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Mental illness and violence
Posted Monday 1 March 2010
By Marion Janner, founder of the Star Wards campaign
Note: this post was written before the transmission of the Why Did You Kill My Dad? documentary.
This is a very difficult blog to write, stimulated by the programme on BBC2 tonight, Why Did You Kill My Dad? (follow the link to watch it on BBC iPlayer).
Firstly there’s the unusual problem of it being inappropriate this time to rabbit on about my dog, Buddy. The issue is inescapably complex, fraught, widely debated and relatively well-researched. Balance is crucial, and this blog post's contribution will probably be through irritating or infuriating people with highly diverse opinions, equally.
Some might think that it’s not very balanced to comment on a programme I haven’t seen. Very Mary Whitehouse (for those of us old enough to remember the excitement of electric typewriters being invented.) But I’ve read a long and multiply-upsetting article in the Daily Mail by the film-maker, Julian Hendy, about his father’s killing; an understandably highly emotive, provoked and provocative piece, so I’ve got a rough idea of what’s to be unleashed.
Before even getting to looking at anything substantial, there’s the language hurdle. Referring to people as ‘service-users’ is generally OK, but in the context of mentally ill people killing ourselves or others, it’s ridiculous.
As Paul Farmer says in Mind’s press release: “The common thread in all the cases in this programme is the failure of mental health services and other agencies to work together to engage people who have complex multiple needs…”. Because Paul covers the most important factors around safety so well, I won’t duplicate these within the three aspects the blog covers: substance abuse, stigma and sense of self. (So nothing about sun, sea or sausages.)
Research in 2009 about the relationship between schizophrenia and violence revealed that it was the additional element of substance abuse which was the primary factor. Why then is this crucial aspect so under-represented not just in media accounts but also within the mental health field? (Interestingly, the newspaper article by Julian Hendy did say that the mentally ill man had a history of excessive use of drink and drugs.)
Statements about ‘the media’ are almost as problematic as those about ‘the mentally ill’ or ‘the Middle East’. The Daily Mail is not The Guardian, blogs are not the BBC. (Er, unless they’re the BBC’s blogs.)
How ‘balanced’ is it reasonable to expect different media sources to be? Is there a difference between the responsibility within a short news piece and a lengthy article in a colour supplement? Should journalists and broadcasters be conscious of the stigmatising impact of concentrating mainly or exclusively on the exceptional? Or is putting each story into its own immediate context without sensationalist language and images sufficiently professional and ethical?
And what degree of responsibility, if any, do those of us with mental illness have in challenging stigma? It’s hard enough just getting through each day, trying to access the services we need and cope with medication side-effects we don’t need. (Oh. And bringing up our kids, earning a living, trying to get our dogs to eat out of a bowl rather than insisting on being hand-fed. She’s such a scamp, that Buddy.)
There’s an interesting issue with anti-stigma campaigns arguably over-looking or denying the legitimacy of concerns about the behaviour of mentally ill people. Many of us who spend time on inpatient wards talk about how unnerving it can be when those around us (and we ourselves) are behaving in a highly ‘unconventional’ or unpredictable way. These extremes of behaviour don’t switch on when we’re admitted and off when we’re discharged so there are plenty of times when people see us in a disturbed and disturbing state.
Perhaps there’s a parallel between the disproportionate, stigmatising effect of the media concentrating on the exceptional and newsworthy, and anti-stigma campaigns avoiding the painful reality that mental illness is often characterised by some of us being irrational and behaving in ways which seem or are highly risky?
A fundamental marketing rule is to start where your ‘consumers’ are. This applies at least as much to ‘social marketing’ campaigns. So if the majority of people you’re hoping to persuade have a particular view (eg mentally ill people are worryingly unpredictable), however unreasonable this may feel, it’s essential to recognise and address it in all its complexity.
Explaining that mental illness is very common and that only a tiny minority of us are dangerous is analogous to telling smokers that cigarettes could kill us. That’s certainly true, but health promotion has moved way beyond that in recognising the complexities and individualities of people’s addiction.
Finally, how do programmes like tonight’s affect our sense of self? I’ve absolutely no idea because there’s four hours to go until it’s inflicted on me. But I’ve seen similar programmes and, beyond the obvious about the gut-wrenching tragedy for the individuals left bereaved, they make me feel a bunch of very painful things about my own illness and about me.
