Stigmatizing Mental Illness

April 1st, 2015

The Times has a story about Andreas Lubitz, the pilot of the Germanwings flight, and whether his mental illness contributed to what by all accounts is a horrific mass killing. The article focuses on how stigmatizing his mental illness could have wide-ranging collateral consequences, with direct references to gun violence.

The co-pilot, Andreas Lubitz, would not be the first aviator to hide the fact that he was having psychiatric difficulties or that he had received mental health treatment.

The reluctance to come forward means that airlines, health professionals and regulators must strike a delicate balance, trying to decrease stigma to encourage pilots to be honest about their problems, while at the same time drawing a firm line beyond which pilots are grounded to protect the public’s safety.

Such issues surrounding mental health are familiar territory in the United States, where a series of mass shootings, including those in Newtown, Conn., and Aurora, Colo., riveted the public’s attention on the responsibilities of therapists who treat the mentally ill.

After the Newtown massacre in 2012, several states, including New York and Connecticut, changed their laws, broadening the circumstances under which mental health professionals can report a potentially violent patient without fear of legal repercussions. Under the New York law, they are required to report to local health officials those who are “likely to engage in conduct that would result in serious harm to themselves or others.”

But those laws remain controversial. And many mental health experts say that the tendency to link mass violence and mental disorders has a negative effect, discouraging people from seeking treatment.

“These kind of stories reinforce the anxiety, the doubts, the concerns that people have that ‘I have to keep my symptoms concealed at all costs,’ and that doesn’t benefit anyone,” said Ron Honberg, director of policy and legal affairs at the National Alliance on Mental Illness.

I’ve previously discussed that one of the perverse aspects of laws making it easier to take guns away from those with mental illness is that it stigmatizes the patient, and makes it less likely that they will report their condition to mental health professionals. Putting aside for the moment that the overwhelming majority of people with mental illness are not violent, doctors have expressed great concern about regimes like New York, where people can be disarmed without any process.

There are no simple answers to people inflicting unimaginable harm to others.