June 07, 2006

A Correction To A Correction

Or maybe it's a clarification. Anyway, in a May 23 post I wrote:

"In a recent post, I wrote:

"I had an email exchange the other day with the lead author of the schizophrenia and violence paper. He assured me that, in terms of absolute risk, schizophrenics were not more violent than the rest of the population. He said he's troubled to see how the TAC people and others are using his results. "They know better," he wrote."

There are two errors in that graf. I wrote absolute risk. I should have written relative risk. Yep, there's a difference. Two, I not only misquoted my correspondent, but I misapplied the bad quote to the wrong point. The correspondent was not criticizing TAC.

I regret the errors."

Let me gingerly tread into the world of stats and risk once again. In terms of risk (the simple form as most of us understand it):

1-year prevalence of any violence in community residents (from a 1990 paper by Jeffrey Swanson, et al.):

With no mental disorder: 2.05% were violent
With schizophrenia: 12.69% were violent

There are differences between relative risk and absolute risk--and anyone who really wants to know the precise difference should go check the Wikipedia entry on risk, which is way too complicated to summarize here. Suffice to say, that when it comes to absolute risk the large majority of people with schizophrenia do not commit acts of violence.

Hopefully, I have it right this time. BTW, if anyone thinks risk is dicey business, look into the four meanings of the term "mean" (known as "average" to most of us).

Posted by Philip Dawdy at June 7, 2006 02:12 PM
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Comments

Good correction to your correction, Philip. LOL This is such a difficult story to pursue. I so appreciate your leadership. Who among us, mentally ill or normal, is going to become violent in the future? Are we able to predict such behavior with any degree of accuracy? In the recent tragic case of Michael Kennedy in Fairfax, Virginia, no one--not Michael's family, his therapist, his friends, former teachers and coaches, multiple experts who evaluated him, the police, judges--raised the red flag that Michael was a potential killer let alone a "cop killer."

Were the Fairfax murders a preventable tragedy? Perhaps, but I think Treatment Advocacy Center is demonizing the wrong poster boy for forced commitment. Michael Kennedy's case reveals that even for a middle class family with insurance living in one of the wealthiest counties (Fairfax) in the USA, psychiatric treatment is inadequate...and hard to come by.

Might this case be about managed care as mismanaged care? Check out this Infinite Mind broadcast titled: Managing Madness: http://www.lcmedia.com/mind9926.htm

Could the case also be about insurance parity? Why was there no bed for psychiatric care for Michael Kennedy in Virginia? Do mental health advocates need to join the folks with pitchforks and torches at Treatment Advocacy Center to demonize the mentally ill and push for forced commitment and forced treatment to get more resources devoted to psychiatric care?!!

Posted by: Moira Wait at June 7, 2006 03:08 PM

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