BBC's Investigative Journalism
A wonderful example of BBC investigative journalism on BBC2 tonight (Monday, 1st March '10). It seems at least four out of every five murders is committed by a "sane" person! Unfortunately the BBC chose to concentrate its investigation on the minority killed by someone who may have had a mental health problem!!!!
I realise that mental health and violence ticks every journalistic box. Unfortunately, enforcing such false impressions only contributes to the culture of fear and prejudice against the one in four people who will suffer from a mental health challenge.
Another question is why, when dual diagnosis is involved, it is the mental health diagnosis that is concentrated on? It is just as correct to say that drug abuse leads to violence.
We also have to emphasise that the challenges each of the people featured is the same as most people involved in mental health services ~ inaccurate & incomplete notes, services not talking to each other & not talking to the carers and when the person approaches the services for help they get turned away! Of course, it is not the fault of those who fail to meet their responsibilities. We have example after example locally of people who are treated without reference to their notes and whose notes contain the records of other people. No! It can't be the services at fault ~ can it?
Once again the BBC has set back all that many have achieved!
- Philip Clark's blog
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Comments
What killed the Father of the journalist-person who made a film?
Clearly, here is an instance where the mental ill-health of the protagonist was of incidental relevance. The incontrovertible Fact that I gleaned was his abuse of substances - a noxious combination when coupled with psychosis. Since there is no necessary connection between psychosis and violence, the Relevant contributory factor was no doubt Cannabis-related or something inducing paranoia for sustained periods. The Point of Relevance therefore, is that this man was an Addict of something which caused him to murder. No mental health condition per se caused that. I do wish people could give a complete objective picture, and not get so close to their topic they cannot see clearly!
Rambuie
Hi everyone
I have now set up a group called "mental health in film and TV" which will hopefully get people on this site talking about these issues. Would love to hear your contributions, thanks.
statistics
It seems the evidence is misrepresented but my maths might be wrong.
A reputable study looking at homicide 1997-2005 showed 10% of murders were by people with mental health problems. 23% of people suffer mental health problems every year according to another reputable source from data from 2007. If there was a greater risk to life then surely the number of murders by people with mental health problems should be higher than 23%? The fact that its lower means there's more risk from people who are 'normal' than from us (admittedly I don't know how that comparison works for psychotic disorders - I suspect that it will reinforce the stereotype I'm afraid).
I saw Sue Caro speak at the 1 in 4 conference last month about mental health and diversity. She's a Senior Diversity Manager with experience of mental ill health. Guess whatever she said was rhetoric. Seems Channel 4 is the only major broadcaster willing to show progressive programs that challenge the public conscious stereotype usually promoted by the mass media with The doctor that hears voices (TV program with Rufus May). Most people who do through extreme mental ill health are no risk to anyone but themselves. Few people consider the completed suicide rate of schizophrenia which has been estimated at around 10% and attempts are much higher.
Few headlines ever say "psycho* makes great piece or art" or anything like that. I'm not aware of a single UK TV program with a good portrayal of a character with schizophrenia apart from the one from Channel 4. There are countless films and other programs where negative stereotypes are used.
I have to admit I found Marion Janner's blog post was good but it was shifting the stigma from one diagnosis to another. The same rational could be used with men because most murders in the UK are committed by men. Stats show that women are most often killed by their partners. In fact, if you consider war is murder then men commit most of them worldwide. I can understand that shifting the blame to another mental illness is a useful tactic and the stigma of dual diagnosis is an acceptable target. Its just a form of ration I don't agree with.
I've been through the experiences that might or might not get me a diagnosis of schizophrenia. Feelings of control by another force or entity. Thoughts being controlled by forces I didn't know or by people I knew. The shattering of the concept of self. The length may not have been six months which means I wouldn't meet the US diagnostic criteria but I might meet the UK one. I've had diagnoses of bipolar, schizoaffective disorder: bipolar type, dual diagnosis and mixed affective disorder while I used mental health services.
I've only tried to kill one person: myself. I do my best not to hurt people. I'm vegetarian. I work for charities. I try to do what I can for other people who are going through the shit that life throws at us. I work damn hard to make a difference in this world and I do that because of my experiences. I even make the stupid mistake of opening up about my psychosis but that's because if someone doesn't risk doing that then the stigma will never, ever change. Least of all when the BBC keep putting out one side of the picture of psychosis.
