Pants-of-dog wrote:@wat0n
1. Quote the text concerning gun violence. I will quote some myself that contradicts the myth that people with mental health issues are dangerous:
Perhaps most importantly, the 1-year population attributable risk of violence associated with serious mental illness alone was found to be only 4% in the ECA surveys. Attributable risk takes into account both the magnitude of risk and the number of people in the risk category within the population [13]. The ECA results implied that even if the elevated risk of violence in people with mental illness were reduced to the average risk in those without mental illness, an estimated 96% of the violence that currently occurs in the general population would continue to occur. The ECA study also found a substantially increased risk of violent behavior within particular demographic subgroups of participants—specifically, younger individuals, males, those of lower socioeconomic status, and those having problems involving alcohol or illicit drug use; these risk factors were statistically predictive of violence in people with or without mental illness [13]
and
After the ECA report, several other notable studies were conducted in the United States examining violent behavior in psychiatric patients. The best known of these is the MacArthur Violence Risk Assessment Study (MVRAS) [15], which followed up a cohort of more than 1000 discharged psychiatric inpatients over 1 year in the mid-1990s and used self- and family-report interviews to measure violent outcomes. The MVRAS found that substance abuse comorbidity was responsible for much of the violence in discharged psychiatric patients; indeed, patients who had only mental illness—that is, without substance abuse—had no higher risk of violent behavior than their neighbors in the community, persons selected at random from the same census tracts in which the patients resided.
and
With respect to the correlates and hypothesized mechanisms that may lead to violence in people with mental illness, some scholars have theorized that social and economic risk factors such as poverty, crime victimization, involvement with illegal drugs and drug markets, early life trauma exposure, and ambient neighborhood crime largely account for the apparent link between mental illness and violent behavior toward others [29]. These studies have reported that persons with serious mental illnesses in the community are often socially disadvantaged over their life course and thus exposed to many covarying risk factors for violence. Along these lines, Swanson et al. [30] published a study on the prevalence and correlates of interpersonal violent behavior in a five-state pooled sample of n = 802 adult psychiatric outpatients with serious mental illness who were receiving services in the states' public behavioral health care systems. The study painted a picture of a group of individuals with serious and disabling mental health conditions, but also a marginalized group with very low social capital—mostly unemployed, economically impoverished, typically residing in disadvantaged neighborhoods, often misusing alcohol and illicit drugs, and reporting alarmingly high rates of trauma and violent victimization over their life course. Many of these characteristics and experiences were found to be highly significant correlates of violent behavior. Conversely, participants in the study who merely had a diagnosis of serious mental illness but did not have a history of violent victimization, were not exposed to neighborhood violence, and were not abusing drugs or alcohol, had annual rates of violent behavior in line with the general population without any mental illness—about 2% [30].
Wow, congrats, you can cherry-pick! Why didn't you quote stuff like the following?
Swanson et. al. wrote:Analysis of ECA data from three sites (Baltimore, St. Louis, and Los Angeles, with a combined total of n = 10,024 participants) identified a statistically significant but fairly modest positive association between violence and mental illness. The 12-month prevalence of any minor or serious violence among people with schizophrenia, bipolar disorder, or major depression was about 12% overall, and 7% in the subgroup with these disorders alone and no substance abuse comorbidity. That was compared with a general-population prevalence of about 2% in persons without mental disorder or substance use disorder, for an adjusted relative risk of 3:1 for mental illness alone. Lifetime violence rates (which could include violence that occurred at any time and not necessarily during a period of mental disorder) were estimated at 15% for the population without mental illness, 33% in those with serious mental illness only, and 55% for those with serious mental illness and substance abuse combined.
This is the paragraph before the first paragraph you cited. By the way, even if mental illnesses can lead to more violent behavior, since the vast majority of Americans are not mentally ill, it's unlikely mental illness can explain the overall prevalence of violent incidents. The following paragraph, which is the next paragraph after your first fragment says the following:
Swanson et. al. wrote:The ECA study thus debunked claims on both extremes of the debate about violence and mental illness—from the stigma-busting advocates on the one side who insisted that mental illness had no intrinsic significant connection to violence at all, and from the fearmongers on the other side who asserted that the mentally ill are a dangerous menace and should be locked up; both views were wrong. The facts showed that people with serious mental illnesses are, indeed, somewhat more likely to commit violent acts than people who are not mentally ill, but the large majority are not violent toward others. Moreover, when persons with mental illness do behavior violently, it is often—although not always—for the same reasons that non–mentally ill people engage in violent behavior. In short, violence is a complex societal problem that is caused, more often than not, by other things besides mental illness. (Suicide or self-inflicted harm, is strongly related to mental illness, as will be discussed later in the article.)
So yes, that study does support the notion that mentally-ill people tend to be more violent than people who are not mentally ill.