My naughty internal twins, Guilt and Inadequacy, usually start dominating, and their companions Despair, Distress and Frustration tend to soon join in. It’s shame by association, helplessness by overwhelm.
I do have murderous compulsions but because of my particular illness, borderline personality disorder, I am fortunate that it is entirely self-directed. People with gentler conditions (and of course others with BPD), will between them have the full array of responses but it’s very hard not to internalise the stigma that the whole ‘mental patients are violent’ imposes.
Perhaps the programme will turn out to have at least elements which are both factual and constructive.
Marion Janner
Why Did You Kill My Dad? was shown on BBC2 at 9pm, Monday 1 March. You can watch it on BBC iPlayer.
22 Comments
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Well said Marion!
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The programme is half-way through. I'm shocked to my core. It is the worst, worst programme I've ever seen. Inexcusable. Anti-loony pornography, with details of the tragedies which build up into the most horrific visual and emotional picture of the danger posed by mentally ill people. Terror ramped up by the specifics of weapons used, the film's music, photographic techniques and the sheer, raw, agonising trauma of the bereaved families.
It must be impossible to watch the programme and be able to process it in a proportionate way, eg taking adequate note of the point briefly made near the beginning that this is only a tiny minority of mentally ill people.
I'm dreading the next half of the programme.
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I have just watched the programme and feel totally frustrated and angry. I can understand that it must be truely devastating to lose someone you love in this way, but I was very disappointed at how unbalanced the programme was.
Despite talking about the number of recorded homicides commited by the mentally ill each year (up to 100 apparently), it failed to mention the total number of recorded homicides commited each year in Britain (600-700). Given that the number of people with significant mental illness in Britain has been estimated as approximately 1 in 6, these figures suggest that someone with mental illness is no more likely to commit homicide than anyone else.
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Yes I was devastated and appalled. I think it's shocking that in this day and age the BBC has to sensationalise the "psychotic violent killers."
I wasn't sure what to expect other than bias but this was worse it was cashing in on relatives trauma (and I am empathic to anyone who has been bereaved by whatever means) and making all those with a mental illness a risk.
It also makes out that the mental health trusts should keep those deemed at risk under lock and key type thing forever. The trouble is as hard as Trusts will try if someone is determined to be violent they will be but fortunately it is fractional to those who commit violent attacks without mental illness.
People with mental illness are individuals and despite the best efforts of mental health teams there are times when they cannot look after someone in the way the public would desire through media scaremongering.
I hope that one of the mental health charities that represents service users like MIND will consider taking on the BBC and asking for a film to be made that reflects the true nature of mental illness. Not a sensational violence thing which coincidentally was preceeded by Panorama on drug addiction in young black people in SOuth Africa where no mention of mental illness was referred to once and violence was explored too.Fenella Lemonsky
Expert by Experience
Group Co-ordinator/
Beat Eating Disorders Group/
North London Hub
UKMHRN
Imperial College London
http://www.organiclemon.org -
"The Mentally ill" - such a stupid phrase, no one refers to The Diabetics.
Too right Maria homicides committed by The Sane far outweigh homicides by us. Often in high profile cases people did ask for help, Michael Stone asked for help but was turned away because his diagnosis [personality disorder] was viewed as untreatable.
Suicide by mental health service users is far more common than homicide and we are far more likely to be the victims of crime than the perpetrators. Where are the stats on that?
This programme did the mental health equivalent of the 'sexing up/45 min to launch' claim and played up the dangerousness myth.
The Zito Trust achieved CTO's. We have high levels of people being detained on those [and other sections] despite no evidence that they are useful. We have a clear hierachy of diagnosis where unless you have a diagnosis of 'severe mental illness' such as psychosis or Bipolar it's quite hard to access a service until you're face down on the floor. Then people are discharged asap. Then welfare reforms are making lives harder, and any old employment at any cost is now the definition of recovery. Now we're being hit with the dangerousness stick again - but it's great for the Daily Dissing papers I guess -
Such an unbalanced programme that didn't get to grips with the reality of the stats in any way. By choosing to focus on the grieving relatives of people who've been killed, it presented a dangerously biased picture.
I'd also like to know how they got permission to show the photos and cctv footage? Without the other side of the story it felt intrusive and unnecessary. What about the effect of the programme on the other people involved, the people who are now locked up, their families and friends?
