0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

1
Letters to the Editor   |    
The Association of Stigma With Violence
E. Fuller Torrey, M.D.
Am J Psychiatry 2011;168:325-325. doi:10.1176/appi.ajp.2011.10121710
View Author and Article Information
Bethesda, Md.

This letter was accepted for publication in January 2011.

The author reports no financial relationships with commercial interests.

Accepted January , 2011.

To the Editor: In their article published in the November 2010 issue of the Journal, Bernice A. Pescosolido, Ph.D., et al. (1) seemed perplexed that stigma associated with schizophrenia did not decrease among the general public between 1996 and 2006, despite evidence that people in 2006 had a better understanding that schizophrenia is a brain disease. The stigma, in fact, increased during this period—a continuation of a trend dating to the 1950s, as reported in a previous publication by these authors (2).

The reason for this trend is self-evident. Until the 1960s, most individuals with severe psychiatric disorders were hospitalized. Deinstitutionalization has now placed most of them in the community, and at any given time approximately half are untreated. In response to their delusions and hallucinations, a small number of these untreated individuals become violent. Both recent (3) and past (4) studies have reported that such individuals are responsible for approximately 10% of the homicides in the United States as well as other violent acts. Studies have also shown that when they are treated, they are much less likely to commit violent acts (5).

The major cause of stigma is thus violent behavior. As stated in the 1999 Surgeon General's report on mental health: "The answer appears to be fear of violence: people with mental illness, especially those with psychosis, are perceived to be more violent than in the past" (6). This is the elephant in the room that we don't like to talk about. We think that talking about it will increase stigma, yet if we don't talk about it, and take steps to ensure that individuals with serious psychiatric disorders receive treatment, we will never be able to decrease stigma. The public reads newspapers and watches television; they will believe what they read and see, not what we tell them they should believe.

Pescosolido  BA;  Martin  JK;  Long  JS;  Medina  TR;  Phelan  JC;  Link  BG:  "A disease like any other"? a decade of change in public reactions to schizophrenia, depression, and alcohol dependence.  Am J Psychiatry 2010; 167:1321—1330
[CrossRef] | [PubMed]
 
Phelan  JC;  Link  BG;  Stueve  A;  Pescosolido  BA:  Public conceptions of mental illness in 1950 and 1996: what is mental illness and is it to be feared? J Health Soc Behav 2000; 41:188—207
[CrossRef]
 
Matejkowski  JC;  Cullen  SW;  Solomon  PL:  Characteristics of persons with severe mental illness who have been incarcerated for murder.  J Am Acad Psychiatry Law 2008; 36:74—86
[PubMed]
 
Wilcox  DE:  The relationship of mental illness to homicide.  Am J Forensic Psychiatry 1985; 6:3—15
 
Swanson  JW;  Swartz  MS;  Van Dorn  RA;  Volavka  J;  Monahan  J;  Stroup  TS;  McEvoy  JP;  Wagner  HR;  Elbogen  EB;  Lieberman  J, CATIE Inves-tigators:  Comparison of antipsychotic medication effects on reducing violence in people with schizophrenia.  Br J Psychiatry 2008; 193:37—43
[CrossRef] | [PubMed]
 
US Department of Health and Human Services:  Mental Health: A Report of the Surgeon General.  Rockville, Md,  US DHHS, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999, p 7
 
References Container
+

References

Pescosolido  BA;  Martin  JK;  Long  JS;  Medina  TR;  Phelan  JC;  Link  BG:  "A disease like any other"? a decade of change in public reactions to schizophrenia, depression, and alcohol dependence.  Am J Psychiatry 2010; 167:1321—1330
[CrossRef] | [PubMed]
 
Phelan  JC;  Link  BG;  Stueve  A;  Pescosolido  BA:  Public conceptions of mental illness in 1950 and 1996: what is mental illness and is it to be feared? J Health Soc Behav 2000; 41:188—207
[CrossRef]
 
Matejkowski  JC;  Cullen  SW;  Solomon  PL:  Characteristics of persons with severe mental illness who have been incarcerated for murder.  J Am Acad Psychiatry Law 2008; 36:74—86
[PubMed]
 
Wilcox  DE:  The relationship of mental illness to homicide.  Am J Forensic Psychiatry 1985; 6:3—15
 
Swanson  JW;  Swartz  MS;  Van Dorn  RA;  Volavka  J;  Monahan  J;  Stroup  TS;  McEvoy  JP;  Wagner  HR;  Elbogen  EB;  Lieberman  J, CATIE Inves-tigators:  Comparison of antipsychotic medication effects on reducing violence in people with schizophrenia.  Br J Psychiatry 2008; 193:37—43
[CrossRef] | [PubMed]
 
US Department of Health and Human Services:  Mental Health: A Report of the Surgeon General.  Rockville, Md,  US DHHS, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999, p 7
 
References Container
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Web of Science® Times Cited: 5

Related Content
Books
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 40.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 7.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 44.  >
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 40.  >
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 40.  >
Topic Collections
Psychiatric News
PubMed Articles