Mental illness does not equal violence



A popular horror film trope: you're stuck in an asylum and need to escape. The patients are out to get you. There's a villain with no clear motive for killing people, so it's revealed they were mentally ill all along.

James McAvoy in SplitUsing mental illness as an explanation for criminality is everywhere. It's in movies like Split, TV shows like American Horror Story and a large number of video games. It's in cop shows like Criminal Minds, in which half of the criminals were shown to be mentally ill.

And it's not just fiction, news coverage also contributes to this perception. Though only 3 to 5 per cent of mass shooters have been diagnosed with a mental illness, in the wake of a mass shooting, a shooter's mental health history is often one of the first topics discussed. The stereotype is so ingrained that after the recent school shooting in Florida, Donald Trump said he would deal with 'the difficult issue of mental health', but didn't mention guns once in his speech.

These portrayals ignore that doctors and mental health advocates have been telling people for decades that mentally ill people are no more violent than neurotypical people. Statistically, people with mental illness are more likely to be the victims than perpetrators of violence. Dr. Louis Kraus, the chief forensic psychiatrist at Rush University Medical College says, 'The concept that mental illness is a precursor to violent behaviour is nonsense.'

In regards to the link between mental illness and gun violence, a 2016 study published in Health Affairs, which focused on two Florida shootings, says that 'if gun violence is thought of mainly in terms of homicide, mental illness is a red herring'. It only becomes a public mental health problem when the definition of gun violence includes suicide and self harm.

The fact that mentally ill people aren't inherently violent isn't a new discovery, yet again and again our media reinforces the perception that violence is often caused by mental illness and therefore people with mental illness have a greater capacity for violence. Research confirms that the number of violent acts committed by mentally ill people is disproportionate to how widely covered it is on the news and other media.

This reinforcement contributes to feelings of shame in mentally ill people, and can prevent some from seeking treatment. It also has a negative social impact. According to Dr Heather Stuart in her article on mental health and the media, 'the presumption of dangerousness ... can be used to justify forced legal action, coercive treatment, bullying and other forms of victimisation'.


"Mentally ill people can commit crime like anyone else, but they make up a very small percentage of violent offenders."


It's tempting to try to find a root cause for violence. Especially violence as horrific as a school shooting. But casting violent crime purely as a mental health issue is disingenuous. There are several key indicators of someone who is more likely to commit a crime: previous offences, history of abuse, alcohol and drug use, age and gender. Mentally ill people can commit crime like anyone else, but they make up a very small percentage of violent offenders.

And yet movies with lazy writing are made, and news cycle continues. I'm encouraged by the more nuanced portrayal of mentally ill characters in film and TV, but the perception that mental illness and violence are inherently related still lingers.

After a piece on the news about a violent criminal, it's easy to say, 'they must have been so mentally unwell,' followed up by, 'we need to do more to reform our mental health systems'. But mental health care deserves its own separate and thoughtful conversation, not just to be a stand-in for preventing criminal behaviour. Continuing to emphasise the link between criminality and mental illness is harmful. It might sell news and TV shows, but in reality, it's stigmatising mentally ill people.



Neve MahoneyNeve Mahoney is a student at RMIT university. She has also contributed to Australian Catholics and The Big Issue. Main image: James McAvoy in Split

Topic tags: Neve Mahoney, mental illness, Florida shooting


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Existing comments

Very interesting article, Neve, on a very complex subject. I have read all the references you cite and must say that they are all flawed (that is not a criticism of you but of the authors quoted). The most serious flaw is that none of the studies have been controlled by comparison with a counter population sample. One of the statistics quoted is that at the time of shooting a percentage of shooters did not have a diagnosis of mental illness - that does not mean they are not mentally ill. Further the allegedly mentally ill group has to be expressed not as a percentage of the entire cohort of violent deaths by shooting including both mentally ill and not mentally ill people but exclusively to a known mentally ill group to achieve the true incidence and any credibility. The research would also gain greater credibility if those not previously diagnosed as mentally ill were re-assessed after the event and found not be mentally ill or indeed mentally ill. Dr McGinty quoted in the article says 'Anyone who kills people is not mentally healthy. We can all agree on that'. Surely that means all shooter-killers are mentally unhealthy or in other words mentally ill. This is also fundamentally incorrect and I'm afraid the good doctor is rather confused and can't be taken seriously. Certainly "mental illness does not equal violence" but that is remote from saying that violent mass killers are not mentally ill, the difference that invalidates the research quoted.
john frawley | 21 February 2018

Thank you for your article has confirmed what for years I have been saying after working in Mental Health, that mentally unwell are not Bad, Bad is Bad, not sick.
Juliana | 22 February 2018

True, Juliana. But I am sure that you would know that the mentally ill who do bad things may not be bad but in their illness have lost perspective of the difference between good and bad.
john frawley | 22 February 2018

Neve, I tend to agree with you. Having dealt with children ( and their parents) as a teacher for decades has shown me a very wide variety of personalities from the violent ( yes there were some) to the most gentile of souls. While by no means an expert in these things, I believe it is a 'cop out' to believe that people do evil actions because they have mental problems. No doubt the perpetrators of these shootings, and I include Bryant, the Tasmanian shooter in this category , have serious social misfit issues , but I think it is a bit rich to say they have mental illness which causes their behaviour. Mental illness , like physical illness runs its course and can improve or worsen with time. It can be episodic, thus the killer may have been 'ill' at the time, yet on later examination, the illness may not be apparent.
Gavin | 23 February 2018

