Don’t demonise the mentally ill. Drunks are far more deadly
NiChoLAS SALvAdoR, the 25- year- old man with schizophrenia who beheaded cafe owner Palmira Silva in north London last September, was sent to Broadmoor this week after his trial.
the jury found him not guilty of the 82-year-old great grandmother’s murder, on grounds of insanity, and he is to be detained indefinitely.
the case could not be more tragic for Mrs Silva’s family because there can be no justice for them. As the judge made clear in the closing remarks, Salvador was in the grip of psychosis and was not responsible for what he did. Yet there is no comfort in the thought that Mrs Silva was in the wrong place at the wrong time.
often in these cases the finger can be pointed at overstretched mental health services who have failed to respond adequately, but Salvador was not even known to mental health services and appears to have become unwell rapidly with his family realising something was wrong only shortly before he went on his rampage.
Stories like this are always tricky. they make the news and are reported on. Just as many trials are given column inches in newspapers, so was this one.
But they also inadvertently fan the flames of fear among the public that mentally ill people, especially schizophrenics, are all dangerous.
it is true that people with schizophrenia do pose a significant danger but the danger is almost invariably to themselves. one in ten commit suicide and the isolation that they experience as a result of the public stigma of mental illness is thought to be one of the main contributing factors to these deaths.
Put like this, it turns out that we, the public, pose a greater risk to schizophrenics than they do to us. it is good to try to get a little perspective on these things. While we, as a society, have become far more understanding with regard to some mental illness, such as depression, conditions like schizophrenia still generate fear and anxiety.
HoWeveR there is also something about the strangeness of conditions like schizophrenia that makes us wary. At the root of this is that in such illnesses, sufferers experience psychosis — paranoid, persecutory thoughts often accompanied by seeing or hearing things.
this makes it is hard for us to relate to the experience of the illness. We tend to fear what we don’t or can’t understand and this is clearly the case with psychosis.
Yet the fact is that the number of people with schizophrenia who hurt others is tiny. Although drunk people do not provoke the same level of fear in the public that schizophrenics do, it is actually much safer to live next to an asylum than a pub, given that alcohol intoxication is implicated in far more homicide cases than mental illness.
Someone who is drunk is much, much more likely to harm you than someone hearing voices.
it is interesting how we evaluate risk when it comes to our safety. We become wary of someone who is mumbling to themselves in the supermarket or acting strange on the bus, but the risk of being killed by someone with mental illness is about the same as the risk of being killed by lightning.
Far more people are killed as a result of domestic violence but we don’t all get in a jitter when someone gets married.
Sometimes the unthinkable happens. i used to work in a secure hospital for people who, like Salvador, had committed crimes as a result of their mental illness.
ALL oF them were detained indefinitely for treatment. Before i began work there i imagined it would be a scary, intimidating place with psychotic monsters prowling the corridors. the reality could not have been further from the truth.
the overwhelming emotion was one of immeasurable sorrow. the patients’ liberty is far more restricted than that of prisoners. Yet because the patients were receiving treatment, most of them were getting better and no longer psychotic.
they had to find a way of dealing with what they had done when they were unwell. they were baffled and horrified by the crimes they had committed, bowed down with guilt and remorse.
Understandably the forensic psychiatrists responsible for these patients take no risks, keeping many detained long after they would have been released if they were in the criminal justice system and had been sent to prison.
While what happened to Mrs Silva is unbearable, i worry that extraordinary, horrifying cases like that of nicholas Salvador will merely make the lives of those with mental illness worse.