Now let's see your second cherry-picked paragraph. Firstly, let's quote the
whole paragraph (the missing part bolded), shall we?
Swanson et. al. wrote:After the ECA report, several other notable studies were conducted in the United States examining violent behavior in psychiatric patients. The best known of these is the MacArthur Violence Risk Assessment Study (MVRAS) [15], which followed up a cohort of more than 1000 discharged psychiatric inpatients over 1 year in the mid-1990s and used self- and family-report interviews to measure violent outcomes. The MVRAS found that substance abuse comorbidity was responsible for much of the violence in discharged psychiatric patients; indeed, patients who had only mental illness—that is, without substance abuse—had no higher risk of violent behavior than their neighbors in the community, persons selected at random from the same census tracts in which the patients resided. However, because many of the patients lived in disadvantaged high-crime neighborhoods in the inner city and because the base rates of violence among both the patients and community comparison groups were substantially higher than in the ECA study, one interpretation of the MacArthur Violence Risk Assessment Study finding is that the social-environmental influences on violence are stronger than the effects of psychopathology and tend to “wash out” those effects at the population level.
Of course no one has claimed that these socioeconomic factors may not be relevant, in reality they are perhaps even more relevant than mental illness. The claim I made is that mental health professionals may be exposing themselves to a higher risks when acting as first responders to a mental illness crisis, which may warrant having the police close by (a block away) to provide backup if called upon to do so. There may also be neighborhoods where the danger is such that they would be exposing themselves to risk by merely being there, even without interacting with any mentally-ill persons, such as places where government officials or even outsiders in general are not welcome and received with hostility whenever they show up.
Now as for your third paragraph, how about you quote the next paragraph too?
Swanson et. al. wrote:At the same time, there is evidence that psychiatric symptoms—and particular combinations of symptoms such as delusions, suspiciousness, and extreme anger—can increase violence risk under certain conditions in certain individuals, and that treatment such as antipsychotic medication to reduce these symptoms can, in turn, reduce violence risk [33,34]. A recent large meta-analysis identified a range of risk factors for violence in persons with psychotic symptoms, which notably included concurrent substance abuse (especially polysubstance abuse) along with antisocial or criminal history, but also identified treatment nonadherence as a significant risk factor in these individuals [35]. Common risk factors for violence can be potentiated by major psychopathology that goes untreated. Persons with a psychotic disorder and cooccurring substance misuse, in particular, tend to have compounding problems: they may “use the wrong drugs” [36] while also failing to take prescribed medication to manage their primary psychiatric symptoms, with the result that psychotic symptoms such as excessive threat perception and hostility can be exacerbated and become more likely to precipitate violence. Cognitive distortion combined with intoxication may also create or worsen conflict in social relationships; aggressive impulses may be disinhibited; and criminogenic social influences that attend the procurement of illegal drugs may, at the same time, increase risk of violent behavior [30,37].
More generally, mental illness may also interact with the specifics of the personal history, socioeconomic environment and substance use by the patient. The same can hold for people without any mental illness... So?
I think this paragraph and
Figure 1 provide good summaries of the facts here:
Swanson et. al. wrote:Studies that have examined the prevalence of violence in psychiatric patients vary widely and systematically by the clinical setting in which the studies are conducted [27]. As shown in Figure 1, meta-analytic studies have found the lowest rates of violence, on average, in surveys of outpatients in treatment (8%). Higher average rates are seen in studies of discharged hospital patients (13%), and those who present in psychiatric emergency settings (23%). Even higher rates tend to be reported in retrospective studies of involuntarily committed patients (36%) [27] and studies of first-episode psychosis patients during the period preceding their first treatment encounter (37%) [28]. Violence risk in people experiencing a first episode of psychosis is of concern, because these tend to be young adults whose symptoms may go untreated for an extended period before contact with a mental health treatment provider who could intervene; firearms restriction regimes based on background checks of records also will not find them
This also supports your previous idea that treatment would help to prevent incidents such as the shooting at the Chicago Mercy. But first responders, given what their job is about, cannot be presumed to be in a position to enjoy these benefits.
Pants-of-Dog wrote:Let me know when you have the gun violence info.
Since they already face greater restrictions to legally buy guns, I would not be surprised it would be overall lower than for the general population. But conditional on having a gun, there is no reason to assume this would be the case.
Pants-of-Dog wrote:2. None of that has anything to do with your claim that police assigned to protect someone (as you propose) are obligated to protect those people. The law says that police are not obligated to protect people.
So dereliction does not exist and neither does the concept of a "special relationship" between the police and a victimized person
Pants-of-Dog wrote:3. I explained why I am focusing on Elijah McClain and Breonna Taylor. Would you like me to repeat it?
Do as you please, the irony is that the Taylor case also goes against your narrative since the DA recused himself and handed the inquiry to the State before any protests began (he did so on May 13)
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