An Important Message from our Chief Medical Officer

The recent horrific killing of 18 innocent people in Lewiston, Maine, has evoked emotions of anxiety, fear, anger and even depression in the general population. Once again, we are beginning to wonder if there is any link between mental illness and violence. Are people with mental illness more violent, or are they risk to public safety? We have seen this debate in the past, but the answer still is elusive.

We are more fearful of violence that is senseless, random, and unpredictable. In an attempt to find a reason for this irrational behavior, we often rush to judgement by attributing it to mental illness. Therefore, it is essential to dispel some of the MYTHS surrounding this perception, so as to avoid stigmatization of people with mental illness. The stigma of mental illness may result in their sliding down the socioeconomic scale followed by poverty and having to live in dangerous and impoverished neighborhoods where they are at higher risk of being victimized.

Literature review on this issue also has not provided any conclusive answer. Recently, however, the reliable and sophisticated “McArthur Violence Risk Assessment Study” has concluded that the prevalence of violence among those with major mental illness who did not abuse substances was indistinguishable from their nonsubstance abusing cohorts. A concurrent substance abuse disorder doubled the risk of violence. Among the mental illness category, schizophrenia had a lower risk of violence, compared to bipolar illness.

Contrary to the common belief, delusions did not have a strong association with violence. There was, however, some correlation between auditory command hallucinations (“hearing voices”) and violence. Substance abuse in the context of noncompliance with treatment is a potentially volatile combination.

In conclusion:

1. Mental health disorders by themselves are not determinants of violence.

2. Substance use is a major determinant of violence, whether there is a concurrent mental illness or not.

3. Factors associated with the increased risk of violence are A. History of past violence, B. Violence in the family, C. Parental substance use, D. Broken family, E. Poverty.

Integrated Services of Kalamazoo has been providing a wide array of mental health services including screening, assessment, counseling, psychiatric and substance use treatment services. ISK has begun providing 24-hours-a-day services at our NEW Behavioral Health Urgent Care & Access Center. It is located at 440 West Kalamazoo Avenue, Kalamazoo MI, or by calling: (269) 373-6000.

Thank you!