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That's what Carl Bell, M.D., and former APA president Paul Jay Fink, M.D., told psychiatrists at APA's 1997 annual meeting in San Diego.
Bell and Fink discussed the multidimensional nature of violence in the United States, noting the influence of the media, the breakdown of traditional family roles, and the pervasive national attachment to guns and the rights of gun owners.
Yet both also emphasized that underlying all these issues are psychosocial factors about which psychiatrists know best: early development and the nurturing of children. They urged psychiatrists everywhere to use that knowledge to influence public policy in their own communities.
"Children who are raised without love become adults filled with hate," Fink said. "We have to incorporate the concept of love in the way we help families and communities and parents. I would like to think that those of us in psychiatry have developed a level of knowledge [about developmental issues]. . . . We know what children need."
Fink said that what he called "the basic tenets of psychiatric knowledge" can inform public health strategies designed to educate young mothers--especially the large number of unwed teenage mothers--in how to raise their children. "That's called applied psychiatry," Fink said.
Bell, who received a Special Presidential Commendation from outgoing APA President Harold Eist, M.D., for his work in helping to reduce violence--especially violence in African-American communities--emphasized that the vast majority of violence in the United States occurs between people who know each other.
The predominant perception of violence, Bell said, is that it stems from predatory strangers, what he termed "stranger danger," or from the random violence of criminals.
In fact, most homicides stem from arguments between friends, lovers, and acquaintances that turn deadly, usually in the presence of alcohol and firearms, said Bell, president and CEO of the Community Mental Health Council Inc., Chicago.
Bell laid much of the blame for this misperception on the media, especially television and newspaper accounts of predatory violence, as well as the flood of movies and television shows that feature bloodshed.
"This propaganda interferes with public acceptance of the fact that it is instead a family-friend phenomenon," said Bell. "This brainwashing is wide sweeping and destructive because it tends to reduce the etiology of violence to phenomena that only occur within a criminal context."
For this reason, Bell said, "investment in public health strategies has taken a back seat to the 'get tough, three-strikes-and-you're-out, criminal-justice-after-the-fact' approach."
Fink described his work as chair of the Youth Homicide Committee for the City of Philadelphia, a panel of representatives from city agencies involved in violence and youth issues. They convene to review facts and gather data about murders involving children.
Fink said, "A year after the death has taken place, we come together to look at the facts: Why did it happen? What do we know about the family? What do we know about the previous history [of perpetrators and victims]?"
Among the patterns that has emerged is that both perpetrators and victims appear to be caught up in a common culture of crime and violence: very often it is impossible to distinguish the backgrounds of the children who are killed from those who do the killing.
Moreover, 80 percent of the perpetrators and 52 percent of the deceased are first arrested between the ages of 10 and 14, Fink said.
"Truancy is the earliest and most important marker for a future problem kid," he said, adding that the most troublesome transition period is between the eighth and ninth grades. There are 230,000 school children in the school district, Fink said, and 30,000 of them are absent every day.
He also reported 26 murders of children under age 5 in an 18-month period. Of these, 40 percent were "murdered by the mother's paramour, whom she may have known for less than a week."
He emphasized that data of this kind are crucial to policymakers in the design of public health strategies to combat violence.
"I would love to see a Youth Homicide Committee in every one of your communities," he told psychiatrists at the meeting.
(Psychiatric News, July 4, 1997)