Myth and Miriam Carey

This is Mental Illness Awareness Week. But the sad tragedy of Miriam Carey is another reminder of how deeply unaware we are about mental illness in general and its relationship to violent behavior in particular.

And how much we rely on myths to fill in the gaps in our knowledge.

We all heard the news about Ms. Carey last week.  But we were not exactly informed by it. 

Ms. Carey drove her car onto a White House driveway, hit some temporary fencing, backed up, and then pulled away. She was pursued toward the Capitol by law enforcement officers in what became a high-speed chase.  Ms. Carey was eventually cornered near Garfield Circle.  Six officers, with guns pulled, approached her car there.  She apparently panicked, scattering the officers as she drove away.  At least nine shots were fired at her as the chase began again.  She eventually got stuck on a median near a Capitol guard station, where she was shot to death by an officer.

As I watched the unfolding news that afternoon, the story was embellished, to say the least.  There were reports of a possible terrorist attack on the White House and the breaching of a White House barrier.  And gunfire had been “exchanged” in an apparent attack on the grounds of the U.S. Capitol, as Senators cowered in their offices.

But then the real story began to emerge.

Ms. Carey hadn’t breached a White House barrier; she had hit a fence or a gate.  No gunfire was exchanged, because Ms. Carey was unarmed.  And Ms. Carey wasn’t attacking the Capitol; she had fled in her car in that direction.

So the narrative changed.  Now Ms. Carey – suffering from mental illness – had “rammed” a barrier at the White House.  She was “obsessed” with President Obama.  She used her car as a 1300 pound “weapon” to mow down law enforcement personnel as she continued on her “rampage.”

And she “chose” to ignore officers who tried to subdue and pursue her.

Words themselves are powerful weapons.  And these new words helped paint the mythical picture of the seriously mentally ill person who stalks, snaps, and kills without warning. 

But this narrative proved to be wrong, too.

We later learned that Ms. Carey apparently drove all the way from Connecticut to Washington with her one year old baby in the car.  So she didn’t “snap.”  And there was no evidence in her home that she had been plotting against the President with whom she was “obsessed.”  And she wasn’t on a “rampage.” Not only was she unarmed, but she apparently managed to avoid pedestrians and other motor vehicles as she raced down Pennsylvania Avenue at speeds up to 80 miles per hour.

But because she is dead the pieces missing from her story – like what she was actually thinking at the time – will probably remain missing. 

And the myth-makers will have another field day at the expense of people with mental illnesses.  Because the facts about mental illnesses don’t fit the narrative.

These are the facts.

People do not acquire mental illnesses by choice.  They can’t turn them off like a faucet.  The people who knew her best said Miriam Carey was not out to harm anyone last week, and that her mental illness was being treated successfully.  But if she was suffering from a mental illness-induced panic in the final minutes of her life as she was chased and under fire, she would have been no more able to turn that off when the police yelled stop than to will herself to stop bleeding from her gunshot wound. 

All mental illnesses are not the same, but none is a very strong predictor of violence.  Postpartum depression – for which she had been treated – is not the same as schizophrenia or bipolar disorder.  But if you believe the myth that any of these conditions by themselves leads to violence, then take a look at the chart accompanying this column about the low lifetime prevalence of violence among people with serious mental illnesses, from an article published almost a decade ago in the New England Journal of Medicine.

And people with mental illness do not “snap” without warning.  There are often years of warnings that go unheeded by payers looking to save a dollar.  And by public officials who cut mental health budgets and deem mental health agencies and services as “non-essential.” And then cower in their offices at the first sign of trouble – the one part of the initial reporting that was, apparently, accurate.

Let’s deal with facts, not myths.  After all, this is Mental Illness Awareness Week.

Paul Gionfriddo via email: gionfriddopaul@gmail.com.  Twitter: @pgionfriddo.  Facebook: www.facebook.com/paul.gionfriddo.  LinkedIn:  www.linkedin.com/in/paulgionfriddo/