The Rare Cases Mental Illness Does Result in Violence

In the mental illness community there is often an outpouring of emotions when violence is wrongly attributed to mental illness or when there is an assumption the mental illness will result in violence. There is strong support and encouragement for those wrongly accused and even outrage towards the accusers. Most forms or mental illness never result in outward violence although many can involve some form of self-harm as a way to cope with the impact of the mental illness. Addictions are a common response to mental illness for many who can’t cope with the symptoms and haven’t found the right treatment. This article is not about those who are not outwardly violent.

This is about the small percentage of people living with mental illness who do resort to violence. This article is also about those who refuse treatment. This article is about those who are on a collision course with unimaginable horrors and who have somehow fallen through the cracks of our mental health and legal systems. This article is about my son.

To protect his anonymity, we’ll call him X. X first began experiencing symptoms of anxiety and depression in late middle school and all through high school. When psychiatry, counseling and medication were not effective at addressing his symptoms, X turned to drugs and alcohol which escalated late in high school. Symptoms of paranoid schizophrenia began to appear late in high school and seem to have been accelerated by drug use. X was barely able to finish high school and then quickly got lost in a world of addiction. He became hostile towards his mother and I and his younger siblings and when that hostility turned to violence it was no longer safe for him to live with us.

X got caught up in a world of drug and alcohol abuse, deepening his depression and anxiety and leaving his paranoid schizophrenia and emerging bipolar disorder unchecked. He soon became suicidal and we were able to convince him to get admitted to a psychiatric hospital. What was anticipated to be a three to five day stay resulted in nearly three weeks as the right balance of medication was found. Near the end of the stay we noticed that our son had returned and we were so grateful.

We were able to meet with the attending psychiatrist before discharge (our son has since refused to allow them to disclose information to us) and he informed us that there are many successful treatment options available and the trick is to find the one that best fits the individual. He also gave us a warning which has remained with us until this day, 13 years later. He noted that while treatment can be very effective in reducing symptoms to the point that the patient can resume a “normal” life, the biggest challenge with these types of mental illness was the patients willingness to remain in treatment.

His prophetic words came to haunt us. X was released from the hospital and returned to our home. The next few months were full of hope as he found steady employment that he liked, remained on his medication and avoided alcohol and non prescribed drugs. We were encouraged by what we saw. Then cracks began to appear. It began with moodiness. Then social withdrawal. Then the hostility returned, toward coworkers and toward family. Evidence of alcohol and drug use reappeared. His mind shifted from embracing treatment to become suspicious of it and then openly rejecting it. This all led to a return of the violent behavior where he destroyed our property but more importantly threatened his mother both in words and in actions. Once again he had to be removed from the home.

The next 13 years have been a cycle of short hospital stays (one day to two weeks), short term treatment (until he refuses), some recovery for alcohol and drug abuse, return to alcohol and drug abuse, minor violent behavior (no permanent injury resulting) and arrests. He has also spent time in jail or prison pending court hearings on a few occasions and is currently locked up pending a trial as of this writing. Over the years he has become less and less willing to even consider treatment outside of the hospital and has been much quicker to return to hostile and even violent behavior.

At one of his hospital stays we were able to convince the psychiatrist (he couldn’t talk to us legally, but he could listen) to request a court order for treatment. This was approved, yet the day X was released from the hospital he stopped treatment and we found that the court order was meaningless. We have petitioned social workers, psychiatrists, police, probation officers, public defenders and prosecutors to involuntarily commit X to long-term care, in the hopes that he will gain enough stability to see the benefits of treatment and be willing to continue it on his own.

Unfortunately, our laws are set up such that even while everyone can see the need for long-term care, there is no ability to involuntarily commit someone unless they are a threat to themselves or others, have shown that they are unable to take care of basic needs or have committed a violent crime. The latter will likely get the person in prison rather than long term psychiatric care, and will not get them the help they so desperately need.

So we continue to watch helplessly as X racks up more and more arrests, short term hospital stays and short term jail time. We wait for the call that the minor violence has finally escalated to something resulting in permanent injury or loss of life to him or to the current target of his anger. And we cringe when we hear advocates protesting that people with mental illness are not violent. While that is true in most cases, it is not true in all and that mentality is actually a disservice to those with mental illness that do have violent tendencies.

We watch, we wait, we advocate. And we hope for the miracle that will one day turn X’s life around.