* - that's using "psycho" in the wider public meaning and not as an abbreviation of psychopath (what is analogous to antisocial personality disorder).
I agree
Hi Philip, I too was concerned about this programme. This is a very complex issue, and it feels hard to argue with someone who has lost someone in such tragic circumstances. It is terrible when anyone loses someone they love in this way. Services do have a responsibility, but not just to keep things under control when it gets serious. Many still need to change their ingrained misconceptions about mental health that cause some people with experience of mental distress to avoid and mistrust them.
Another thing the film did not mention was that a person with experience of mental distress is more likely to be on the receiving end of violent crime than to be the perpetrator. And yes, if you do the maths, Prof Appleby’s statistics on the BBC programme reveal that 91% of violent crime is committed by people who do not have a mental health diagnosis. There is a minority who become violent, nobody should deny that. Mental health doesn’t discriminate, it touches all kinds of people. But people do discriminate, and I worry that a film like Why Did You Kill My Dad will provide fuel for their prejudice.
This problem does not just rest with mental health services but society as a whole. We all need to take responsibility for what we say and how we think and how we treat each other. This includes, or perhaps especially refers to the media. In the long run, maintaining stereotypes, engendering fear in the viewing public, is not going to help the victims of violent crime, or prevent crime happening in the future. If we all feel more able to talk about mental health without sensationalising, we can encourage people experiencing distress not to feel afraid or ashamed about seeking appropriate support.
I would thoroughly recommend reading Dolly Sen on the Guardian, and Marion Janner on the Mind website, who have both written very eloquently in response to Julian Hendy's programme.
Subconscious prejudice
I think the problem here is also how we chose to challenge prejudice. I think there needs to be a deeper, philosophical debate about this.
Perhaps we tend to challenge prejudice as being conscious and overt. That tends to leave a sizeable chunk (often a majority of people) unaware of their subconscious prejudices.
To illustrate, the academic Martin Gilens published a book entitled Why Americans Hate Welfare. What Gilens shows is that Americans support welfare to "deserving" people but not "undeserving" people. However, with further analysis of statistical surveys, it becomes clear, underlying this is a long-term, lingering racial prejudice that has roots in antipathy towards black slaves. Now it isn't just the usual-suspect foxy shock-jocks, tea-party types but those who regard themselves as liberals that perpetuate stereotypes in the media. When Gilens showed these editors statistics showing that they disproportionately show black people in "undeserving" underclass imagery (young single mothers, drugs, violence) and disproportionately show white people in "deserving" poverty (sudden redunancies, then losing homes), the editors were shocked by the statistics.
Similarly, I would suggest those at the BBC who produced/commissioned the program last night are unlikely to be overtly prejudiced towards people with mental health issues. In fact, they may well be suffering work-related mental health issues themselves, under huge pressures to achieve in a media job.
I think the best way to challenge prejudice is to recognise that prejudice is common. We are all capable of prejudice, it is natural to be prejudiced when we are confronted with something/somebody we don't understand and fear. If we accuse or try to shame, then people are likely to bury their prejudices into their subconscious.
There is nothing better than irrefutable statistics and as you say Philip:
80% of murders are committed by "sane" people.
Slippages and honesties
Hi there, tired eyes, Janie from MissionMiraculus here.
First of all, the 'slippage'...somewhere along the line we need to do a tightening up and clarification on the use of quantitative statistical data. It can't be the case that 90%; 91% and 80% of all murders are committed by individuals or groups without a 'mental health illness' profile. In fact the data are very confusing and complex.
In all likelihood across the 'mental health illness' spectrum, chances are that those with diagnoses of 'depression' and 'anxiety disorders' will be found at the lowest possible risk category for culpability of murder. Those with a profile of 'paranoid schizophrenia' and 'drug induced psychosis (paranoid)' will probably be right up the high risk category, although not as high as those who, on examination, appear to fit the description 'anti-social personality disorder' or 'a-social personality disorder'.
