Colby Cosh: Let’s not pretend there isn’t a link between schizophrenia and violence

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A Canadian Press wire story that ran on Sunday observes that Quebec is suffering an apparent outbreak of literally crazed violence. On Feb. 8, a bus driver in Laval rammed his vehicle into a daycare, killing two children, and emerged naked and screaming from behind the wheel. Pierre St.-Amand is undergoing psychiatric evaluation. On March 13, a man drove a pickup truck randomly into a crowd in the town of Amqui, killing three. Steeve Gagnon has been charged with first-degree murder; reporters had no trouble finding that he had a history of delusional, incoherent social-media ranting.

On St. Patrick’s Day, a Montreal teenager with a history of mental illness was arrested for slaughtering his parents and grandmother, and on March 27, a police officer was fatally stabbed by a habitual criminal who had repeatedly been found “not criminally responsible” for violent acts and then turned loose.

This bare recitation of facts is pretty extraordinary. In an entire year, the whole province of Quebec typically has somewhere between 60 and 80 homicides. The list we have just given contains nine murders and covers about seven weeks. In noticing this, however, we risk “stigmatizing the mentally ill,” a sin that is of grave concern to University of Ottawa law Prof. Emmanuelle Bernheim. Bernheim, a specialist in “mental health and access to justice,” doesn’t like that this spasm of extreme violence by the self-evidently insane has politicians talking of involuntary treatment for psychiatric disorders.

When the premier of Quebec says what amounts to, “Man, I guess we’d better do something about all this violence caused by mental health problems,” Prof. Bernheim balks and calls the remarks “problematic.” The professor, as paraphrased in the CP story, claimed that the research “does not show that people with a mental illness are more likely than others to be violent.”

If you look at the research, however, what you’ll find is that sufferers of specific mental illnesses characterized by delusions and paranoia are much, much more likely to perpetrate violence than the average person in the general population. This risk of violence is strongly associated with substance abuse, but since substance abuse is a co-morbidity of schizophrenia and allied disorders, you might as well say “schizophrenics are harmless unless they drink or do drugs, which many or most of them do.” A 2009 French review paper estimated that “Schizophrenia increases the risk of violence by six to 10-fold in men and eight to 10-fold in women.” Prof. Bernheim’s statement isn’t quite a lie, but it is tantamount to a lie, and by now everyone knows this.

Are the destigmatizers really helping their cause by talking mush and silently conflating depression and anxiety with flagrant psychosis? If we understand the wire copy correctly, Bernheim actually pointed out to CP’s Morgan Lowrie that St.-Amand and Gagnon had “no history” of violent crime “and nothing indicates that they were being treated for mental illness.” Again, as everyone knows, an outburst of random violence is often the initial occasion for a garden-variety psychiatric diagnosis to be transformed into one of schizophrenia; it’s a disease very often treated for the first time in a correctional setting. The professor, we suppose, does not really believe that those vehicle killers won’t be defended by psychiatrists insisting that mental illness is the explanatory cause of their violence, even though mental illness is never supposed to be an explanatory cause of violence.

National Post

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