Speaking of Psychology - Dispelling the myth of violence and mental illness (SOP27)

Episode Date: July 9, 2015

Recent mass shootings have inevitably led to news reports of the suspected shooters’ mental health, but psychological research shows there is no clear link between mental illness and violence. In this episode, clinical and forensic psychologist Joel Dvoskin, PhD, talks about the misconceptions surrounding mental illness and violent behavior and how basic prevention efforts could help stop future violent events. APA is currently seeking proposals for APA 2020, click here to learn more https://convention.apa.org/proposals Learn more about your ad choices. Visit megaphone.fm/adchoices

The state of a perpetrator's mental health is often the focus of news reports in the aftermath of mass shootings and other acts of violence. Legislators and the public want to be able to predict if and when a person will become violent. In this episode, forensic psychologist Joel Devoskin talks about why the stigma surrounding mental health is to blame and also how psychologists can help prevent more violence if they are just given the opportunity. I'm Audrey Hamilton and this is speaking of psychology. Joel DeVoskin teaches in the Department of Psychiatry at the University of Arizona. He is chairman of the Governor's Advisory Council on Behavioral Health for the state of Nevada. He's also a clinical and forensic psychologist.

He served as an expert witness in several state and federal courts throughout the U.S., and he specializes in assessing a person's risk of violence to self and others, as well as workplace violence prevention. Welcome, Dr. DeVoskin. Thank you very much for having me. There have been several high-profile shootings in the news where there are the suspect has been described as having some sort of mental disorder, either officially or anecdotally. What sort of message is this sending to the general public about the association between mental

illness and violence? Is there a link? Well, there's a lot of messages that it sends, and some of them are very inaccurate and, in fact, counterproductive and harmful. The short version is that while people with serious mental illness are slightly more likely to commit acts of violence than, people without mental illness, the risk that it creates is pretty small compared to other known risk factors, for example, current substance abuse. It's also true that a lot of the people that you read about, these anecdotes are played up by the media, and people overgeneralize from these very dramatic examples. So when you see somebody do something horrible, you think

it happens more often than it actually does. So the facts are pretty clear that, first of all, mass homicide accounts for a very tiny percentage of all the gun deaths in the United States, like one or two percent. And even homicide is less of a problem in terms of gun deaths than suicide. Another example is where the electronic media focus on long guns like Bushmasters and assault weapons, they account for a very small percentage of gun violence in the United States. United States, the vast majority of gun violence has to do with handguns. So there's a lot of misinformation, and the press only cares about selling, or not the press, but the electronic media, mainly cable news, mainly care about selling airtime.

So they put on the things that are the most dramatic, and that causes people to overgeneralize. The results of that is that it creates additional stigma about mental illness and actually discourages people from getting treatment. So it's bad for a lot of reasons. What role does mental health stigma play in the debate over gun violence and gun policy, specifically stigma? Well, again, the politicians have an unfortunate tendency to react to what is most publicized and also to react to anecdotes as opposed to solid research. And we don't know enough to really guide public policy. So stigma, which is sort of a collection of myths and stereotypes, tends to guide public policy far too much.

And as I said, much of it's incorrect. So we end up with policies that people tout as saying we did something, but in fact it's either not helpful or in some cases counterproductive. And we'd be far better off as a country if instead of relying on stigma, people were encouraging really good research about how to reduce gun violence rather than just react to these extreme cases and the stigma and myths and stereotypes. An example of this, you know, some legislators have been pressing for laws that prevent the sale of firearms to anyone who has ever been diagnosed with a mental illness.

