John Weston Parry, J.D.
The discrimination and stigma associated with mental illnesses largely stem from the
[greatly exaggerated] link between mental illness and violence in the minds of the general
public. (United States Government—SAMHSA)
Violence and our exaggerated fears about violence have badly distorted our perceptions about persons with serious mental disabilities, who are targeted for incarceration and other coercive interventions by legislatures, law enforcement, and the judiciary. Carrying out these coercive interventions has meant bending and breaking the strict rules that are supposed to govern police procedures and due process. A whole host of legal fictions have arisen to excuse these breaches of constitutional and other legal guarantees that normally extend to everyone else, but are diluted or removed for members of this highly stigmatized group. People with mental disabilities not only can be ensnared by discriminatory laws, but also become the subjects of incarceration and other harsh governmental interventions based on predictions or impressions about what they might do in the unforeseeable future. This fundamentally flawed and unfair predictive or impressionistic element of our criminal, juvenile, and civil laws are fed by a circular presumption and widespread belief that people with mental disabilities must be more dangerous than anyone else.
As a result, people with mental disabilities not only have to cope with the inflated perception that they are inherently dangerous, but because of that perception they also must cope with the exaggerated fear of violence in our society, which ultimately affects them more than anyone else. Such exaggerated and distorted perceptions about dangerousness are inculcated into almost all Americans, particularly our boys and young men, through a constant bombardment of images of violence from cradle to grave. Whether it is television, our most popular sports, news, video games, or some of our most popular music, violence, aggression, destruction and mayhem often drive the entertainment and profit-making engines in this country.
At the same time, legitimate First Amendment concerns, along with the money, political connections, apologies, excuses, and propaganda of the industries involved, ensure that our attention is diverted away from prevention, public education, public health, and other treatment programs to reduce the sources of such violence and images of violence. Instead, the focus has been on incarceration and coercive, inhumane control of those stigmatized people in our society, who are perceived as being the most dangerous Americans because they have mental disabilities. Yet, without our myths and false beliefs about violence, there would be little support for the types of invidious discrimination and legal fictions that are reserved exclusively for persons with mental disorders, conditions, and aberrations deemed to be dangerous.
How this type of discrimination has unfolded in this country is explained in Mental Disability, Violence, and Future Dangerousness: Myths Behind the Presumption of Guilt (Rowman & Littlefield October 2013), Chapter 2, “Sanism and America’s Exaggerated Fear of Violence.” Brief copyrighted excerpts without the references are reprinted below with permission of the publisher and author, along with reflections based on the book and other materials.The excerpts are in bold with italics.
The Broad Reach of Sanism and Exaggerated Fear of Violence
Violence combined with an exaggerated fear of violence are potent social concerns…, particularly in the context of persons with mental disabilities, who most Americans incorrectly believe are substantially more dangerous than other people. Even some influential psychiatrists…deliberately stoke the flames of irrationality…. Sanism, a term that law professor Michael Perlin developed, is the social manifestation of this prejudice and animus, which has led to widespread civil rights deprivations for persons with mental disabilities, including confinement, abuse, neglect, and even the imposition of the death penalty. Yet, unlike racial discrimination, sanism rarely is condemned publicly and continues to be practiced openly with few social constraints. Today, if someone at a newspaper or television or radio station utters a racial slur there is likely to be a sustained public reaction rebuking that person, often with dire consequences to the offender. On the other hand, if someone in the media utters a similarly insensitive sanist slur, there is likely to be either widespread agreement or ignorance that a slur has taken place.
Sanism is widespread in the United States due, in large part, to the greatly exaggerated link between mental disabilities—particularly mental disorders—and violence, which has been “promoted by the entertainment and news media,” certain involuntary treatment advocates, and others for various selfish purposes. The risk of violence is greatly inflated by the media and entertainment industries that produce the news, television, movies, video games, and spectator sports. Even though there is little empirical justification for their fears, the vast majority of Americans believe that persons with mental illnesses pose a threat for … others and themselves…. This has created an irrational environment, which not only tolerates, but condones, invidious discrimination and deprivations of fundamental rights, as long as the subjects of such animus have or are perceived to have a mental disorder, condition, or aberration. In this context, we have become a nation that readily and enthusiastically embraces popular beliefs over logic, science, statistics, and empirical evidence, as long as those beliefs confirm what we want reality to be.
