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Inside the numbers

Today's Post column puts a massive study of violence and mental illness under the microscope and finds that the headlines didn't quite match the findings. I am curious to see what response it might elicit from the profession. To my surprise, I've received some warm, grateful comments from the general public; in general I have the luxury of treating this issue as a fascinating abstraction, but there are those for whom it is not.


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Comments (7)

I was confused, probably due to ignorance, about your parenthetical comment:

(The degree of increase in the risk is quantitatively less, mind you, than you would experience from, say, merely having a female neighbour replaced with a male one. But in matters like these, we are often rightly more concerned with a 10% increase to a high background risk than we are with a doubling of a low one.)

Can we put some numbers on this? If the risk of a random female neighbour being violent is (made-up number) 0.01, then the risk of a male neighbour being violent is something like 0.02, and a sex-undetermined mentally ill person's propensity for violence is 0.025?

The reason I'm asking is this makes it sound like crazy women are less violent than sane men, which is totally possible, but that fact sort of suggests the magnitude of the risks involved.

If I've misinterpreted this, or if it's more subtle than that, I hope you'll correct me.

Otherwise, alternative headline: crazy people slightly more violent than sane men!

The observed raw numbers in the sample were

Any female: .02
Any male: .042
Any mentally ill person regardless of sex (or substance-abuse status): .051

So, double everything in your imaginary sample and you were pretty much spot-on. In terms of predictive power, the switch from female to male would carry a much higher confidence because there were lots of both in the sample. (Some parts of the NESARC sample had to be re-weighted for the purposes of regression, to make them more representative of the population, but the effects were slight.)

The most robust predictors of violence in the sample, overall, were age, prior history of violence, sex, prior history of juvenile detention, and divorce or separation in the preceding year.

George Skinner:

I was intrigued by a letter in today's Post responding to your column. James Morton asserted that a majority of defendants suffer from some degree of mental illness, and therefore punishment is an ineffective deterrent. He advocates treatment instead, but does not take his argument to the logical conclusion that perhaps these defendants should be held in treatment until they're judged cured. The justice system nevers seems to be able to figure out whether its objective is punishment, rehabilitation, or incapacitation. It does a pathetic job of the first because society's values have changed markedly over the past couple of centuries. The second again would require that people are held until they're deemed cured: no point releasing a serial car thief until we can be sure that they won't do it again. The last option, incapacitation, is something that the justice system can do relatively easily and is indisputably effective at keeping offenders from re-offending for a time, but again a combination of credit for time served, statutory release, and lenient sentencing undermines the premise.


Colby, I was mentally preparing an analogy about how I bought a lottery ticket last week, and how I bought two lottery tickets this week, and how I'm therefor SIGNIFICANTLY more likely (100% likelier!) to win the lottery this week, and you should buy my ticket from me in advance of the draw for mere millions. But then, crafty bastard that you are, you inoculated yourself against my mental onslaught with the very paragraph cited by Ryan. So I won't arm the rhetorical warhead. But I'm still buying a lottery ticket.

Christina McGrath:

Unpredictable circumstances when combined with alcohol and/or drugs, have the ability, to drive a person to act out violently. Circumstance at any given time can drive any one of us to commit acts that would not ordinarily be representative of our character. The fact that someone with a mental illness knows their circumstance, unlike the individual that just finds out about his/her child’s death or cheating spouse for example, means that us as a society can and should be putting supports in place to help prevent this toxic mixture of circumstance, drugs and alcohol etc. Instead, we listen to what the media tells us, articles such as your own, which coerce us into believing that Psychiatric discoveries are invariably presented in the media in the most destigmatizing way and yet in the same sentence, refer to these individuals as lunatics. Do you really think that intelligent readers wouldn’t pick up on this contradiction? Please explain to your readers, how calling someone with a mental illness a lunatic is the most destigmatizing way possible?

Joan Edwards Karmazyn:

Mr. Cosh,

Below you will find the response that has been sent to the President and CEO and the Editor of the National Post from the National Network for Mental Health in answer to your stigmatizing and discriminating article on mental illness. The challenge now for you Mr. Cosh, is to begin to find the facts and print them as they are and not continue to take them and the research out of context to serve your biased, pathetic journalistic endeavours. You have chosen to report in the sensationalized Hollywood style of telling a story that serves the bottom line of selling newspapers only and does not attempt to tell the truth of the facts and the research. You sir, are the epitome of the 'if it bleeds, it leads' mindset that serves to create hate and fear in our fellow citizens, setting back the work of those in Canada who are striving to end stigma and discrimination towards those of us who live with a mental illness. A person in your position needs to be ashamed of himself for practising such unethical journalism...and the newspaper, the National Post needs to immediately take you to task and not renew any writing contracts with you if you choose to not rise to the challenge to find the truth in the facts. We, the psychiatric consumer/survivor community of Canada will not tolerate this form of hate journalism. Get with it Mr. Cosh...do the work and find the truth in the facts and research and become an ethical journalist if even for the sake of your own mind, soul and conscience!

Joan Edwards Karmazyn,
Canadian Citizen living with a mental illness;
mental health champion, leader and activist

Colby Cosh, Columnist

National Post

1450 Don Mills Road, Suite 300
Don Mills, Ontario
M3B 3R5

March 5, 2009

Dear Colby,

While you may wish to reflect the views of the "experienced news consumer", you sadly lack the lived experience of a mental health consumer.

You lack the ability to report a factual and balanced view of mental illness, violence, addiction and the relationships between them. .

If we were to believe your article, the one in five prevalence of Mental Illness would mean that sheer anarchy would reign in the streets.

Here is a news flash:

Experienced mental health consumers work all around you, live next door to you already and go to work, pay taxes, raise their families and participate in the fabric of Canadian Society.

Even many people completely disabled by mental illness volunteer or take part in the world in whatever positive ways they can.

What we wonder is why, then, are we not seeing positive profiles and reports about people living with mental illness?

So I invite you to learn from us. I challenge you to profile an experienced mental health consumer each week for the next year.

Replace opinion with fact and hopefully prejudice with respect.

Yours truly,

Carmela Hutchison, Past President

On behalf of the Board of the National Network for Mental Health


Douglas Kelly, Editor-in-Chief, National Post

Paul Godfrey, President and CEO, National Post

The Honorable Michael Kirby, Chair, Mental Health Commission of Canada

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