Reaction to escape of state-committed patient stigmatizes people with mental illness

IT was a sad day at the Spokane Interstate County Fair last Thursday. If you were reading The Seattle Times, you would think it was because Phillip A. Paul escaped from an outing organized by Eastern State Hospital, where he is committed as a forensic (legal) patient. However, what makes this story sad to me was the misinformed and sensational reaction of some news stories and even by local and state officials.

Many of the news stories had a headline that linked mental illness to violence. "Insane Killer," "Mentally ill killer," "Schizophrenic killer" were used repeatedly. Research has continuously found that a diagnosis of major mental illness alone does not predict violence. The severity of Paul's symptoms and his history of violence and criminality are a valid concern, but not his diagnosis alone.

This type of reporting contributes to a public misperception that people with mental illness are violent, which leads to stigma and discrimination that is a barrier to treatment, employment and housing for millions of Americans living with mental illness.

There were several instances where sensational and disrespectful language was used in news reporting. By describing Paul first and foremost as an "insane killer," it made him seem as though he were an immediate and direct threat to the community, even though he was well-medicated at the time of his escape.

Yes, he committed a heinous crime where he was found incapable of distinguishing between right and wrong, but he was hospitalized for treatment and public safety. Paul was also described as "a paranoid schizophrenic," but it is more accurate to say that he lives with schizophrenia. We are all people first and foremost. People with mental illness (even murderers) are much more than a diagnosis.

In response to Paul's escape, Washington's secretary of Social and Health Services temporarily halted outings for all state hospital patients with criminal histories, ordering a systemwide review of its security and safety procedures. Local officials were reportedly stunned that people like Paul would be taken to a fair when engagement with the community can be an important part of forensic rehabilitation. Unfortunately, the fact that "forensic patients" like Paul recover was lost.

Paul had no right to escape and his history of violence suggests that he may have posed an imminent risk to the public and should have been more closely supervised. It is appropriate to be looking into what went wrong in terms of Paul's supervision at the fair. That said, research has demonstrated that assertive, mandated and committed forensic rehabilitation can achieve high-quality outcomes. In terms of a policy response, it's important to maintain perspective on this event and to not erect barriers to recovery for all forensic patients. The key is to strike a balance between public safety and the protection of civil and human rights.

Misinformed and sensational reactions to events such as this one and to the infrequent tragedies where a person with mental illness is involved in a violent act have severe consequences for millions of Americans living with mental illness.

There is still hope for this sad story if only news media and public officials will stop finger-pointing, sensationalizing and stigmatizing. As this news coverage has shown, little is known or understood about what takes place in the forensic section of our state's inpatient mental-health-treatment centers. The press has a watchdog obligation to investigate and expose accountability problems, but it bears equal responsibility to report on positive outcomes and to avoid fear-mongering.

Jennifer Stuber is assistant professor at the University of Washington School of Social Work.