After The Navy Yards Shooting: When Diagnosis Becomes Stigma
09/23/2013 - 14:23
Aaron Feinstein
Aaron Feinstein
Aaron Feinstein

Last week, while sipping my coffee at a café, I overheard a troubling conversation. A small group of seemingly well-informed Brooklynites were discussing the recent shooting at the Navy Yard in Washington. One of the smartly dressed guys chimed in, “He’s schizo! That’s why he did it. Schizophrenics kill people all the time!” His friends laughed and agreed with his reasoning, and moved onto the more compelling question of what to eat for lunch.

We all want to search for a “why” in these horrific shootings, but in the process we often stigmatize and label the most vulnerable in our population, without discussing the bigger issues within our violent culture.

I work with individuals with a range of mental health and developmental diagnoses, and I find that even I share this desire to understand the mental health element of these shooters. I find myself walking a similar path of the Brooklynites at the café, whether I choose to label the shooter with a diagnosis or not.

But let’s get the facts straight. The majority of people with schizophrenia never commit acts of violence. A review of recent National Institutes of Health data of initial psychotic episodes shows that 35 percent commit a violent act, and less than one percent of the violence required hospitalization from serious injury. That means that two-thirds of these cases result in no violence. 

The problem with assuming a diagnosis is the reason a person goes on a shooting rampage is that rather than looking at a shooter as an individual with an individual motive, we broaden the topic to the entire diagnosis or label. This can be incredibly offensive and hurtful to those with mental health diagnoses, and creates a public dialogue about mental health that looks at the forest without seeing the trees. It further stigmatizes some of the most vulnerable in our population.

Ironically, I struggle with this dynamic in my own profession. As someone who is not a licensed clinician whose practice is focused on a certain population, I have had the privilege to work with people who have a variety of mental health and developmental diagnoses. I like that I don’t have to work within the confines of a diagnosis. In the classes and groups that I run, we never take a diagnosis-first approach to the individuals we work with, and I believe that is a strength.

I am an advocate for clinical treatment, but I also believe that diagnostic labels can get in the way of looking at a person as an individual, with an individual set of circumstances and ways of being. I’ve had a difficult time in some places where I’ve worked, where the dialogue among mental health professionals centered around diagnosis rather than individual development.  I strive in my own work with The Miracle Project and Actionplay to create cultures that are built on compassion and understanding, rather than a diagnosis-first mind set.

Let us move away from this kind of stigmatization in our profession. When these horrible incidences of violence occur, I think it is time for those of us who work with people who have a variety of mental health conditions to reassess our work, and realize that compassion and human connection is what allows people to grow beyond whatever diagnosis they may have.

If there is hope for our culture, it is going to come in the form of compassion and human connection, not in the tendency – common even among the well-meaning – to turn diagnoses into labels that stigmatize.

Aaron Feinstein is the Director of The Miracle Project New York, an inclusive musical theater based socialization program for children with autism and developmental disabilities, and the Executive Director of Actionplay which provides training for museums and cultural centers to develop compassionate and sensory aware educational programming for children with autism and developmental disabilities. He is also a dedicated home-based developmental interventionist.

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