Wednesday, March 09, 2016

A Tiff Over Mental Health

Amanda Levitt is not pleased.

In the recent Democratic debate in Flint, Hillary Clinton noted "You know, we have our differences. And we get into vigorous debate about issues, but compare the substance of this debate with what you saw on the Republican stage last week."   Bernie Sanders responded

Well, let me make a couple of responses. Let me pick up on the last point the secretary made. You know, we are, if elected president, going to invest a lot of money into mental health. And when you watch these Republican debates, you know why we need to invest in that.

"Those who do suffer from such disorders," writes The Washington Post's Yanan Wang, "are calling out Sanders’s ableism."   because he equated the GOP circus with mental health disability.

Wang doesn't explain what "ableism" is. It might refer to being able, though if so, I suffer from a severe mental disability given my level of skill at home repair (and various other things).   Wang cites the tweets of Ms. Levitt, who quite ably tweeted "Another way to not have people vote for you, imply that mental health issues are the cause of the GOP's behavior" and "I have a mental disability. Racism (etc.) is not a mental health problem. It's a hate problem."

Here is where instinct would compel someone to complain "get over it." But that trivializes the problem of mental health. Still, there was a lot wrong with the Republican debate that went beyond racism. which admittedly is not a mental health problem. It turns out, however, that neither is the vast majority of violent crime.  In an article published in 2003 in a psychiatric journal, researcher Heather Stuart acknowledged

The major determinants of violence continue to be socio-demographic and socio-economic factors such as being young, male, and of lower socio-economic status.

Second, members of the public undoubtedly exaggerate both the strength of the relationship between major mental disorders and violence, as well as their own personal risk from the severely mentally ill. It is far more likely that people with a serious mental illness will be the victim of violence.

Third, substance abuse appears to be a major determinant of violence and this is true whether it occurs in the context of a concurrent mental illness or not. Those with substance disorders are major contributors to community violence, perhaps accounting for as much as a third of self-reported violent acts, and seven out of every 10 crimes of violence among mentally disordered offenders.

Republicans cite mental health to avoid confronting the peril of a dangerously armed public. Democrats- including Bernie Sanders- latch on to mental health to avoid the controversy of gun safety measures and because there are a lot of people, the vast majority law-abiding, who simply need help. Few if any politicians will openly recognize the mental health dodge. Advocates such as Levitt and Wang need not get over it or even be less sensitive. They should be more sensitive- sensitive to the cultural winds enabling them to enjoy their moment in the sun. Rejoice and give thanks.

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