An enduring link exists in the public mind between dangerousness and mental disorder (Link et al 1999a: 316). ‘Mental disorder’ is defined in the Mental Health Act 1983 (amended by the Mental Health Act 2007) (Jones 2009:307) under section 1 as “any disorder or any disability of the mind”. ‘Mental illness’ encompasses diagnoses of ‘psychoses, anxiety states, affective disorders and hysteria’ (Jones (2009:308). Danger and dangerousness are ‘fuzzy’ concepts (Dallaire et al. (2000:681), difficult to define or assess (Slovic and Monahan (1995:50). Cocozza and Steadman (1976:1087) define ‘dangerous’ behaviour as ‘violent assaultative behaviour’ against others, stating that perceiving dangerousness involves estimating that a person will exhibit such behaviour. Allen and Nairn (1997: 379) highlight different forms of perceived dangerousness, including violence to persons and property, threats, destroying the peace of mind or family lives of ‘normal’ people, and of course, danger to the mentally disordered individual themselves.
PUBLIC FEAR OF MENTAL DISORDER
A fundamental aspect of the human condition stigmatises the ‘different’ (Gilbert (2000). On a psychosocial level, concerns of ‘dangerousness’ are closely related to unpredictability. We rely daily on a set of normative ‘expectancies’ – where these are not met – as often occurs with the mentally disordered, we perceive a threat to these norms – and to ourselves (Dallaire (2000:681-2). A connection between mental disorder and dangerousness was highlighted by nineteenth century psychiatrists to account for serious crimes, which were committed without ‘logical reason’ (Foucault 1978, Jones 2009:316). Studies from the 1950s document highlight fear felt by the public when faced with mental disorder (Nunnally (1961). This connection is ‘enduring’ (Crisp et al. (2000:4) – from references in Greek and Roman literature, through the Middle Ages, the Renaissance and into the modern era, the perceived link between mental disorder and violent behaviour is as ‘old as recorded history’ (Ion and Beer (2003:238).
Media
Thanks to ‘disproportionate and often flamboyant’ media coverage, images of the ‘violent mental patient’ remain deeply ingrained in public consciousness (Harris and Lurigio 2007:543, Porter 2003, Meyer and Barry 1992:77). Coverage of the Virginia Tech massacre in 2007 was centred on the perpetrator’s previous psychiatric care (Elbogen and Johnson (2009:152). Although the complex relationships between media portrayal and public attitude have yet to be fully researched, Kaminski et al. (2010) found that highly publicised shootings on college campuses led to increased fear among students. Link and Stueve (1995:172) state that the results of a 1990 nationwide telephone survey showed that 80% of the American public linked mental illness to public fear and violent activity. In 1994, the Glasgow Media Group found that 75% of media coverage linked mental illness to violence (Allen and Nairn 1997:375, Philo et al. 1994). Similar results emerged from studies of daytime television (Fruth and Padderud 1985:387), primetime television dramas (Signorelli 1989:330) and movies (Hyler et al. 1991:1047). Historically perpetuated through word-of-mouth, contemporaneous fear of the mentally disordered is heavily influenced by relentless media portrayal of the ‘violent’ mentally disordered individual (Monahan (1992:513).
However, this perception is by no means unique to the media-saturated Western world; public association between mental disorder and violence has been found in Israel (Link 1999a), Laos Westermeyer and Kroll 1978, Australia Jones and Horne 1973) and Central Africa (Murphy 1976). It has also been found to endure across socio-demographic divides (Nunnally 1961, Pescosolido 1999:1345), remaining a ‘cornerstone’ of public apprehension and fear about the mentally disordered (Stuart and Arboleda-Flórez 2001:659).
Legislation
Szmukler (2010) and Dallaire (2000:692-3) believe mental health legislation in ‘most’ jurisdictions carries an underlying assumption that the mentally ill are ‘dangerous to others’, allowing a form of preventative detention based on ‘risk’. Peay (2003,2009:490) and Pescosolido et al. (1999:1339) support this, stating that legislating for compulsory treatment regardless of the consent of the mentally disordered patient (in contrast to the physically troubled patient, whose consent is obligatory) serves to reinforce the conclusion that the mentally ill are ‘more dangerous and more deserving of intervention&rsqu