Behavior Screens Off Mental Illness
On mentioning mental illness in callout posts
In response to my post about Nonlinear, a number of people asked me why I objected so strongly to Alice and Chloe being characterized as mentally ill. The argument, I think, goes something like this: “Alice and Chloe were (let’s stipulate) actually mentally ill. Mentally ill people do often believe wrong and irrational things. All things equal, any given claim made by a mentally ill person is far more likely to be wrong or irrational than the same claim made by a neurotypical. It’s not proof, of course, but it ought to be one piece of evidence that we weigh.”
To be clear, my true rejection is naked self-interest. I have Bad Person Disease. With a lot of hard work, discipline, support from others, and of course medicating away my problems, I have worked my way up to being a solidly mediocre person. I’m proud of my mediocrity. When people assess my credibility, I want them to look at the things I’ve actually done wrong (of which there are more than enough) and not by every single bad thing done by everyone else with borderline personality disorder. I don’t have any control over what they’re doing! I would like to be judged not by the diagnosis in my psychiatrist’s file but by the content of my character!
But I think there are good reasons for people without borderline personality disorder to share my position.
Privacy is important. People often share things with their friends that they don’t want spread all over the public Internet: because those things are easily misinterpreted, because they’re embarrassing, because a bunch of people will go “ew! cringe!”, because they’re just none of anyone’s business.
Some things are more private than other things: nudity, sex, medical conditions. In general, those things aren’t shared without the person’s consent unless there’s a very good reason. Mental illness, I think, should be in this category. It often involves the worst experiences of someone’s life, which are generally private: I think everyone would prefer to get to choose who knows the details of their rape or exactly what they did when they found out their spouse just died. It’s often humiliating: sometimes mental illness means being a grown adult who is shaking and crying because they tapped the door three times instead of four and that’s wrong and they know this is insane but they can’t stop. Mental illness is stigmatized: many people will refuse to (say) hire you if they know that you were in a mental hospital, even if you can do the work.
I’m very open about my mental illness, for many reasons. I’m prone to experiencing crippling shame, and the best approach I’ve found is being loud and open about the traits I’m ashamed of. Few people talk openly about the experience of living with borderline personality disorder, and I wanted to push back against the narrative that we’re all monsters. But I want to emphasize that I can do this because I’m very privileged. My community is generally accepting of severely mentally ill people. And—crucially—I’ve never had to pay my own rent.
Even so, there are things about my life I’d never share publicly, and that would be invasive and violating for other people to share.
Callout posts often involve sharing private information about people’s lives. Discussing someone’s sexuality may be necessary to provide evidence that they’re a serial rapist. The details of how someone abuses someone else may be entwined with their medical condition or their drug use or, yes, their mental illness. There’s a principle of proportionality: you should balance the person’s privacy with the amount that the evidence helps the case that the person is committing some serious harm that the general public needs to be aware of. Even if Eve embezzled money to fund her romantic getaways with Bob, you don’t need to include a testimony about how great Bob is in bed to explain her actions. And if you’re writing a callout post about a rapist, information about their specific fetishes is rarely necessary.
I think that mental illness usually doesn’t provide enough information that it should be mentioned in a callout post. Indeed, I think information about mental illness often makes people more wrong about what’s going on.
Mental illness often isn’t much evidence one way or other about whether someone was victimized. True, many mentally ill people misinterpret “you’re busy” as “you hate me personally and want me to die,” or similar distortions that affect their ability to accurately report on interpersonal situations. But the distortions work both ways. You get mentally ill people going “Eve was busy, so she hates me and wants me to die”, but you also get mentally ill people going “Eve tells me I’m worthless all the time, but I am completely worthless, so she’s just giving me helpful criticism that will help me improve as a person.”
Further, mentally ill people are also more likely to be victimized. For example, one study found that people who were involuntarily hospitalized for mental illness are two and half times as likely to be victims of violent crime than the general population. Mentally ill people are a vulnerable group. Predators prey on people who have few other options and whom they know won’t be believed.
