By Vaughan Bell

Posted Sunday, Jan. 9, 2011, at 12:52 AM
ET

Shortly after Jared Lee Loughner had
been identified as the alleged shooter of
Arizona Rep. Gabrielle Giffords, online
sleuths turned up pages of rambling text
and videos he had created. A wave of
amateur diagnoses soon followed, most
of which concluded that Loughner was
not so much a political extremist as a
man suffering from "paranoid
schizophrenia."

For many, the investigation will stop
there. No need to explore personal
motives, out-of-control grievances or
distorted political anger. The mere
mention of mental illness is explanation
enough. This presumed link between
psychiatric disorders and violence has
become so entrenched in the public
consciousness that the entire weight of
the medical evidence is unable to shift it.
Severe mental illness, on its own, is not
an explanation for violence, but don't
expect to hear that from the media in the
coming weeks.

Seena Fazel is an Oxford University
psychiatrist who has led the most
extensive scientific studies to date of the
links between violence and two of the

most serious psychiatric diagnoses—
schizophrenia and bipolar disorder,
either of which can lead to delusions,
hallucinations, or some other loss of
contact with reality. Rather than looking
at individual cases, or even single
studies, Fazel's team analyzed all the
scientific findings they could find. As a
result, they can say with confidence that
psychiatric diagnoses tell us next to
nothing about someone's propensity or
motive for violence.

A 2009 analysis of nearly 20,000
individuals concluded that increased risk
of violence was associated with drug and
alcohol problems, regardless of whether
the person had schizophrenia. Two
similar analyses on bipolar patients
showed, along similar lines, that the risk
of violent crime is fractionally increased
by the illness, while it goes up

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We're too quick to use "mental illness" as an explanation for violence.

substantially among those who are
dependent on intoxicating substances. In
other words, it's likely that some of the
people in your local bar are at greater
risk of committing murder than your
average person with mental illness.

Of course, like the rest of the population,
some people with mental illness do
become violent, and some may be riskier
when they're experiencing delusions and
hallucinations. But these infrequent cases
do not make "schizophrenia" or "bipolar"
a helpful general-purpose explanation
for criminal behavior. If that doesn't
make sense to you, here's an analogy:
Soccer hooligans are much more likely to
be violent when they attend a match, but
if you tell me that your friend has gone
to a soccer match, I'll know nothing a
bout how violent a person he is.
Similarly, if you tell me your friend
punched someone, the fact that he goes
to soccer matches tells me nothing about
what caused the confrontation. This puts
recent speculation about the Arizona
suspect in a distinctly different light: If
you found evidence on the Web that
Jared Lee Loughner or some other
suspected killer was obsessed with soccer
or football or hockey and suggested it
might be an explanation for his crime,
you'd be laughed at. But do the same
with "schizophrenia" and people nod in
solemn agreement. This is despite the
fact that your chance of being murdered

by a stranger with schizophrenia is so
vanishingly small that a recent study of
four Western countries put the figure at
one in 14.3 million. To put it in
perspective, statistics show you are about
three times more likely to be killed by a
lightning strike.

The fact that mental illness is so often
used to explain violent acts despite the
evidence to the contrary almost certainly
flows from how such cases are handled
in the media. Numerous studies show
that crimes by people with psychiatric
problems are over-reported, usually with
gross inaccuracies that give a false
impression of risk. With this constant
misrepresentation, it's not surprising
that the public sees mental illness as an
easy explanation for heartbreaking
events. We haven't yet learned all the
details of the tragic shooting in Arizona,
but I suspect mental illness will be
falsely accused many times over.

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