This is NAMI National Executive Director Mike Fitzpatrick's article from the NAMI Blog.
Along with so many other Americans, NAMI members have been saddened by the tragedy in Aurora, Colo. in which 12 people were slain and 58 wounded in a theater at the premiere of a Batman movie.
NAMI does not speculate about mental illness or other factors that may be involved in such tragedies-or for that matter other kinds of news events. No one should diagnose through the news media.
Despite many public perceptions, we do know that generally the likelihood of violence from people with mental illness is low. In fact, the U.S. Surgeon General has reported that "the overall contribution of mental disorders to the total level of violence in society is exceptionally small." There are many reasons why violence occurs in our society, many of which have nothing or little to do with mental illness.
On the other hand, violence sometimes occurs. In some cases, it is because something has gone wrong with the mental health care system. At this time, that does not seem to be the case.
Recognizing that there is a problem is always the first step. Right now, public inquiry is focused on whether or not the behavior of the person responsible for the tragedy ever caused anyone or any institution to encourage or require him to be evaluated
The Surgeon General has acknowledged that the risk of violence among individuals with mental illness increases to some degree in the case of substance abuse or psychosis, a symptom which typically involves a "break with reality" through paranoia, hallucinations or delusions. Social withdrawal may precede such breaks. Early warning signs of psychosis, particularly in the year leading up to the break, may include:
- Worrisome drop in academic or job performance
- New trouble thinking clearly or concentrating
- Suspiciousness or uneasiness with others
- Decline in self-care or personal hygiene
- Spending a lot more time alone than usual
- Increased sensitivity to sights or sounds
- Mistaking noises for voices
- Unusual or overly intense new ideas
- Strange new feelings or having no feelings at all
Young adults in their 20s are the most common age group to experience the first onset of psychosis. This is a stage of life that usually challenges young people to develop more independence, establish an identity, create intimate relationships and move away from home. Immediate family members, who usually are most aware of changes in behavior of a loved one, play a less central role at this time, particularly if a person has moved to another city or state, such as to attend college or graduate school.
Psychosis is treatable. Many people recover from a first episode of psychosis and never experience another one. The first step, however, is always recognizing onset of the illness and getting treatment.
Again, one cannot diagnose based on media reports. Risks of violence among people with mental illness are low overall. It is important not to perpetuate stigmatizing stereotypes. However, NAMI has been asked by the news media and many concerned families over the last few days about warning signs and what to do.
Regardless of whether or not violence is a concern and regardless of what the case may turn out to be in the Aurora tragedy, the first step is to recognize warning signs of illness and to reach out to a person who may be in trouble. Help them get help.