As a result of our sanism, we are willing—and often eager—to take draconian actions against individuals with mental disabilities based on subjective, unreliable, and usually inaccurate predictions that they might be or continue to be dangerous sometime in the unknowable future. Yet, most of us would recoil at the idea of taking comparable actions based on similar predictions of or impressions about antisocial behaviors, if they were applied to members of other supposedly dangerous populations, such as gang members, people who possess assault rifles, gay coaches, Catholic priests, African-American adolescent males, Caucasian men, professional football players, or soldiers who have served in combat. It is remarkable that the only group of people in the United States who are at serious risk from this societal angst and concern about future violence and related antisocial behaviors are persons with mental disabilities, who, more often than not, are trying to cope with compelling psychological and medical issues, poverty, isolation, abuse, neglect, and stigma. Instead of receiving the help they need, these vulnerable individuals must try to avoid incarceration and other deprivations of their fundamental rights that this lack of assistance often produces.
Expanding the Pool of Potential Victims of Sanism
[A] misconception has been perpetuated, repeated, and accepted… that persons with mental disabilities are particularly violent…. At the same time, in revising its Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), the psychiatric profession has been expanding the numbers of people who will be labeled as having psychiatrically defined mental pathologies, and thus stigmatized as being potentially dangerous. The underlying motivation of these psychiatrists seems to be to increase the number of people who are likely to receive mental health care and treatment, which is not an altogether selfish result, given the fact that many people in need of care and treatment go without. The problem is that these psychiatrists are targeting certain individuals for highly intrusive, coerced care, which tends to be inhumanely delivered, at the expense of the far greater number of people with serious mental disorders, who are in dire need of consensual care in order to avoid being incarcerated and deprived of their fundamental rights.
By increasing the pool of potential patients in a society overwhelmed by sanism, we expose even more people to indefinite incarceration, the death penalty, and other deprivations of rights … because the assumption is ever-present that “these” people will be a threat to society…. These rights deprivations are justified by legal standards that link their newly diagnosed mental disorders to predictions of dangerousness. Moreover, soldiers and veterans of recent wars, who have been or will be diagnosed with various combat-related mental disorders face a heightened risk of being accused of dangerousness, which arguably could be linked to their combat training and war experiences. Consequently, there is every reason to believe that even more people will be diagnosed with mental disorders and deemed dangerous than ever before.
Double Standard in the Law
Sanism has spawned a double standard in the law in which people with mental disabilities are treated differently than everyone else. In the early 1990’s, John La Fond and Mary Durham revealed this legal inequity in the context of incarceration. As a result of sanism and the way violence, exaggerated images of violence, and people with mental disabilities are portrayed in our news, media, sports and entertainment, Americans who are thought to have a mental disability and to be dangerous are subjected to less fair and unfair legal proceedings, which…result in harsher or much harsher penalties…. In one set of circumstances, the legal system supports a presumption that persons subject to quasi-civil commitment or the death penalty have a mental disability that makes them inherently more dangerous. In other circumstances, the legal system does not allow those same types of mental disabilities to reduce their culpability or even entitle them to special treatment once they are confined.
Anglo-American law traditionally recognized that serious mental impairments normally diminished culpability, which required reductions in punishment or rendered criminal charges null. Today, in its place we have a double standard, which has been expanding in large part because we have been taught repeatedly through … the popular media, to be afraid of and to devalue persons with mental disabilities. Instead of protecting the rights of this particularly vulnerable group of people, we have used the legal system─including lawyers, judges, and mental health professionals─to diminish their constitutional protections, creating new meanings for a suspect classification and tyranny of the majority.