Yes Louise, the stats on suicide could have put it into proportion - over 1000 suicides a year by people who've been in touch with mental health services in the preceding 12 months. A huge number compared to the number of homicides.
And since its self injury awareness day, how about considering the number of visits to A&E each year - some 150,000. Shocking.
And 71% of people with mental health problems experience hate crimes, harrassment and abuse, which mostly goes unreported.
Huge numbers in all that - and none of it about dangerousness to other people. This programme missed the point. But it's programmes like this that influence how people think, so that over 33% of people think we're prone to violence. I'm so disappointed that the BBC showed this rubbish.
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There is an obvious need for change in the system if such homicides are to be avoided in the future.
What is the change and who is going to take responsibility ?
The system is undoubtedly doing us a great service in other areas, but this program highlights in dramatic form how victims and perpetrators are being let down! Writing reports is the easy part - but doing something about it is another matter.
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The National Confidential Inquiry shows that alcohol and drugs are by far the main factors in homicide, not diagnosis.
2 women a week are killed by a current or former partner:
http://refuge.org.uk/get-help-now/what-is-domestic-violence/domestic-violence-the-facts/ -
Thanks for this Marion. I was deeply concerned about the programme. I felt the shot selection, imagery, language, tone and format was both painful and grief laden, and deeply worrying.
I really feel for every family involved, but when I watched it, it made me think about programmes about social service failings around child abuse, or programmes about people who've lost children to paedophiles.
I'm concerned because it raised valid points about learning from tragedies, but in a way that makes it clear that restriction, deprivation of liberty etc are the only ways to manage. It never mentioned recovery, or the risk to people with mental health problems.
It reminded me of the Zito Trust's foundation...
I'm glad Mind responded so articulately on Newsnight.
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Have you ever noticed the way the media always use the worst possible photographs of people convicted?! Small point I know but it all contributes. I also detest the way the media will associate violent crimes with psychosis/mental illness/personality disorder when the person may have no recorded history let alone history which also includes violence. I remember when Bin Laden was referred as psychotic. Rapists and paedophiles are sometimes referred as 'obviously' psychotic and these words are attached to violent crimes simply to add a greater heinousness to them or by way of explanation as if we cannot comprehend violence unless it is madness, that way it couldn't possibly be any of us could it. Violence is either mad or evil but we can't fight evil so if we call it mad then we can lock it up.
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I've just watched half of this and won't watch any more. The focus is entirely on how devastated the families are of people who have been killed. Nothing wrong with that - if you're creating a sensational piece rather than a documentary, but showing clips and interviews of people who have had a loved one killed is emotional - then you state a few facts about how the killers have been mentally ill. Many people will make a connection that is wrong - that mentally ill people are killers. The presenter even tried to talk up the figures at the start even though the evidence is against him.
Replace the words mentally ill people with 'car drivers', just because some car drivers drive recklessly and kill people and there'd be an outcry. Imagine - all car drivers being associated strongly with being killers. Just wouldn't happen.
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Does this come from when we were kids and told not to walk away with anyone we didnt know - ie 'Stranger Danger' in cases of child abuse or murder. it is more often than not the abuser/killer is often a relative or someone known to the family. I noticed when they were interviewing the lady owner from the newsagent, she said that murder doesnt or shouldn't happen to nice people, and also that Newton had looked over her and stright down the street and seemed to be 'Off with the fairies'. Unfortunately bad things do happen to 'good' people, and whose to say if you're 'bad' that you desreve to die any more than a 'good' person. In the programme and also on Newsnight they didn't say from what background the killers in the other homicides were made up from. Or the fact that people with mental health problems are likely to be those who get attacked rather than the perpetrators.
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Thanks to all for these really interesting responses to the programme. They've certainly sharpened my thinking about why what is in some ways a perfectly reasonable proposition (looking at the trauma of families bereaved by homicide) was so appallingly, inexscusably carried out. I just wish I'd read these before I wrote my original piece! For example, thanks very much Philippa for the analogy with car drivers. I've been struggling to find a suitable analogy and had only got as far as people with ginger hair!! Car drivers is a perfect analogy and I hope you don't mind me 'borrowing' this in future.
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Even newsnight 'is political correctness stopping society from connecting mental health issues with violence?' - was that a joke? Surely that's one of the most common beliefs surrounding mental illness?
