Bernice A. Pescosolido ( pescosol@indiana. edu ) is a distinguished professor of sociology at Indiana University, Bloomington.
Bianca Manago is an assistant professor of sociology at Vanderbilt University, in Nashville, Tennessee.
Health Aff (Millwood). 2019 Oct;38(10):1735-1743. doi: 10.1377/hlthaff.2019.00702.
Highly publicized acts of violence routinely spark reactions that place blame on the perpetrator's presumed mental illness. Despite solid evidence that people with mental illness are unlikely to be dangerous, such prejudice can lead to support for inappropriately using legal means to force people into treatment. We examined trends in public perceptions of violence and support for coerced treatment across a twenty-two-year period using data from three National Stigma Studies. The studies gave respondents one of three vignettes describing people who met clinical criteria for mental disorders or one describing a person with nonclinical "daily troubles." Perceptions regarding potential violence and support for coercion generally rose over time-significantly so for schizophrenia. By 2018 over 60 percent of respondents saw people who met criteria for schizophrenia as dangerous to others, and 44-59 percent supported coercive treatment. Sixty-eight percent saw people with alcohol dependence as dangerous to others, and 26-38 percent supported coercion. Lower but substantial percentages were reported for people with depression and, remarkably, for those with nonclinical "daily troubles," who were viewed as dangerous. These findings reflect political discourse, not scientific data, and could lead to policies that would be ineffective and misdirect the search for the underlying roots of violence while unnecessarily increasing stigma toward people with mental illness.
高频率的暴力事件通常会引发反应,将责任归咎于犯罪者所谓的精神疾病。尽管有确凿的证据表明,精神疾病患者不太可能具有危险性,但这种偏见可能会导致支持不当使用法律手段强迫人们接受治疗。我们使用三项国家耻辱研究的数据,在二十二年的时间里,考察了公众对暴力行为的看法和对强制治疗的支持的变化趋势。研究给被调查者三种描述之一:一种是符合精神障碍临床标准的人,另一种是描述一个有非临床“日常麻烦”的人。人们对潜在暴力行为和对强制治疗的支持通常随着时间的推移而上升——对精神分裂症的上升幅度尤其显著。到 2018 年,超过 60%的受访者认为符合精神分裂症标准的人对他人有危险,44-59%的人支持强制治疗。68%的人认为有酒精依赖的人对他人有危险,26-38%的人支持强制治疗。对患有抑郁症的人的比例较低,但也相当高,而对那些有非临床“日常麻烦”的人,人们认为他们也很危险。这些发现反映了政治言论,而不是科学数据,可能会导致无效的政策,并错误地引导人们寻找暴力的根本原因,同时不必要地增加对精神疾病患者的污名化。