Problematizing the medicalization of violence: a critical discourse analysis of the ‘Cure Violence’ initiative

The “disease” of violence against health-care workers is a wicked problem. Managing and preventing violence in health-care

“…The idea of violence is socially constructedwho is considered violent and what actions are considered violent vary within the socio-cultural context (De Haan, 2008). Violence is often described metaphorically as a disease, using epidemiological terminology and graphics similar to those used by epidemiologists to describe its prevalence in specific populations, even in non-health-related settings (Riemann, 2019). Violence at any level of severity can lead to ongoing negative impacts on those who experience or witness it.…”

“…More recently, initiatives such as "Cure Violence", a project aimed at ending gun violence in the USA through health-based interventions, have advocated the existence of links between pathology and violent actions. This position is counter to the idea of rational behavioural choice and presumes that perpetrators of violence are victims of disease (Riemann, 2019). The medicalisation of violent and challenging behaviour has changed the way that violence is perceived by society, altering societal expectations around how such behaviour is managed (Martinez et al, 2019).…”

“…Understanding the trigger for violent behaviour becomes more complex when there are questions around whether individual perpetrating violence is responsible for their own actions. Although there is an appeal in the idea that violent behaviour is not a "rational" choice, there are also significant challenges with this stance (Riemann, 2019). When considering the extent that disease plays in causing involuntary violent and aggressive behaviour it is important to consider what happens if the person is not responsible.…”

Public health and violence

“…These questions naturally arise from Malte Reimann's (2019) critical analysis in this issue, in which he problematises the 'medicalization of violence', drawing on the case study of CV. Through the language of epidemiology, Riemann charges that CV effectively marginalises the contributions made by fields such as criminology and sociology, and by extension, promotes treatment models that become 'disentangled from socioeconomic inequalities and explained by reference to individual pathology alone' (Riemann, 2019). Individual behaviour and community norms are thus the priority for change; broader structural factors that might drive violence are reduced to 'modulating' factors (Riemann, 2019).…”

“…Through the language of epidemiology, Riemann charges that CV effectively marginalises the contributions made by fields such as criminology and sociology, and by extension, promotes treatment models that become 'disentangled from socioeconomic inequalities and explained by reference to individual pathology alone' (Riemann, 2019). Individual behaviour and community norms are thus the priority for change; broader structural factors that might drive violence are reduced to 'modulating' factors (Riemann, 2019). Kwon and Cabrera's (2019) analysis of mass shootings in the US likewise identifies and addresses the side-lining of structural factors in explanations of violence.…”