Dispelling the myth of violence and mental illness

CrossCurrents

The violent mentally ill person is a well-entrenched fixture of the popular imagination. Yet the following facts reveal that the mental illness–violence link is not as clear as it may seem:

Numerous studies have found that people with severe mental illness who are on medication are no more dangerous than members of the general population. A U.S. study published in 1994 in Hospital and Community Psychiatry found that clients who receive regular psychotherapeutic support from a mental health professional are far less likely to commit a violent act than those who do not.

A 1998 article in Social Psychiatry and Psychiatric Epidemiology argues that although recent evidence points to an increased likelihood of violence by those with mental illness, it is unknown whether this relationship is causal (i.e., stems directly from the illness) or whether it is a relationship of association (i.e., links stem from other factors such as living conditions and relationships).

Even among clients who have behaved violently in the past, predictions as to future violent behaviour are not reliable. Studies show that “predictions of future violence will be wrong for two out of three patients” (American Psychiatric Association, www.psych.org).

Community-based workers indicate that general societal violence and crime promote stress, aggravate symptoms and increase the vulnerability of people with mental illness. In the case of severely ill clients who suffer from psychosis, a threatening environment can be the most important single factor in escalating a paranoid delusion into physical violence.