People tend to draw overly broad conclusions when they discover someone is mentally ill. Mental illness generally isn’t Wrong About Everything Disorder. People have specific ways their thoughts are distorted. If someone believes that all their friends secretly hate them, they can still accurately report that their boss stole their wages from them. If someone believes that they’re much fatter than they actually are, they can still tell whether their boyfriend hits them. It’s also possible to compensate for your thoughts being distorted, and most mentally ill people do, at least a little bit. If someone had a manic episode ten years ago but their bipolar disorder is well-controlled by medication, that really shouldn’t affect their credibility. Similarly, some people will go “I know I’m socially phobic, but I’ve checked the facts and tried to take an outside view and consider alternate interpretations, and I really think that my so-called friends are being cruel to me because I don’t want to pay the Church of Scientology $10,000 so I can get clear.”
But many people don’t have an understanding of mental illness where mentally ill people do specific things for specific reasons that make sense to them. If someone’s thoughts are distorted one way, they assume, then everything that person believes is untrustworthy. If someone behaves in an unusual and counterproductive way in some situations, then they can’t be predicted at all—they could do anything! If someone is known to be mentally ill, then they might do literally anything you’ve heard of any mentally ill person doing in any situation anywhere in the world.1
In fact, knowing someone is neurodivergent can make people take a more negative perspective on their beliefs and actions, even when the neurodivergent person and the neurotypical person believe and do the same things—even when neurodivergent person is behaving better. I don’t have an uncontroversial case of this about callout posts specifically, for obvious reasons, but consider this paper that found that neurotypical people give more money to charity when people are watching, but autistic people don’t. The authors write:
[I]n healthy individuals, improving one's social reputation acts as an instrumental reinforcer because better social reputation is rewarding. We think that there are at least two possible explanations for this deficit in ASD individuals. The first possibility is that they can represent the presence of an observer but may be unable to take the extra metacognitive step of representing what the observer thinks of them (reputation). The second possibility is that they can represent the observer as well as their reputation but lack normal social reward processing.
That is, autistic people being less hypocritical is characterized as a deficit in social reasoning.
This is pervasive when people talk about mental illness, often in faux-compassionate ways. If a borderline and a neurotypical act the same way about someone they don’t like, only the borderline is accused of “splitting black.” If both an autistic person and a neurotypical are unpleasantly surprised by someone flaking, only the autistic person is accused of “rigidity.” If both a depressed person and a neurotypical person hold strongly to their viewpoint of the world, only the depressed person is accused of “black-and-white thinking.”
To be sure, often borderlines intensely hate people for no good reason, autistic people are distressed by plan changes to an unhelpful degree, and depressed people think in a black-and-white way. But it’s also very easy to reach for those explanations when a mentally ill person is simply behaving in a way you don’t like. If someone is making accusations that you don’t want to be true, you can say “well, mentally ill people are unreliable, they must be making it up”; if someone is defending themself and you’d really rather they be guilty, you can say “well, mentally ill people often do harmful things, they must have done it.”
As they say, argument screens off authority: if someone makes a good argument, it shouldn’t matter if they’re a tenured professor or a thirteen-year-old with a special interest. I would propose that, equally, behavior screens off mental illness.
Let’s take a trivial example. If all you know is that Heidi has ADHD and Ivan doesn’t, you should assume that Heidi will run late and Ivan will show up on time. But if you’ve gone to dozens of events with Ivan and Heidi, and every single time Ivan runs 45 minutes late, and every single time Heidi is at most five minutes late, Ivan is the one you should tell that the movie starts 45 minutes before it actually does.
There are any number of reasons a person can run late. Maybe they have ADHD. But they could be overbooked such that they’re constantly running from one engagement to another, or get engrossed in their work, or have a small child that makes going anywhere on time impossible, or have a serious case of the planning fallacy, or just not think that showing up to places on time is very important. Once you’ve observed that Ivan always runs late, you can make decisions based on his actual behavior and not his diagnosis.
