‘Root causes’ matter indeed.
Since taking office on January 1, New York City mayor Eric Adams has focused intently on mental-illness-related crime and violence. For most New Yorkers, aghast at spectacles such as the mass shooting in Brooklyn on April 12, the need for such a focus is obvious. But many leading mental-health advocacy organizations, such as the New York Association of Psychiatric Rehabilitation Services, view things differently. As they see it, even asking whether mental illness causes violence risks exacerbating the larger mental-health crisis. They fear not only that stigmatizing the mentally ill will create discrimination but, what’s worse, that it will make people who need help too ashamed to seek it.
Mental-health advocates urge us to view mental illness as a social problem. The point is fair enough. Serious mental illness is generally assumed to be at least partly biological at root, even if the precise causal mechanisms remain obscure. (“Serious mental illness” is a government term that connotes a psychiatric disorder that impairs someone’s ability to function in ordinary society: hold down a job, maintain relationships with family and neighbors, etc. Most people considered seriously mentally ill have been diagnosed with either schizophrenia, bipolar disorder, or major depressive disorder.) But there’s no doubt that, from a clinical perspective, we neglect the social dimension of mental illness at our peril. An effective treatment program for schizophrenia includes many nonmedical components, such as housing, personal relationships, and meaningful daytime activities. Medication may suffice for many illnesses, but not for this one.
Stephen Eide is a senior fellow at the Manhattan Institute and contributing editor of City Journal.
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