How to Block the Es­ca­lat­ing Cy­cle of Men­tal Ill­ness and Vi­o­lence

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In men­tal health, in­ter­ven­ing early with treat­ment is prov­ing to be key to re­duc­ing com­mu­nity vi­o­lence and men­tal health crises.

The study, a joint ef­fort from North Carolina State Univer­sity, RTI In­ter­na­tional, Duke Univer­sity Med­i­cal Cen­ter and Arizona State Univer­sity, was launched to un­der­stand the con­nec­tions be­tween men­tal health prob­lems and vi­o­lence.

Many have as­sumed the con­nec­tions be­fore, but much of that was based on guess­work rather than ab­so­lute data.

As RTI’S Richard Van Zorn, one of the lead au­thors of a re­cent pa­per that cov­ers this new study, noted, an ear­lier anal­y­sis showed that around one-third of adults di­ag­nosed with men­tal ill­ness were likely be­come vic­tims of vi­o­lence within a six-month pe­riod. That sug­gested dig­ging deeper into the prob­lem, as the re­searchers looked into two key ques­tions: If some­one is vic­tim­ized, are they likely to be­come vi­o­lent? And if some­one is vi­o­lent, are they likely to be­come vic­tims them­selves.

As the study showed, the an­swer is yes to both ques­tions, sug­gest­ing as a first con­clu­sion that be­ing a vic­tim of vi­o­lence can make one more vi­o­lent. As a sec­ond it says that vi­o­lent peo­ple at­tract be­com­ing vic­tim­ized them­selves.

Add to that the is­sue that be­ing men­tally ill po­si­tions in­di­vid­u­als for a higher like­li­hood of be­com­ing a vic­tim of vi­o­lence in a rel­a­tively short time, and one can be­gin to see how not treat­ing the men­tally ill quickly can rapidly com­pound the vi­o­lent na­ture of a so­ci­ety.

The study re­viewed 3,473 adults with men­tal ill­ness who had an­swered ques­tions both about caus­ing vi­o­lence them­selves and be­ing the vic­tim of vi­o­lence against them. The study in­cluded un­der­stand­ing ev­ery­thing from med­i­ca­tion us­age to liv­ing con­di­tions, such as whether they were home­less, were hos­pi­tal­ized for men­tal health treat­ment, or lived at home. The study also in­cluded un­der­stand­ing the var­i­ous kinds of ther­apy those men­tally ill in­di­vid­u­als were re­ceiv­ing. It then kept tabs on each per­son’s sit­u­a­tion and ex­pe­ri­ences for a pe­riod of up to three years each.

Some per­haps ob­vi­ous con­clu­sions of the study were that those who used drugs had a much higher prob­a­bil­ity of com­mit­ting vi­o­lence, and that al­co­holism was linked to be­com­ing a vic­tim of vi­o­lence.

Be­yond those kinds of self-med­i­ca­tion to deal with such ill­ness, af­fec­tive symp­toms such as anx­i­ety, be­ing de­pressed and hav­ing poor im­pulse con­trol were also quite tightly associated with vi­o­lence.

As one of the other re­searchers associated with the study, Sarah Des­marais, an as­so­ci­ate pro­fes­sor at North Carolina State ob­served re­lated to th­ese ‘af­fec­tive symp­toms’ (as they are re­ferred to), what it shows is that re­ly­ing on pure drug or al­co­hol use pro­grams to treat the men­tally ill would not stop the ill­ness and vic­tim­iza­tion cy­cles. The study says it is clear that ther­a­peu­tic in­ter­ven­tions or med­i­ca­tion de­signed specif­i­cally to treat the anx­i­ety, de­pres­sion and im­pulse is­sues, should be ad­dressed early as well.

The study went on to eval­u­ate more com­plex is­sues, such as the domino ef­fect of­ten hap­pen­ing when one vi­o­lent event trig­gered a se­ries of other things to hap­pen, all of which made the sit­u­a­tion that much harder for the in­di­vid­u­als in­volved to man­age them­selves. In one case, for ex­am­ple, a sin­gle in­ci­dence of vi­o­lence trig­gered seven other things to hap­pen, in­clud­ing nu­mer­ous new psy­cho­log­i­cal symp­toms, home­less­ness and be­com­ing more vi­o­lent them­selves.

In the end, the study points to the need to be able to ob­serve such men­tal health prob­lems at the ear­li­est pos­si­ble stages, fol­lowed by tar­geted early treat­ment and ther­apy of many dif­fer­ent kinds (not al­ways in­volv­ing drugs), in or­der to keep men­tal ill­ness and vi­o­lence from fur­ther spi­ral­ing out of con­trol in our mod­ern world.

Photo by Ju­lia Shashk­ina

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