While I agree with John Frawley, I also agree with the thrust of this article that, “Using mental illness as an explanation for criminality is everywhere.” In fact it seems to be the default position for authorities after all such incidents. After the January 2017 Melbourne car attack, the Victorian police commissioner was quick to suggest the perpetrator had mental health problems, and after last December’s Melbourne car attack, The Age was quick to suggest the perpetrator was mentally ill.
Ross Howard | 23 February 2018

We all have the potential to become mentally ill or to do bad things if pushed far enough, but some more than others. Some people are very bad and some are fragile mentally and easily pushed over the line. The answer is to strictly limit the availability of dangerous weapons and to have good mental health supports and programs. Education and kindness are also necessary for a healthy society, as bullying and isolation does a lot of damage to people. We need to work on these things to make a safer community.
Cate | 23 February 2018

Isn't it the same as saying "being a redhead does not equal violence"? Or "being black does not equal violence"? In the end, unless someone has a severe and obvious psychotic illness such as paranoid schizophrenia, then diagnosis of mental illness as just as subjective as religion. When we talk about God and religion we presume the existence of a divine being (which we can't prove) - just as discussion about psychology presumes the existence of the mind (which we can't prove). The issue for me is whether someone who has a paronoid/psychotic/delusional condition can actually be culpable when they are clearly acting in self defence? And on another issue..... sociopaths/psychopaths..... I've heard lots of commentary from psychologists who suggest that many of our powerful CEOs and influential leaders are sociopaths, and the only difference between them and a stereotypical criminal sociopath is education and opportunity to channel their condition into something productive.
AURELIUS | 23 February 2018

In his book: Madness and Civilization: A History of Insanity in the Age of Reason, Foucault (and yes, there are some people who don't agree with him) highlights how the origins of the idea of madness lie in the notion of 'unreasonableness'. As a person who has qualifications in Public Policy, Public Health and Theology, I've been aware how societal pillars such as medicine, law, religion and the military are used to try and help control, contain and define what madness is and is not (and the different disciplinary 'languages' used to describe the human condition). At different periods in history these 4 societal pillars (there may be more) are called upon to attend to the human condition ... to address power imbalances, to attend to vulnerability, to uphold trust, and to keep people safe/secure as best as possible. As John Frawley says: 'mental illness' is a complex subject - indeed! But what is less often reflected on is the culture (pathological or otherwise) and spirituality (hopelessness or otherwise) within which mental illness and health can flourish ... and how these cultures & spiritualities emerge, develop and thrive. This is why Constitutions and Public Policies that support healthy societies are so important ... but are often not talked about as part of democratic discourse. Let's hope that the wonderful, resourceful and energised young people of America can generate a discourse that will see change in their Constitution and Public Policies that reflect everyone's right to a healthy & safe society. Is that so 'unreasonable'? I'm just so grateful we do not have this issue to deal with in Australia. It would be helpful for all to remember where the pathology is actually located ... and if it is in the human person and/or beyond? I think of America as imploding in on itself when I listen to these tragedies ...
Mary Tehan | 23 February 2018

Mary Tehan. As I'm sure you know, the societal pillars, Medicine, Law and Religion [Divinity], that you mention have been included as the learned professions together with Education since the fourteenth century in the great Catholic universities of Europe notably Oxford and Cambridge in our heritage. The military has never achieved the same level of societal "pillaring". The four Learned Professions, because of the monopoly they enjoyed in their practice, were characterised by service to society without a fee if necessary. In the modern world we have abandoned that concept of true professional practice, usually through governmental policy. You point succinctly to the need for Constitutions and Public Policies to support and promote a healthy society, something that characterised the rise of Western Civilisation. With the erosion of public policy in the West generally we are living in the early phases of the decline of our society. What we witness today in terms of liberalisation of Laws governing civilised society, the rise of issues like domestic violence, suicide, self mutilation, sexual profligacy of all sorts, pederasty, human psychological distress [mental illness to some] are the very societal changes that preceded the fall of the Greek and Roman Civiisations and replaced them with the Dark Ages. It seems to me that our society is in the early phases of a similar fall and ultimate demise as a societal regulator and the people will have no impact when it comes to cleaning up the mess.
john frawley | 24 February 2018

‘Mad’ is ‘bad’ if it can distinguish between right and wrong. All other things being equal, if Cruz would have felt aggrieved at being shortchanged at WalMart or McDonald’s after the shooting, he is culpable. If all other things are not equal, and Cruz would have felt aggrieved at being shortchanged just after sterling service in saving America from a colony of extraterrestrial body snatchers using the school as their base, then he wouldn’t. I think it’s safe to assume that Cruz knew that he was killing ‘normal’ human beings in cold blood and, at least from watching TV if from nothing else, such activity is forbidden by the law. His offences as such are not against 17 people but against what the law says about those people, viz., that nobody should be shooting them to death. Mental health is irrelevant to the gun debate because all of the shooters knew that they were breaking the law. None of them thought they were defending society against body snatchers from outer space. Whatever other forms of mental illness they may have had at the time of executing the crime, the relevant form was absent.
Roy Chen Yee | 25 February 2018

Roy, I can't see anyone or the argument in the article disagreeing with you. Of course mentally ill people are still culpable. The argument is that being mentally ill doesn't make someone tend towards violence - just as the fact that he has Hispanic ancestry doesn't make him violent. The US gun lobby/Trump/Republicans want us to think that cracking down on mentally ill people will stop these massacres - and your comment is quite right, it's not about being mentally ill!
AURELIUS | 26 February 2018

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