Violence and Other So-Called Antisocial Behaviors
What should concern Americans most is violence which causes serious bodily harm or death to another person, or creates an immediate and unambiguous risk of such bodily harm or death. Yet, inevitably we conflate that type of violence with a myriad of antisocial behaviors that are viewed as being immoral, gross, lewd, or disgusting or somehow threaten our economic or social and emotional well-being. We continually refuse to make meaningful distinctions between very different types of dangerous-like behaviors based on their relative seriousness. Instead, we prefer to lump them altogether in order to elevate the importance of the least serious antisocial behaviors, so that they may be dealt with as severely as the most serious ones. Also, when people with mental disabilities are the subjects, [a]lmost any crime… is likely to be equated with dangerousness…. [And] what might happen—or is mistakenly thought “likely” to happen—often is considered equally determinative as what actually has happened.
In our society, almost everyone feasts upon violent and sexually violent images, and even violence itself. “Violence has a stranglehold on our nation” warns the National Mental Health Association. “Americans have what sometimes seems to be an insatiable appetite for it.” Most affected are our kids, particularly boys who are exposed in the early years of their cognitive development… [which] is constantly reinforced throughout their childhoods…. While everyone is affected differently…, very few people… escape those effects entirely. The result of such exposures is that violence has been increased throughout our society and is made to appear even worse than it actually is…, especially when it involves people with serious mental disabilities.
Causation: Societal Violence Versus Individual Dangerousness
A common argument against taking meaningful steps that would force us to acknowledge that we share a collective responsibility for violence and images of violence in our society is that we cannot determine how much of this exposure to violence may have contributed to a particular individual acting violently. We conveniently conclude that individuals should be totally responsible for any violence that they produce, regardless of the social and environmental circumstances and factors that may be involved.
This flawed logic ignores the essential difference between causation when it is applied to populations versus individuals. Not surprisingly, Americans tend to embrace the type of causation that best fits the outcomes they prefer. When it comes to holding our society responsible for violence and images of violence, we chose to fixate on individual causation. Yet, when we try to prove that an individual with a mental disability is dangerous, we chose to focus on group causation instead. This is a pseudo- intellectual bait and switch.
With regard to violence and images of violence in our society, the inability to empirically attribute responsibility to an individual is only relevant when the suggested response targets individuals, as opposed to society as a whole. A response that would target our entire population through prevention, public health, and public education is both reasonable and cost-effective, even though it is not possible to determine how specific individuals will respond to such interventions. There is no necessity to determine individual causation, however, in order to justify these types of social responses.
How much violence each individual is exposed to remains unknowable. Nor are we able to measure accurately how and to what extent such exposures will affect a given individual. What we do know is that high exposures… in any population…will increase the amount of aggression and violence… in that population. As a matter of sound public policy, there is every reason to implement measures to control violence and the images of violence in our society as a whole, particularly its impact on our children, and even more so boys. The empirical evidence is overwhelming that such prevention policies, if implemented properly, could have a substantial and lasting effect in reducing violence and the fear of violence in our society at a fraction of the cost necessary to incarcerate, monitor, and supervise individuals with mental disabilities who we predict or presume are likely to be dangerous based on unreliable and biased evidence.
Conversely, problems with causation also have occurred when it has been misused to justify measures that target individuals who have mental disabilities because it has been presumed that this class of individuals is inherently dangerous. Not only is the presumption incorrect, but the greatly exaggerated danger posed by this group is then inappropriately attributed to specific individuals. This misleading and inappropriate application of causation not only creates a double standard that works to the extreme disadvantage of people with mental disabilities, but it also employs the logical fallacy of predicting individual behaviors based on their sharing certain characteristics with a particular group. By developing and using legal procedures and methodologies that try to forecast which individuals with mental disabilities will be or continue to be dangerous based on misperceptions about group behaviors, we have done—and continue to do—substantial damage to our Constitution, legal system, and our basic notions of justice and fundamental fairness.
The Media and Violence
Our senses are bombarded with violence and images of violence through our most popular leisure activities, particularly those enjoyed by boys and young men. This cultural violence emanates from multiple sources. In addition to the news media, movies, and video games, two of the most prominent are sports and, even more so, television.
The most popular spectator sports in this country have an element of violence or extreme aggression. All of our major team sports, even those played by girls and women, have become increasingly violent. The most popular American sport by far is football—professional, intercollegiate, and high school—which is a violent game played by boys and men with an often deliberate disregard for the welfare of its participants and to women in particular, who have been the primary victims of the aggressive and violent excesses of football players off-the-field.
