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Sunday, February 18, 2018

A plea: please exclude people with mental illness from the mass shooter narrative

Another school shooter. Another flurry of social media thoughts and prayers. Another seventeen funerals. Another raft of quotes from Mister Rogers, another war of pointed fingers, another synod of politicians and talking heads proclaiming not the time and not the time.
And another squirming moment where all heads turn toward us, toward people with mental illness; we may agree on little, the people of this nation, but we can all agree we'd be better off with fewer crazies in our midst. Drug 'em, hospitalize 'em, send 'em off, or lock 'em up - humanely, of course, always humanly. It's not the mentally ill's faults, those poor unfortunate souls, that they're hard wired for mass murder; they need protecting from themselves just as much as we need protection from them. And the one in five of us who might disagree, the one in five Americans who lives with a mental illness, well, we most of us keep quiet when these calls come, keeping our symptoms locked away inside us, if we're lucky enough to be able to do so, in a secret prison of our own shame. Those of us with the resources to manage our illness to the point we can keep it under wraps, well, we hear what y'all say about "the mentally ill," how we're weak and lazy, unreliable, untrustworthy, other, less-than. Violent. Dangerous. We're not stupid, most of us, we have a sense of self preservation. So we keep our diagnoses to ourselves and thank our lucky stars we're able to.

This is not a post about guns. This post doesn't endorse a position on the left or right. This post is about people with mental illness; about how we do not belong in this mass shooting narrative. And I'm writing this post because unlike most people with mental illness, I don't have the good sense to be quiet about having one, and I think that lack of good sense obligates me to speak up in defense of the people who don't or can't speak up for themselves. I'm speaking up because every damn time someone slaughters school full of children, this narrative starts, left right and center, about helping the mentally ill, as if we're the ones responsible. Well we're not.

But how can I say we're not violent when we all know that people with mental illness are dangerous on some level? How can I say that when the man who murdered seventeen at a high school in Florida this week does, in fact, have a history of mental illness? I can say it because one in five Americans is living with a mental illness, and the vast, vast majority of us are as peaceful and law-abiding as anyone else. We haven't done anything to be lumped in with mass murderers, and we don't deserve to be further stigmatized and isolated every time someone who isn't us commits unspeakable evil.
Now, when I say "mental illness" I'm referring to a diagnosable disorder characterized by patterns in thoughts, feelings, or behaviors that impair a person's ability to function in their daily life. These disorders include depression, bipolar disorder, anxiety disorders, schizophrenia, and PTSD, among others. This is probably the definition we should all be using for mental illness - I've heard a lot of people say "oh well clearly if you want to murder people you're mentally ill," but that doesn't really compute. Mental illness is a medical diagnosis. Evil is not a medical diagnosis, nor is hatred, nor is desire to kill. Certainly there are evil people who have mental illness, but there are evil people who have asthma too, and we don't go stigmatizing asthmatics every time we find out a mass murderer used an inhaler. 
Now it's really important to note that I'm not saying mental illness can't cause people to behave violently. It absolutely can, in certain cases, but probably not in the ways you think. Most people with mental illness, especially those, like me, whose symptoms are well controlled with medication and healthy lifestyle, are as peaceful and law-abiding as people without mental illness. I think we're about 1% more likely to behave violently? But by "behave violently," I mean we're about 1% more likely to punch a guy in a bar fight or shove the person in line in front of us at Target. That's a far cry from mass murder. According to a study from the American Journal of psychiatry, only one in every twenty violent crimes is perpetrated by someone with a mental illness, and since one in every five of us is someone with a mental illness... well, you do the math, I'm just a writer.
Now, our likelihood of becoming seriously violent does increase if we're abusing drugs or actively psychotic. And here I want to take a moment with the word "psychotic." Psychosis happens a lot with people who have schizophrenia, but can also happen with other disorders, like bipolar disorder. Not everybody who has a mental illness will ever experience psychosis, though.  "Psychosis" refers to a state in which a person is incapable of telling what's real from what isn't. A psychotic person might hear sounds other people can't hear, see things others can't see, or be absolutely convinced of things that aren't true. For instance, a psychotic person might have a conversation with an empty chair, convinced their long dead mother is sitting in it. They might also believe they work for the CIA, that they're secretly William Shakespeare, or that Jesus Christ is standing at the end of the bed telling them their winning lotto numbers. Psychotic symptoms vary greatly in severity, and while psychosis always causes suffering to the people who have it, it's not actually terribly common for psychosis to lead to violence. It might, in fact, lead a person to send their entire Medicaid check to a televangelist because God spoke to them through the television and told them to. That happened at a group home I used to work at more than once. Psychosis might also lead a person to douse themselves in bleach because they believe they're covered in bugs, or to write a 10,000 page manifesto that's utter gibberish, or to wear the same filthy clothes every day because it wards off the warlock that's after them. Those behaviors might seem weird and scary, but they're not as likely to lead to violence as you might think. 35% of people with schizophrenia have had at least one violent episode in their life, which seems like a lot. But the vast majority of those violent episodes have been minor things - slaps and shoves and the like; only 1% of people with schizophrenia have ever hurt somebody so badly that they even had to go to the emergency room. ONE percent of people with ONE form of mental illness (a relatively rare form at that) and now everybody with ANY mental illness gets implicated in EVERY mass murder, whether the murderer happened to have a mental illness or not? That's pretty unfair. One might go so far as to call it ignorant bigotry. 

