Hornstein: Mental Illness and Violence

The notion that mental health professionals might somehow be able to prevent horrific acts of violence—by predicting whether patients are likely to commit them on the basis of their thoughts and feelings—is “a naive fantasy.”

According to Mount Holyoke College psychology professor Gail Hornstein, there is no evidence in the field of psychological or psychiatric knowledge indicating that mental health professionals could make that kind of assessment.

“It’s a huge myth to think that there is any direct relation between a diagnosed mental illness and any kind of violence,” Hornstein said. “In fact, study after study have shown that people with a mental illness diagnosis are much less likely to engage in any kind of violence than the general population.”

Hornstein’s comments come after the state of New York passed in January a law that requires mental health professionals to report patients who express homicidal or suicidal thoughts. The law was the first legislative response to the mass murder of 27 people, including 20 children, in Newtown, Connecticut, the previous month.

Hornstein, who is an expert in the psychotherapy of psychosis, said it is understandable for the public to want to know what would lead people to commit such terrible acts of violence. The problem, she said, is that no easy answer to that question exists.

“Unfortunately, we can’t really predict whether someone is going to engage in an act of violence,” she said. “We all have the capacity for frightening thoughts, we all feel angry at times. Anyone, regardless of their mental health history, who is in a rage is more likely to engage in violent acts against other people.”

The solution, Hornstein added, is to create more opportunities for people experiencing difficult thoughts and feelings to openly discuss them and “try and sort them out so that they don’t need to convert them from thoughts into actions.”