Similarly, there are any number of reasons someone can (for example) make false abuse accusations. Maybe they’re mentally ill in some way. But they could be a vengeful person who found a way to get revenge on people they hate. Or they could have joined a subculture with wacky ideas about what counts as “abuse.” Or they could be a teenager who made something up to cover up their consensual sex with their boyfriend and now everything’s gotten way out of hand. Or they could believe that their partner is their property and therefore their partner disobeying is abuse.
Mental illness is a social construct, sure, we could declare anything to be a mental illness. But many, many people who harm others don’t have any condition presently listed in the DSM. Nor is their behavior responsive to therapy and medication, or difficult for them to control such that it shouldn’t be held against them too much, or otherwise in any way the kind of thing we want to classify as a mental illness.
The reason doesn’t matter. If Greg has falsely accused multiple people of abusing him, his victims may want to come forward. But his victims should present specific evidence that events didn’t happen the way Greg said that they did. If the evidence is convincing, it doesn’t matter whether Greg is mentally ill or not. A consistent pattern of seriously harmful behavior is enough to expel someone from a community—just like a consistent pattern of being late to movies is enough to expect that your friend isn’t going to show up at the movie on time. Mental illness is a side issue, one that is likely to mislead as much as it is to make people’s views more accurate, and it’s not worth the privacy violation.
Sometimes including fictional mentally ill people.
> consider this paper that found that neurotypical people give more money to charity when people are watching, but autistic people don’t. The authors write: "[I]n healthy individuals, improving one's social reputation acts as an instrumental reinforcer because better social reputation is rewarding. We think that there are at least two possible explanations for this deficit in ASD individuals. [...]" That is, autistic people being less hypocritical is characterized as a deficit in social reasoning.
When I read this, I thought the paper was correct, because their reasoning is rational (i.e. a rational person should be willing to pay more if they get a greater benefit in the form of a better reputation). However, the details of the method seem to confirm your criticism. The "person watching" in the experiment was "an unfamiliar person" supposedly brought in to compensate for faked computer problems. The expected reputational benefit in this case is likely to be minuscule or zero, since the observed action is (what most would consider) a supererogatory donation & the observer is a stranger whom the experimental subject is likely to never meet again; thus treating the reputational benefit as negligible is the rational decision, & it would probably be more accurate to interpret the study as finding that neurotypical people, but not autistic people, irrationally overvalued the observer's opinion of them.
On this specific point:
> Mental illness often isn’t much evidence one way or other about whether someone was victimized. True, many mentally ill people misinterpret “you’re busy” as “you hate me personally and want me to die,” or similar distortions that affect their ability to accurately report on interpersonal situations. But the distortions work both ways. You get mentally ill people going “Eve was busy, so she hates me and wants me to die”, but you also get mentally ill people going “Eve tells me I’m worthless all the time, but I am completely worthless, so she’s just giving me helpful criticism that will help me improve as a person.”
It sounds like you're saying "mentally ill people have a high false positive rate, but they have a high false negative rate too", so it kinda balances out?
But if the context is "a mentally ill person has accused someone of victimizing them and we would like to know if that's true or not", these don't balance out. The opposite, actually: a high false negative rate decreases the probability that any given positive measurement is a true positive.
Consider: someone is tossing a coin and telling you the result. Suppose 10% of the time, if they see tails, they'll say heads. Now when they say heads, you think there's some chance it was tails. (p(heads | they-say-heads) ≈ 90.9%.) But also, 5% of the time if they see heads, they'll say it was tails. Now *when they say heads*, you think the chance it was actually tails is *higher*, becauses the collection "coin flips where they say heads" has the same number of false positives but fewer true positives. (Now p(heads | they-say-heads) ≈ 90.4%.)