Mental Illness

Deinstitutionalization and Public Fears of the Mentally Unstable

Although about half of all Americans will have a DSM disorder in their lifetimes, the vast majority of these diagnoses are not associated with aggressive behaviors. Estimates from the National Institute of Mental Health (NIMH) project that less than one out of five Americans receives the help needed for their mental problems. Research in the 1920s through the 1950s showed that mental patients actually had similar arrest rates as that of the general population. With the rise of deinstitutionalization in the 1960s or the release of mental patients from hospitals into community-based treatment, studies began reporting that mentally ill persons were responsible for a disproportionate number of violent crimes. Although many of these studies were later criticized for methodological weaknesses, they helped to fuel public fears about the release of mentally unstable persons into the community.

Numerous studies have reported on public perceptions that mental disorders and violence are invariably related. Individuals with severe mental illness are commonly regarded as dangerous, unpredictable, and at times, predatory. Yet according to a 2001 report by the U.S. Surgeon General, the danger that the majority of individuals with mental illness pose is actually quite small. Although an abundance of research has come forward to support these statements, the same literature does indicate that specific types of mental illness may play a role in the development of violent offending in childhood and adulthood.

Childhood or Adolescent Mental Disorders Linked with Violence

Although most children are unruly, disruptive, or recalcitrant at times in their growth, such behaviors become problematic when they regularly interfere with their function across a number of domains, [Page 451]including family, school, and peers. Numerous studies have documented a link between early and persistent aggressive behaviors in childhood and adolescence and subsequent later aggression. The number of juvenile offenders entering the criminal justice system with multiple mental health problems has also raised important questions about what role mental health might play in the development of violent behaviors.

There is compelling evidence of a relationship between various childhood disruptive disorders such as oppositional defiant disorder and conduct disorders and later serious offending. In addition, other disorders such as attention-deficit/hyperactivity disorder, depression, and substance abuse disorders have also been associated with aggression in youngsters. Depressed children, especially boys, may be filled with feelings of hostility, irritability, and aggression much more than are similar adults. Depression in children and adolescents has also been linked to violent behaviors such as suicide ideation and attempts, delinquency in adolescence, and homicidal ideation in adulthood. Research has suggested that boys with depression who also use or abuse substances become significantly more aggressive against others than do females, who tended to hurt themselves more. Youths with comorbid, or co-occurring, mental disorders have been shown to have a greater risk of violence later in life. Although there has been increasing attention to these types of juvenile mental health problems, the complexity surrounding childhood disorders and human development makes this a controversial topic. The media attention given to high profile school shootings and senseless acts of cruelty by youths has only reinforced public fears about juvenile predators.

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