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Violent behavior by individuals with serious mental illness

¹National Institute of Mental Health Neuroscience Center at St. Elizabeths Hospital, Washington, DC 20032.

Hospital & Community Psychiatry

|July 1, 1994

Summary

Most individuals with serious mental illness are not dangerous, but a violent subgroup exists. Predictors include past violence, noncompliance, and substance abuse, impacting stigma reduction efforts.

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Area of Science:

Psychiatry
Criminology
Public Health

Background:

The association between serious mental illness (SMI) and violence is a contentious issue.
Mental health advocates assert that individuals with SMI are not inherently more dangerous than the general population.
This study examines the validity of these claims by reviewing empirical evidence.

Purpose of the Study:

To investigate the perceived association between violent behavior and serious mental illness.
To evaluate the accuracy of claims that individuals with SMI pose no greater risk than the general population.
To inform policy and public perception regarding mental illness and violence.

Main Methods:

A comprehensive review of recent scientific studies and media reports on violent behavior in individuals with SMI.
Emphasis was placed on the most current research findings.
Analysis focused on identifying patterns and predictors of violence within this population.

Main Results:

The majority of individuals with serious mental illness do not exhibit more dangerous behavior than the general population.
However, a distinct subgroup within the SMI population demonstrates increased dangerousness.
Key predictors for violence in this subgroup include a history of violent acts, medication noncompliance, and co-occurring substance abuse.

Conclusions:

The findings necessitate a re-evaluation of criteria for involuntary treatment, medication adherence monitoring, and mandated follow-up care.
The existence of a violent subgroup complicates efforts to de-stigmatize mental illness by challenging the narrative of non-violence.
Addressing the issue of violence within this specific subgroup is crucial for reducing the overall stigma associated with serious mental illness.

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