Do we really need to turn the mentally ill into victims?

8 October 2013

Public wrath has finally moved from the Daily Mail, and to the Sun over its splash yesterday on the mentally ill. It’s deemed especially offensive because this is apparently Mental Health Awareness Week.

For some time now mental illness has been becoming the new victimhood du jour, and among the reasons is that mental illness is so spectral and ambiguous that lots of people can join in (especially journalists). Laurie Penny wrote that it was unfair to use stereotypes about mad axe man because: ‘Like a lot of people, I sometimes get depressed and anxious. On precisely none of these occasions have I flown into a murderous rage and stabbed up a stranger.’

Mental illness is as broad as physical illness, and anxiety and unhappiness are common, indeed part of the human condition. Saying ‘my recurring common cold is more representative of illness than tuberculosis’ may be true, but it tells us nothing about the latter.


Another reason for mental illness’s popularity is that it is an effective way to escape censure. Among the most prominent critics of the Sun is Alastair Campbell, who as far as I know has never shown any remorse for the things he did while in power (compare with Damian McBride, whose frank apology was so rare as to unnerve people) but instead has re-branded himself as a victim.

And victimising the mentally ill is unlikely to be effective because it tends to involve ignoring reality, or at least probability. Some forms of mental illness can be dangerous, and tabloid exaggeration should not blind us to this; schizophrenics, for example, are seven times as likely to commit homicide than the public at large (and I think that statistic does not take into account that many are sectioned).  That doesn’t mean they’re all mad axe men, but it’s a probability that people will bear in mind when dealing with sufferers, however many awareness days there are.

It was the politicisation of mental health that helped to bring about Care in the Community, which was influenced by totally misguided ideas about what schizophrenia is (and Tory penny-pinching). Now we increasingly see mental illness in Darwinian, biological terms, and progress is being made, but it would be naive to treat the mentally ill as another victim group, and possibly harmful if it deterred people from openly debating the risks. They don’t need to be made martyrs; they need treatment.

But then I’m only sceptical because I’m a conservative, the political equivalent of depressive realism. Will there ever be a cure for that?

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  • Jon Mendel

    The article linked as a source for the blog post’s argument that there’s an increased likelihood of homicide with schizophrenia argues that “In reporting the association between violence and schizophrenia, a shift of focus from the relative risk to the absolute risk posed to the community should reduce stigma.” It emphasises that a balanced representation of the risks associated with schizophrenia should acknowledge that “the probability that any given patient with schizophrenia will commit homicide is tiny (approximate annual risk is 1:3000 for men and 1:33 000 for women)”.

    It is unfortunate that the sole academic article linked in the blog post is one that criticises the way that the post represents risk (although such criticisms – and the tiny absolute risk of any given patient committing homicide – aren’t mentioned in the blog post). A closer reading of the article linked might be helpful in thinking through how to present risk better

    • Ed West

      the problem with your argument is that people’s evaluation or risk tends to be quite cautious, so that 1: 3000 is not that safe. If you told people they could choose between an airline that had a fatality rate of 1: 1000000 (the standard European carrier rate) or something like 1: 100,000 or 1:50,000, the rate for the riskiest third-world carriers, that’s not something people will tend to ignore. So even if your typical schizophrenia is not going to attack you, the general public will stll be aware that risk is heightened.

      there is, of course, the fact that schizophrenia homicides, rare though they are, are more shocking to the general public because they are so random, but even without that people would still make judgments based on risk

      • Jon Mendel

        If you’re arguing that, say, a 1:3000 chance of a given male patient with schizophrenia committing homicide in a given year would also have made your point, it would have been more informative to have used this figure rather than give the relative risk (“seven times as likely” doesn’t tell readers what the absolute – very low – risk is). You could also usefully have put the figure in context: in England and Wales (2010/11) “the risk of being a victim of homicide was 11.5 offences per million population”( This compares to e.g. a risk of dying in transport accident that was around 1:20,000 back in 2006 ( Being killed in a homicide at all, let alone by a schizophrenic person, is a small risk compared to much more mundane things like accidents or smoking.