Those with a profile of 'paranoid schizophrenia' and 'drug induced (paranoid) psychosis' are almost certainly in a high risk group both for suicide and murder. Fear is at the core of both illness conditions, the emotion frequently if not overwhelmingly behind acts of murder, as indeed, behind almost all unhealthy and destructive social attitudes, beliefs, interactions and patterns. The fact that the fear may be groundless is irrelevant to the person experiencing the fear. For the fear-possessor the threat is real regardless of its truth status or evidence base for or against reasonableness. Impulsiveness of action by individuals suffering from these disorders or psychic 'events' is common and it is for this reason that there is some reasonableness in highlighting the importance of 'risk' and 'risk minimisation' in relation both to suicide and murder or palpable social harmfulness. To develop instruments of psychic healing for these individuals should be placed as a top priority agenda item within the mental health community. It is true to say that the paranoiacally psychotic individual is 'out of character' and 'not him/herself' when s/he acts under such a mind state. True or not, however, the actions that take place can prove fatal to self or other and where they prove fatal or near fatal to 'other' then this individual will suffer huge remorse and difficulty of integration following a clearing of the psychotic state. S/he is unlikely to try very hard to conceal his/her crimes since s/he is normally extremely distressed by the outcome of his/her ill state.
Those with an 'a-social personality disorder' (who often exhibit symptoms of a narcissistic personality disorder, too, in fact a-social personality disorders are almost co-extensive with narcissistic psychic positions) are a difficult and unpredictable grouping, also a grouping who emphatically DO exist and comprise a bigger than may be imagined populace. Yet precisely because the defining feature is that the person is 'asocial' as distinct from 'anti-social' such individuals are unlikely to be identified and defined as such until or unless their social personal life goals are frustrated by someone or something that causes a temptation to act anti-socially as a means of removing the obstacle.
Those with an 'anti-social personality disorder' do, however share with the 'asocial' person, a stance of attitude to self and others that militates against genuineness in interactions and appearances and which inclines toward the development of complex and sophisticated 'acting' of preferred and advantageous social identities.
Thus, in relation to criminal behaviours, both the 'psychopath' and the 'asocial individual' is liable to be the very hardest to 'spot' and 'reveal' without there being a specific ugly and criminal event that they can be tied to. These individuals, especially the asocial individuals, are all too often the very last people upon whom suspicion falls. They DO know what they are doing; they deliberately CONCEAL their anti social acts and they appear by and large to be the kind of individuals who 'care' more even than the majority of us, since this 'respectability status' and so forth provides the curtain of life behind which they can do as they wish without come back.
Chances are, the anti-social individual will arise from more overtly brutalising early circumstances and will be slightly easier, therefore, to 'track down' in relation to criminal offences, depending on just how quick witted and intelligently organised s/he is.
The asocial individual may never commit a criminal offence. (This is a repeat, but is worth mentioning) Then again, s/he may. Assuming that the asocial individual is driven by narcissistic impulses and drives then criminality of behaviour may only arise when and where another appears to threaten or undermine the asocial/s positive social identity or to expose parts of his/her conduct that would prove undermining of it in a significant way. At this point the asocial individual can become very dangerous indeed. S/he has no conscience in relation to her/his behaviour toward others - what appears to be conscience is mere attachment to preferred and/or acceptable (to him/her) social reputation / identity. One more possibility. The asocial individual who hasn't been driven to significantly anti-social and/or illegal behaviour may quite feasibly believe that they are as 'good' and 'respectworthy' as others take them to be. Where she/he is driven to behaviours and strategies that are wholly outside of such repute then the asocial individual does discover that the identity is in jeopardy, both in relation to 'personal identity' and to their social reputation. Robbing such an individual of his/her 'good reputation' is tantamount to murder of sorts to the asocial human being. S/he can become actively and cold bloodedly dangerous in pursuit of 'silencing' such a threat.
So: these are almost certainly the two highest risk groups of human beings vis a vis criminally anti-social behaviours of aggression of various kinds. Murder, of course is inclined to be a male expression of annihalating rage. But in the groups referred to impulsive acts of rage are relatively unusual. The asocial and antisocial personality types will much prefer to plan out their revenges and/or censorships.
Ironically when such individuals have become criminal, and if, for example, they murder or attempt murder and are caught (the last part, getting caught, is a moot point, they will generally be pretty good at signposting away from themselves), they may acquire a 'mental illness' status: this will put them inside mental health statistics and falsely increase the population for consideration as illness related crime.
I'll be very very pleased to see any comments on this - essay, really, isn't it lol. It is an output of reflections of observations developed over many years at both 1st, 2nd and 3rd hand...