Victims and families of violent psychiatric patients

Previous studies that have addressed the issue of violence committed by psychiatric patients have primarily been concerned with determining the incidence of violence and defining the characteristics of the offenders. This study addresses the issues of who are the likely victims when psychiatric patients are violent and what are the situational and interpersonal factors that relate to this violence. Medical records of 300 patients admitted to a locked university-based short-term treatment unit were extensively reviewed to assess the presence or absence of preadmission violence. Fifteen percent of the 300 patients assaulted another person within two weeks prior to admission. Fifty-four percent of the violent patients assaulted a family member. There were no differences in demographic characteristics between violent patients who assaulted a family member and violent patients who assaulted someone outside the family, except for with whom the violent patient was living at the time of the assault. Patients who assaulted a family member were significantly more likely to live with family than were patients who assaulted someone outside the family. Sixty-four percent of the patients who assaulted a family member planned to return home to their family after discharge. We identified four types of families within which patients assaulted family members: multiple mental illness families, multiple violent families, delayed help-seeking families, and prompt help-seeking families. The implications of our findings for prevention of future violence are discussed, including the issue of outpatient civil commitment.