Mental Illness and Violence: How to Push Back on Dangerous Narratives

When Dr. Michele Kerulis first heard the premise of the 2019 film Joker—a man descends into madness and becomes a violent criminal—she became concerned. As an expert in mental health, the Counseling@Northwestern professor believed the origin story for the famous Batman villain could be problematic in its depiction of mental illness.

Dr. Kerulis recognized that every film, television show, and news story that perpetuates the misleading connection between mental illness and violence further stigmatizes mental illness and causes harm to those who have a mental health diagnosis.

“People are afraid of knowing somebody with a mental illness,” Dr. Kerulis said. But “in fact, we all know people—many people—who have issues related to mental health symptoms.”

Statistics on people with mental illness tell a very different story than the narratives audiences are often presented. According to the Department of Health and Human Services, only 3 to 5 percent of violent acts can be attributed to people with a serious mental illness. Additionally, people with severe mental illnesses are more likely to be victims of violent crime than the general population.

Some people have conditions “that keep them from being able to function day-to-day as a member of society who is able to hold a job, somebody who is able to gain employment, someone who is able to keep a home or a roof over their heads,” Dr. Kerulis said. “That kind of vulnerability puts people in situations that are more dangerous than others, therefore increasing their likelihood of being the victim of crime.”

Go to a tabular version of the data at the bottom of the page for information about the topics teens post about on social media.

According to a report on the perception of violence and mental illness published in the Journal of Epidemiology & Community Health, some symptoms associated with severe mental illness can compromise a person’s ability to perceive risks and protect themselves, making them vulnerable to physical assault. Those symptoms include:

• Impaired reality testing
• Disorganized thought processes
• Impulsivity
• Poor planning and problem solving

Even though violence committed by people with mental illness happens less frequently, news media can sometimes sensationalize incidents involving a person with a history of mental health issues. This is compounded by the fictional depictions of mental illness in television and film in which violence has become a common motif.

These depictions not only cast a stigma on the mental health conditions portrayed, but onto all types of mental illness, Dr. Kerulis said.

As a result, people experiencing symptoms of mental illness may be more likely to delay or avoid treatment, according to a study on mental health stigma and its effect on help seeking. A 2018 survey for the Substance Abuse and Mental Health Services Administration [PDF, 1.7 MB] found that 60 percent of adults and 50 percent of children do not receive treatment for their mental illness.

This is troubling considering how common mental health diagnoses are. According to the National Alliance on Mental Illness, 1 in 5 adults have symptoms of a mental illness at some point.

By discouraging people from seeking help when they are experiencing mental illness symptoms, communities are at a higher risk for acts of violence, Dr. Kerulis said. The best way to prevent and deter violence involving people with mental illness is to ensure they have access to ongoing and long-term care.

How to Destigmatize Mental Health Topics

Having open, honest conversations about mental health can reduce stigma and encourage people to seek treatment. Individuals can take the initiative by considering the following:

• Dr. Kerulis urges individuals to be proactive in their own education about mental health. Seeking reputable sources, such as government agencies and mental health organizations, is critical for finding accurate information.
• Use person-first language. Instead of referring to an individual as schizophrenic, say “person diagnosed with schizophrenia.” This helps to minimize the “othering” of individuals with a mental illness, according to the National Alliance on Mental Illness (NAMI).
• Avoid using harmful labels. It is important to be conscious of language used to describe behavior, such as the words “crazy” or “lunatic.” Whether it is related to or unrelated to actual mental illness, it can be hurtful to those who do have a mental health diagnosis, according to NAMI.
• Challenge misconceptions. Bring attention to misleading portrayals of mental illness in news and entertainment. This is a helpful way to raise awareness and start conversations with others.

Dr. Kerulis emphasized the importance of building media literacy to be critical of inaccurate depictions of mental illness in news and entertainment media.

“The more accurately somebody can listen to a news story or watch a movie and understand sensationalized fiction versus reality, the more as a society we will start moving towards being more accepting of talking about mental health issues,” Dr. Kerulis said.

How to Talk About Mental Illness in News and Entertainment with Children

Children and adolescents may be more easily influenced by the content they consume. Adults can use the following tips from Dr. Kerulis to facilitate conversations:

Ask open-ended questions. This allows children and adolescents to lead the conversation and engage in a more meaningful way.

• What did you think about this scene?
• What is your interpretation of what just happened?
• What is your understanding of why the character acted this way?

In addition to gauging a child’s understanding of mental health issues, use these conversations to assess their development of coping skills:

• Do you know people who you think might act this way?
• Do you ever have times when you feel like you can’t control your behaviors?
• What would you do if you were in a similar situation?

---

Educators and school staff should also be prepared to lead discussions about mental health in a constructive way. Adults in a school setting should consider the following suggestions:

Foster discussion of mental health in the classroom through formal lesson plans.

• For example, this lesson plan on analyzing media coverage of mass shootings can help students process a difficult topic. Dr. Kerulis recommends that teachers give their students a warning that some of the content of this lesson might trigger uncomfortable feelings and that school counselors should be available to assist students who wish to talk.
• Dr. Kerulis also recommends Sue Klebold’s TED Talk, My Son Was a Columbine Shooter. This is My Story, to hear a family member’s perspective of the tragic events.

Encourage students to explore mental health from verified sources by teaching them to ask the following questions provided by Common Sense Media:

• What type of expertise does the author have on the subject they are writing about?
• What is the website’s main purpose?
• What is the quality of information and who is the intended audience for the content provided?

Talking about mental health is a crucial step in decreasing stigma; it is equally important that conversations are nuanced and intentional in how individuals with mental illness are portrayed to reduce harm and encourage those experiencing symptoms to seek help.

Citation for this content: Counseling@Northwestern, the Online Master of Arts in Counseling Program from The Family Institute at Northwestern University