A very articulate response by Paul farmer but I wonder how many of the viewers of Hendy's vomit actually watched the more balanced discussion on newsnight? Not many me thinks.
Many thanks julian for undoing some of the hard work put in by those of us fighting stigma, I don't think anyone would be interested in doing a very emotive film on those of us with a severe mental illness that have never been violent but have experienced it at the hands of 'The Sane'.
loved the comment about car driversYet another 'Boo' for the BBC
jojo -
A documentary fuelled by anguish and anger is never going to form the basis for a balanced and constructive analysis. It's a terribly sad subject, and one's heart goes out to the film-maker and his family. Unfortunately, the film was oversimplistic, scaremongering and an exercise in scapegoating. What did his film say? That the victims' families suffer terribly; that there is a stronger link between mental health and violence than political correctness allows; and that Mental Health Trusts are completely to blame for repeated failures. That's alright as far as it goes, maybe, maybe not. But the way the film was made was unequivically awful with a dreadful emphasis on graphic detail and emotive music. It completely failed to acknowledge the suffering of ALL those affected by these tragedies. It failed to emphasise the comparitive rarity of such events (tragic though they all are). It failed to well and truly emphasise that most people who have been mentally ill pose absolutely no risk. It failed to emphasise how common it is to have some kind of mental health problem. And by blaming the Trusts it failed to recognise the hard work done by many people for little pay and little social status to help people with health problems. Moreover, it failed to recognise that these health workers are at greater risk - however minimal that may be - than members of the public are at risk of a random attack. And how he could fail to criticize the police or the courts is absolutely beyond me. And I could not believe that he did not address the issue of the law and what is required for someone to be legally sectioned. He made it all sound so easy to sort out. And he, ridiculously, failed to try and find out why lessons aren't being learned from these tragedies: is it due to lack of funding, poor organisation, what? The unforgivable problem with his film is that he has failed to unite people to work to minimise these tragedies. None of us want these tragedies - just on a human level. But also as people who have experienced mental health problems, every time there is a tragedy, we are tarred. So on every level we want there to be progress. But this documentary has alienated us. It has no doubt aggravated the Mental Health Trusts who are there to deliver services. It may deter people from acknowledging their problems and seeking help. And it has stirred up old prejudices in the public - you only have to look at the comments at the end of the Daily Mail article for proof. So there it is. Something needs to be done, for sure, to limit these tragedies. But I'm not very convinced that this film will help achieve that. And, unfortunately, the spin-off will be more fear, more prejudice, more ignorance which we will all have to deal with in our daily lives. A real shame all round.
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The BBC's very keen to talk about mental illness and in many cases, does a fair job; a fair job but not the best it can. So people like us need to keep it on its toes, be involved. The BBC will listen but when it's presented with such a grief-packed fait-accompli like this prog., of course it runs with it, unchecked. The obvious bit about compare and contrast homicides committed by, er, normal people as opposed to us ill folks is a disgraceful omission. BUT the Beeb would do well to look within its own organisation for the way it treats people who have a mental illness. It doesn't practice what it preaches. Its middle management have no idea about how to support staff who are depressed, stressed and anxious. Many large organisations fear legal repercussions if they don't provide safe working conditions so they blame other reasons for stress in the workplace. It's sooooooooo important to have a trained Mental Health First Aider who can recognise symptoms and knows how give support and we should press for this at every opportunity.
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Insensitive, thoughtless and downright offensive. Comments such as 'Hendy's vomit' do absolutely nothing to further this important debate.
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@James Wooldridge. It was precisely because the film was so emotive and unbalanced that people feel attacked and tarred by association. It is unquestionably an important debate, but Hendy's over-simplistic, broadbrush and accusatory approach failed to really address why there have been repeated errors and how changes can be effectively made. Hendy's approach of exposing his awful pain - which we all feel for as fellow human beings - and angrily and simplisticly blaming the Health Trusts is an inadequate response to this complex problem. More thought is needed and more collaboration. That wasn't the way to do it. And regrettably, one spin-off of the programme is that it left a lot of people who have to contend with mental illness, feeling a lot worse about themselves and a lot worse about the attitudes they face from others.
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Yes, my heartfelt apologies for the 'vomit' comment, the programme really hit a nerve. I shall compose myself before posting next time.
