Lots of talk this week about mental health in the wake of
that mass killing in Santa Barbara, especially about how we might be better
able to identify mass murderers before they commit an atrocity.
Certainly, that’s a great aim, but it’s also very
important to note that the overwhelming majority of people with “mental
illness” are not violent, and even when some do commit violent acts, it’s more
– tragically - often on themselves.
To our great shame, I think, we know appallingly little
about mental illness, especially when compared to “physical” conditions.
The diagnostic criteria for defining “mental” or
psychological conditions are way too often frustratingly vague and malleable
(think ADHD, bipolar disease in kids, many others); our therapeutic strategies
ineffective or worse, harmful; our knowledge about when to intervene, how to
intervene, what to do if we choose to intervene more in line with wishful
thinking than based on hard science; even our knowledge about prognosis for most
“mental” conditions is often just guesswork, which is why there was such
surprise at last week’s study from the UK (published in the journal World Psychiatry) that concluded
that mental illness robs on average 9-20 years of life from an individual
suffering from one of those conditions, a toll about double that exacted by
smoking.
This should be a wake-up call that “mental illnesses”
desperately need at least as much attention – research, dollars, media – as
other more “fashionable” problems.
