3. Violence A Real Danger if Disease Not Treated

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This is the third in a series of seven articles called “Breaking the Silence,” by Patricia A. Forsdyke Past President of the Kingston and Napanee Chapter of the Schizophrenia Society of Ontario.

My Aunt Evelyn, who suffered from schizophrenia, was strangled by another inpatient at the age of 65. My dad had to identify her body. Forty years of grieving came to an end. He was deeply upset and ridden with guilt. He explained how they had tried to have her home at the beginning of her illness, but her episodes were too violent. She pulled a knife on my grandmother. They could not be both a home and a hospital. My grandmother was also caring for Evelyn’s child.

No doubt Evelyn, during the long course of her illness, had been violent towards patients and staff, but she was never charged for any of her assaults. Nowadays she would be. Sixty years later, she would probably be in a prison rather than a hospital. My father always felt ashamed that she had been institutionalized. I can only imagine what he would have felt if she had been in jail. One thing he knew for certain: She was mad, not bad.

The public sometimes suffers as a result of a schizophrenic’s preoccupations. In the United States, Theodore Kaczynski, the Unabomber, produced many victims. His family had searched for help but to no avail. When his manifesto appeared in The New York Times, his family immediately recognized it as that of their relative. They had the onerous task of leading the authorities to the Montana cabin where Kaczynski had led a solitary existence. After the trial, they turned over the reward money to help the mentally ill. Their pain continues; Kaczynski remains without insight and refuses treatment in prison. In the case of the man who shot Ottawa sportscaster Brian Smith, there was ample warning that he was a time-bomb waiting to go off.

Sheila Deighton’s family got help only after her mentally ill spouse shot their mentally ill son. Her husband Alistair’s paranoid schizophrenia had never been diagnosed, though the family had cried out for help. I have met Alistair. He is now quite sane, as he responded well to medication. After this preventable disaster, the family now has all the help they need, but they have unfortunately lost a son.

People are driven to having a mentally ill relative charged with a crime to get help. Imagine how dangerous this can be if attempting to get help by this route fails. Out of concern for the public and their loved one, families gamble on their own safety. And there is another risk: Their loved one may take off and wander the country, whereabouts unknown.

Some schizophrenics get the help they need after being charged with a crime, and they usually respond well to treatment. Schizophrenics who have gone this route often end up with a stabilized illness and a much better quality of life. But help is not quick by this method. Many wait months in jail before a hospital bed can be made available.

It is a myth that the seriously mentally ill are no more dangerous than the general public. Untreated schizophrenia and manic depression are often dangerous when the illness is untreated, or when the patient is in the height of an episode. In addition, schizophrenia combined with street drugs or alcohol can be explosive. Those who argue that schizophrenia is not dangerous are simply trying to reduce the stigma towards the mentally ill. In doing so, they are in cahoots with the civil libertarians who believe that you wait for a violent event before intervening.

Patients do not forget what went on when they were sick. They must live with the results of their actions. Most of their violence comes out of their paranoia or from hallucinations. Families are often the victims. Yet we are beginning to hear planners talk about the concept of managing a psychosis in the home. Proper professional care must be demanded. The “home hospital” concept is ludicrous. In reality, families would be further imprisoned in their own homes.

Forty per cent of schizophrenics attempt suicide at some time, and about 10 per cent succeed. One wonders whether the death certificates record: “Died as a result of untreated schizophrenia.” I suspect that this is another area of silence.

Talking about violence risks increasing discrimination towards the mentally ill, but not talking about violence minimizes their special needs when their illness forces them out of control. This is a classic “Catch 22.”  By hiding schizophrenia, we become accomplices. We make it a crime to be ill.


Read previous article in series, “A Terrible Brain Disease”          Read next article in series, “Fads and Myths Cloud Understanding”