Football is ritualized warfare that brings more entertainment value to its hundreds of millions of spectators than any other American sport. We love football in large part because it is violent; we love images of violence and even violence itself because we have been exposed to it and desensitized beginning in infancy and arguably in the womb. There are many other spectator sports that bring us great pleasure that incorporate violence as a core value as well: boxing, caged fighting, hockey, lacrosse, racecar driving, and wrestling to name the most conspicuous. Even basketball and baseball have their share of aggression and violence involving players and fans alike.
We have long known that [s]ports are a microcosm of society, mirroring our social values…. [W]inning by overly aggressive and even violent means is too often—and arguably most of the time—more important than fair and safe play… “[V]iolence in sports has become commonplace” and “an epidemic plaguing our nation.” Even Congress, which is loathe to do anything that would displease us as consumers of violence, has frequently threatened to regulate violence in athletics hoping that this might scare the sports which are the worst offenders. Our sports pages and media coverage of sports often feature incidents of crime and violence by our most popular athletes. Tongue in cheek, the Christian Science Monitor ran a prominent headline that read “For sports news, see . . . crime pages.”
This close association between our most popular sports and violent crime goes back… [at least] twenty years. A 1995 Los Angeles Times study used court documents to identify 252 incidents involving  active American or Canadian sports figures….” These arrests and alleged offenses included murder, sexual assault, and spousal battery…. [T]he most likely offenders were professional and collegiate athletes who “played” football…. Nothing since suggests that violence and images of violence in sports has abated. In fact, by all indications such violence and extreme aggression continues to increase, particularly among female athletes.
Television has had an even greater influence on our culture than have sports. The average American has the television on, or is watching television programming through some other media devise, many hours of each day. For kids, television and videos based on television programs have become de facto parents and a substitute for the unstructured play that used to fill the void when parents, family, and school were not present. Television has had an overwhelming influence on the lives of most American children and adults, which has taken the psychology of passive-aggressive behaviors to a new dimension. In the viewing and listening process, the dubious connection between violence and persons with mental disabilities has been reinforced time and time again in the most irresponsible and unrealistic ways. This is particularly true with television news.[V]iewers are immersed in… descriptions and depictions of murders, rapes, and other violent crimes, extreme weather, and sports violence…. [S]uch tragedies account for as much as “42% . . . of local news.”
While actual violence … appears to be steadily decreasing, perceived violence continues to grow….Through constant exposure to images, depictions, and news of violence, people are led to believe that violence is significantly more prevalent and more severe than what the facts demonstrate….Too often those penetrating images involve extreme violence committed by persons with mental disabilities. Such powerful but distorted images also are repeated time and time again in movies, video games, over the Internet, and on the radio. There are few filters for violence unless it is viewed as being obscene because of its sexual content. In our society a bare breast or naked butt draws more negative attention and condemnation than the grizzly dismemberment of a living person’s limbs or a decapitation. As a result, we seem to be more concerned about sexual offenses—many of which are merely antisocial or immoral, rather than violent—than we are about murder, violent assaults, and mayhem.
Scapegoats for Exaggerated Fears About Violence
Due to sanism … people with mental disabilities have become…scapegoats for our preoccupation with violence. The news and entertainment media deliberately and painstakingly… portray these individuals using inflammatory and distorted words and images…. Thus, it should not be surprising that when violence and extreme violence are discussed by politicians and policymakers and difficult choices are being weighed, the one area of consensus that emerges time and time again is the desirability of placing prior restraints on the fundamental rights, freedoms, and liberties of persons with mental disabilities. As the National Rifle Association has made clear, the Second Amendment does not apply to persons with mental disabilities. Moreover, cost-effective steps to prevent and mitigate violence and to provide meaningful care and treatment to those who have serious mental disorders, conditions, or aberrations are scrapped in favor of expensive incarceration, coercive monitoring and supervision, and even executions.
As a result, our criminal and juvenile justice systems are filled with persons with mental disabilities who are not only treated more harshly than offenders without such disabilities, but are denied humane care and treatment. In this skewed world, the mental status defense, which has become nearly extinct, has been replaced by the mental status offense, which almost guarantees greater punishment and mistreatment for persons who have serious mental disabilities.