You know what else is really ignorant? The notion that the drugs people like me take, that allow us to function in society and have meaningful lives, those drug are the cause of mass shootings. Mass shootings happen because of Ritalin and Prozac and all those nasty happy pills we crazies delude ourselves into needing. I first started seeing this notion pedaled on far right wing conspiracy-theory type blogs a few years back. Every mass shooter in the past twenty years, they say, was on SSRI drugs at the time of their crime. Those articles cite sources to "prove" their assertions, but those sources are all other conspiracy websites. No actual evidence at all. Lack of proof notwithstanding, those notions found their way into the Internet slip-stream, onto more mainstream conservative platforms, then onto the mommy blogs where they exploded, and now the notion that psych meds cause murder seems to be all but common knowledge online. Nobody checks the sources anymore - they've heard it so much it must be true.  

But actually, psychiatric drugs, even SSRIs, though very common, do come with huge side effect risks. That's why we make psychiatrists go to school for fourteen years before we give them leave to write these prescriptions. The amount we don't know about the human brain is staggering, and our understanding of how these drugs affect the brain is in its infancy. The brain, y'all, is a barely solid and impossibly fragile mass of grey snot and with all the things we don't know, all the variables that factor into the equation, medicating a mental illness is a minefield. That's why scientists dedicate their entire lives to locating those mines and helping patients steer clear of them. With, it can't be overstated, incredible success.
Back in the 1800s, most people with severe mental illness could expect no quality of life whatsoever. Having a mental illness meant restraints and prisons, experimentation, forced sterilization, stigmatization, isolation, torture, starvation. Later mental illness meant lobotomies - ice picks shoved through the eyeball straight into the brain. It meant writhing in one's own filth alone in a padded room for days on end. It meant abuse, neglect, it meant being disowned by families and locked away for life. Later it meant drugs that made one a living corpse devoid of free will - suffering still, but suffering slowly now, and quietly. 
Finally though, we're developing drugs that have powerful impact with far fewer risks than previous generations of drugs. These new meds are nothing to be taken lightly - there are serious risks that need to be weighed, and anybody who takes them needs to have a long talk with a doctor or two and read every word of those package inserts before they take the plunge. But the fact is people with mental illness deserve lives without constant suicidal thoughts, without self-injury, without constant panic attacks, without delusions, without invisible voices screaming in their ears, without being forced to spend our lives trapped inside a mind bent on its own destruction. We have treatments now that let us hold down jobs, live peacefully with our own families, live independently and make our own decisions. 
And now people are trying to say these drugs that let so many of us participate in life rather than spending it locked away or dead or worse can turn us into murderers. Without evidence. Without expertise. Without any regard for the suffering of people who have a mental illness and need help. Yes, there have absolutely been cases in which a bad response to a psych med has had devastating consequences; but no, the drugs we use to deal with the symptoms of mental illness are not going to turn us into mass murderers. Anyone who tells you otherwise is unforgivably ignorant
Y'all, having a mental illness really, really sucks; having the world think that your mental illness makes you a serial killer is really rubbing salt in the wound. And now people want to claim that the medication that helps make life bearable turns us into murder machines? How much insult do you really need to heap on top of all this injury? We already make less money than people without mental illness. We're already more likely to be homeless. Discrimination against people with mental illness is so rampant that most sufferers are terrified to let the people closest to them know about their diagnosis; you've probably got a friend or a coworker or a family member going through mental health hell right now, suffering in silence to avoid others' judgement. Our care is stupid expensive, and we generally have to fight an uphill battle to get our insurance to cover it - even though there are laws on the books saying that they have to. We've got enough to deal with already.

Here's the bottom line, cats and kittens. People with mental illness are not, no matter how you measure it, more likely to go on a shooting rampage than people without. Bringing us up every damn time someone commits mass murder is ignorant, discriminatory, and just plain wrong - factually and morally. People with mental illness are fighting an uphill battle just trying to make it through the day and live our best lives; it is wrong to heap stigma and discrimination on top of that. 
And we need you. We need you to speak up on our behalf - when the folks around you talk about people with mental illness being dangerous, we need you to call them out. We need you to pass the word on that we've done nothing to deserve to be held responsible for mass shootings that we had nothing to do with. We need you to ask your friends to stop running their mouth whenever they bring up false claims that people with mental illness, or the drugs they take, are responsible for mass shooting deaths. We're tired. We're scared. We're grieving these horrific shootings like everybody else, but we're doing that grieving while a bunch of ignorant bigots on cable news give us the side eye and try to make us take the blame. Please, just stop making people with mental illness part of the mass shooter narrative. We've had enough.

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