I feel for all the families represented in the programme and noone is saying these events are anything but truly horrific. Noone is denying that these events occur and noone is saying that such issues should be swept under the carpet, far from it.
All we ever ask is for some balance when airing a documentary, not just in relation to mental health. Attitudes towards people with mental health problems may have improved but the mental illness/violence fear remains disproportionate, there is still a long way to go. When seen as having a mental illness it is still the case that all too often we are assumed to be dangerous.
I say again that my heart goes out to people affected by these tragedies, just as it goes out to those who's lives have been affected by the wrongful assumption that they are violent. Lessons need to be learned, of course, but the work put into fighting stigma and discrimination doesn't need to be undone at the same time.
jojo -
I too felt angry and pain during and after this programme - the pain of seeing so many small steps forward in overcoming stigma trampled on by biased, narrow and destructive images and words.
Thank you Mind for giving us the opportunity to feedback.
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My father was murdered in Australian in 2000 by a patient of the W.A. mental health services. Your bloggers know nothing of the pain and and grief families go through, especially when the 'service users' get all the attention and support afterwards. My father was a senior clinical psychologist who was had worked for the Dept. of Health for over 35 years and still this happened to him. He was murdered in his own house with the murderer using one of his own kitchen knives. Sentenced to 18 years prison, he will be out in 2020. I have had to bring up two of his grandchildren alone - who always ask about their granddad and what happened to him. There are many substance abuse users who claim they were mentally ill after they have committed a serious offence, which is what he did. Luckily the courts did not agree. Until you have lost a family member, how dare you moan on about 'bias' and Jo Jo, your comments are particularly offensive and your lame apology is fake and pathetic. Why don't you start talking about what is a real issue in Mind, instead of always trying to avoid a difficult and distressing subject. Oh yeah, and I am a MInd user now - thanks to having my father brutally murdered by someone with supposed mental health issues. SD
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Susan I know that everyone here would feel the deepest compassion for your terrible loss and suffering, losing a loved one by murder is appalling [whether the perpetrator has a diagnosis or not].
Perpetrators of violent [or sexual] crimes often scrap the bottom of the barrel for excuses for their actions, this would be true of many of the 600 odd murders committed by people with no diagnosis each year.
Victims of these crimes often see sentences which feel insulting.
This man raped his own daughters fathering 9 children, his sentence was reduced and I'm quite sure their lives have been shattered by their sane father who did this to them:http://news.bbc.co.uk/1/hi/england/south_yorkshire/8058533.stm
There is much injustice within our criminal justice system i.e. rape convictions and paedophiles are released to reoffend. Alcohol and drugs [when this is for real and not used as an excuse] are the major factor in many violent crimes.
Service users are far more likely to be the victims of crime but where are the statistics, where is the interest? People with psychiatric history have little credibility in a court room as a victim or a witness. The notorious Haslam and Kerr abused patients for years and there was little justice for those women. What justice is there for those service users who die through control & restraint, fatal reactions such as agranulocytosis, neuroleptic malignant syndrome or cardiac problems? There is no support or compensation for those who are permanently disabled by tardive dsykinesia/dystonia. There is no compensation for those who have been saddled with diabetes through antipsychotics. There have been estimates that service users live 10 yrs less. Service users are far more likely to die by suicide then kill. Often people ask for help and don't get it.
As for support & attention given to those convicted it's no picnic for those in High Secure services.As for prison sentences, yes they should be reviewed irrespective of whether the person has a diagnosis or not, for many violent crimes there should be a life sentence in my view and for life to mean life.
No Susan none of us can ever know what pain you've endured.
Just as many people cannot appreciate what suffering many service users live with including being the victims of crime [and hate crimes]. We are more detested within society than any other disability group and have had to live with the association of violence which I think Mind has not shirked as an issue.TV prgrammes are rarely complementary to us we've seen so many programmes about how bad and dangerous we are which are not productive. I've nothing against programmes which help us all to further debate and make positive changes but this programme was not doing that.
I think people feel saturated with so much negative press it's not unreasonable to need a place to let off steam, I don't think Jo Jo was outrageous, can we really not cope with words like vomit? It didn't offend me, I didn't think she needed to apologise but the fact is she did and I think we should have the good grace to accept someone's apology.
I'm deeply sorry for your tragic loss and suffering and sorry you have now become a user but I really wouldn't wish upon you all the discrimination we experience daily.
Commenting is now closed.