Should mental health be taken into account when deciding who can own a firearm? If a person has schizophrenia, the likelihood that they will kill a stranger has been estimated, according to research, at 1 in 144,000. So it's popular for politicians to say, oh, I did something. You know, the myth is you'd have to be, quote, crazy to do something like this. So retrospectively, you look at people and you say, wow, this obviously, that guy should have been branded. But the truth is that most of the people, even of these anecdotes, were people who were very early on in their illness who had not been identified as seriously mentally ill, who wouldn't have been on the list anyway. There's a couple of exceptions to that. So for the most part, it's just stuff that's

easy to sell as to say, I did something really important, but alcohol accounts for a great deal more violence than mental illness does. As a forensic psychologist who assesses people who might be a risk to themselves or to others, what challenges do you face in determining who will become dangerous? Well, there's a whole bunch of research about assessing the risk of dangerousness that looks at the traits of a person. But we know that all human behavior is an interaction between a human being and the circumstances or situations in which they find themselves.

And it's very difficult to predict the situations that a person's going to be in in the future. We think that a better strategy is when you become aware of a person who is either uttering or posing threats, is then to look at the person in the context of the situation they're in and make recommendations to intervene and change that situation. Steve Hart, one of my colleagues and friends, calls these risk scenarios, is under what circumstances would this person be likely to harm somebody? That's much more helpful than saying this guy's a high-risk person based on these sort of all-or-nothing determinations. But there are a number of different methods of risk assessment, and many of them are really good. Some are actuarial, which help you look at the kind of overall risk that a person might present.

But it won't tell you how they're under what circumstances they will or won't. So even if you knew that somebody had a 50% chance, was in a group of people with a 50% chance of being violent, you don't know if they're in the 50 that will or the 50 that won't, and it may depend on the situations in which they find themselves. When you do risk assessment, risk assessment by itself isn't very important. What matters is the steps that are taken as a result. So that could be treatment, it could be intervening in the situations, it could be skill teaching for people.

Their goal is no longer to call people names. It's to actually prevent violence. What ways can mental health services be more effective and assessing and treating people who could present a danger to themselves or others. Well, in my opinion, the most important role of the public mental health system in preventing violence is not related to the treatment of serious mental illness, although that's very important for clinical reasons. But where we really want to see the public mental health system better funded and better

capable of intervening is in crisis response. So when somebody feels depressed, enraged, insignificant, they have access to a firearm, maybe they're drinking too much that night, maybe they just got fired. And so it's like this perfect storm of despair. It would be very important for our system to be able to give that person really competent suicide prevention services in this crisis to give them an alternative to. ending their life as a way of ending their psychological pain. And that's something, and it's not a criticism of the people who are doing this work. There's some wonderful first responders, both in

mental health and paramedics and police. But if you get good at this, you can't keep doing it because the pay's not very good. If you want to raise a family, people quit those jobs and go into other things so they can make better living. So we need more money so we can have more timely, competent crisis response services by the public mental health as well as other first responder systems. And that would, I think, dramatic, every time somebody commits a mass homicide, they're ending their life. They're either going to commit suicide or they're going to get the police to shoot them or they're going to go to prison or hospital for the rest of their life. They've given up. Their life is over. And we know how to prevent suicide. We just don't do it.

We know a ton about suicide prevention, and yet the suicide rates in the United States haven't gone down because we haven't made a good societal investment in suicide prevention and crisis responding. And that, I feel, is very important and would make a very big difference. I also would say that we need a lot more information and data, and Congress has, to an unfortunate extent, stifled research on preventing gun violence. So the national violent death reporting system has only exists in, I think, 16 states. That should be nationwide. CDC, the Center for Disease Control, is discouraged from doing research on gun violence.

And it's not about the Second Amendment. There's going to be guns in the streets of America for as long as I'm alive. But that doesn't mean that we can't learn more about how to prevent violence, violent use of these guns and inappropriate use of these guns. through a variety of mechanisms, including public information, training, safety training. There's a lot of different things that we, and we just don't know which things work because there hasn't been enough research done. Okay, Dr. DeVoskin, thank you so much for taking the time to speak with us. I appreciate you're having me. Thank you.

For more information on DeVoskin's research and to hear more episodes, go to our website, speakingofpsychology.org. With the American Psychological Association, Speaking of Psychology, I'm Audrey Hamilton.