My girlfriend is a fan of violent police/crime television series and she jokes sometimes about being mentally ill and being able to commit a violent act and not be punished for it. She says since she's diagnosed with a mental illness she'd only go to a hospital. These statements are becoming more frequent. What, if anything, can I do to stop her from thinking this way? Should I tell someone? If so, who?
(Column: Ask the Therapist)
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There is little you can do to stop the thinking. Let's worry about the possibility that she will act out her thinking. Psychology regards suicide and homicide as twin expressions of despair. You have probably heard the expression "a danger to self or others" -- which means both types of behavior have a similar mental origin and need to be regarded very seriously. Ask your girlfriend: Do you have a particular person in mind? Have you thought how you would do this violent act? And, do you have the means to carry it out? These questions will not cause her to take action or put thoughts in her head that aren't there. If she answers: "Yeah, it's Harry I want to get and I'll shoot him with the gun that is in my pocketbook," then you must hurry. If she has been diagnosed mentally ill, please tell her therapist or psychiatrist. Mental Health professionals must take legal action if a patient is planning violence against a specific person. The therapist can ask for an involuntary hospitalization.

You may also want to tell your girlfriend that being mentally ill is not a guarantee that she will get hospitalized -- and anyway she will wind up in the forensic (police, locked) unit of a mental hospital if she does get hospitalized. But the legal definition of insanity is different from the psychiatric one. If your friend can understand right from wrong and admits to understanding what she was doing, then she can wind up in prison without mental health treatment.

If your girlfriend is not in treatment, despite having a diagnosis, you have a more difficult situation. There are mobile crisis teams you can call to get her assessed. You can call 911 if you feel there is an immediate danger, but she will have to say the same things to them that she said to you. But if she is not in treatment, she is more at risk for winding up in a prison rather than a hospital. But, again, if she winds up in a hospital, she may spend a long time (years) on the locked and secured forensic unit, just like prison. Tell her this. Tell her it is not a joke and not like a TV show. She is not an actor who is the bad guy one day and turns up in another show after that as a hero. If she wants to bring her life to a halt this is a good way to do it. She will spend months in pre-trial, jail-like circumstances and then may be locked away nearly forever with or without treatment and definitely without a life.

Of course, if you do any of these things you may no longer have a girlfriend. On the other hand, she may be glad you stopped her. And, when all is said and done, we have to live with ourselves. If I let someone kill or harm someone else without having tried to stop them, I have a moral responsibility even if I don't have a legal one.
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