family when the youth “crosses over” to the Juvenile services system.
      Since I am “on a roll” here, taking a look at “mental Health diagnoses” through another lens is helpful to me. For instance, Borderline personality disorder is often viewed through a very negative lens. However the research indicates that this “diagnosis”. Can be very successfully treated using trauma informed care. The same would apply to “Conduct Disorder.” If we use the lens of trauma generated behavior, and use trauma-informed care, we come up with a different solution than punitively driven solutions.
      Thanks again for commenting.
      Kathy

    2. drkathy – Salisbury, MD – I am a psychologist and I own 6 mental health clinics in Maryland, ESPSMD.com. We specialize in working with troubled youth and their families. I have written 2 books and 1 assessment about youth violence and I lecture internationally on bullying and youth and family violence.
      drkathy says:

      Dear Laura: you are so right. I will add this. The research has determined a couple of things. The majority of those with personality disorders have been maltreated by caregivers in early childhood, changing the way they their brains function and how they relate to others from trusting and positive to untrusting and often aggressive. These negative responses toward other human beings is passed on from generation to generation as abused and neglected children grow up and abuse and neglect their own children and other people. It is in the stopping of maltreatment of children that will reduce mass violence around the world. This will be done through trauma informed care of all family members in a violent, chaotic family.
      Thanks for responding. I love hearing for you.
      Kathy

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