        The judgements people make on risk can be affected by the way risks are presented – see for example this study on how doctors respond to relative vs absolute risk information CRUK has a good discussion of this in the context of cancer If you’re arguing against “ignoring reality, or at least probability” then the way in which blog posts present risk is important – or they can help to add to a distorted impression of the risks we face.

        • Ed West

          but people assess risks in relation to like minded things, so with a mentally ill person no one thinks in comparison the risks from cars, flying, disease etc but in regards the comparison – sane people. for something to be stigmatised (mental illness) it to has to be frowned upon in regard to something else (mental health).

          I agree more generally about the risk factors and their perception, but I dont think attempting to destigmatise a condition that does make a significant difference to a person’s risk factor will prove that successfull.

          • Jon Mendel

            You think people will always focus on such a narrow comparison, and use it to stigmatise? Even taking likelihood to commit homicide, the Home Office report I link above records 90% of homicide suspects as male (197 men, in that year) but I don’t think men are stigmatised in the same way as people with schizophrenia can be. People with schizophrenia are more likely than others to be victims of crime and violence, and I’d hope that people can also empathise with the risks they face.

            If reporting focuses just on relative risks, there are loads of things that might alarm even if they are remarkably unlikely to happen – the classic ‘X makes Y disease 10 times more likely’ tabloid headline, for example, look worrying even if this means a change in your risk of a disease from really tiny to tiny. I don’t know whether attempts to de-stigmatise schizophrenia will work – though I hope they will – but I don’t think communicating risk in this way is informative, and it could potentially make people worry more about what is (in absolute terms) a tiny risk.

            • Mr Grumpy

              You think people don’t worry more about suffering violence from men than from women?

  • HaroldAMaio

    Do we
    really need to turn the
    mentally ill into victims?

    By the “we” do you mean you? What makes you think we are a
    generic “the” or victims?

    We are a very broad demographic, we earn to the millions,
    hold every university degree and every professional,white, and blue collar job.
    Does not sound like victim to to me

    “Schizophrenics” ,people with schizophrenias are aloe a
    broad demographic. It is a disease of degree. Each of my acquaintances with this
    illness holds a doctorial degrees, one teaches law. Yes I am aware of a great
    many people whose less is so , they have little to no contact
    with reality. It is likely when you refer to “schizophrenics”, it
    is they your mean.

    Harold A. Maio, retired Mental Health

    • Jackthesmilingblack

      How would you diagnose these behaviors?
      A blogger who over the past five years has told me on the blog pages of
      some half-a-dozen British MSM publications, including the Spectator, that I’m not British, but Japanese. I’m talking of at least 100 times without exaggeration, almost certainly because I’m a Brit living in Japan. If a fellow Internet correspondent criticizes Britain, or significantly disagrees with him, this person reacts by assigning a different race and nationality to his antagonist. Presumably labelling another person a foreigner is the greatest insult he can bestow. Specifically saying that only genuine Brits should be eligible to comment on a British publication. I assumed it was a form of obsessive-compulsive disorder, but sadly his mental health problems are far more severe.
      His definition of what constitutes “British” is so narrow that many Caucasian Brits would fail to qualify. On occasion he has told me I’m a
      paedophile, live in an Internet cafe, and get this, guard at a Japanese WWII PoW camp. Must have been a previous existence. 
Ultra-nationalist, sure. Xenophobic racist bigot without doubt, but my question is this: By providing him a forum, isn’t the Spectator exacerbating his mental health condition? And isn’t there the danger that when cyber stalking no longer satisfies, he will move on to actual stalking?
      Jack, Japan Alps

      • Toby Esterházy

        The (Japanese) Lady doth protest too much, methinks.

        • Jackthesmilingblack

          This is the nutter I was referring to. Talk of the devil …

          • Toby Esterházy

            The “nutter” that tells the truth and nothing but the truth? Having been to a boarding school in Oxfordshire does not you a British person make, any more than your name on a birth certificate recorded “Oxfordshire”.

            You are about as British as Japanese knotweed!

        • Kennybhoy


          • Toby Esterházy

            You Scottis? If not, then why are you hiding under a Scottish name? Are you Jonathan Pollard, per any chance? Or are you Melanie Philippsohn?

      • Kennybhoy

        Good post. :-)

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