[Hpn] Perception that People with Mental Illness Are Violent Is Unfounded

Morgan W. Brown norsehorse@hotmail.com
Sun, 15 Sep 2002 01:16:48 -0400


-------Forwarded News Release-------

Three Risk Factors Cited in Violent Behavior Among People With Severe Mental 
Illness
<http://news.mc.duke.edu/news/article.php?id=5806>

* subject keyword: mental illness, Psychiatry, violence

contact : Tracey Koepke , (919) 684-4148 or (919) 660-1301
koepk002@mc.duke.edu
date : 8/30/2002


Durham, N.C. -- People with severe mental illnesses are highly unlikely to 
become violent toward others unless they have additional risk factors 
combined with their psychiatric disorder, according to a new study led by 
researchers at Duke University Medical Center.

Among people with severe mental illness, a combination of three risk factors 
-- having been a victim of violence during childhood, living in a 
neighborhood where violence is common, and having a substance abuse problem 
-- can increase the likelihood of violent behavior more than tenfold, the 
researchers found. Without any of these risk factors, those with severe 
mental illness were no more likely to engage in violent behaviors than 
people in the general population without a psychiatric disorder.

“Acts of violence by people with mental illness are rare,” said Jeffrey 
Swanson, Ph.D., associate professor of psychiatry and behavioral sciences, a 
sociologist at Duke and lead author of the study. “While the illness 
certainly plays a role, the risk factors we examined compound the illness in 
a way that makes violence more probable. Those risk factors should be a 
large part of the focus of treatment and services for persons with mental 
illness and a history of violence.”

Swanson noted, “violent crimes committed by psychiatric patients become big 
headlines and reinforce the social stigma and rejection felt by many 
individuals who suffer from mental illness. But our findings suggest that 
serious violence is the rare exception among all people with psychiatric 
disorders. The public perception that people who are mentally ill are 
typically violent is unfounded.”

The study appears in the September 2002 issue of the American Journal of 
Public Health <http://www.ajph.org> and was funded by the National Institute 
of Mental Health <http://www.nimh.nih.gov> (NIMH).

The researchers conducted confidential interviews with 802 adults from North 
Carolina, New Hampshire, Maryland and Connecticut who had been treated for 
severe psychiatric conditions such as schizophrenia, bipolar disorder or 
major depression.

Participants in this observational study were asked whether they had 
committed any acts of violence toward others during the previous year that 
involved the use of weapons or caused physical injury to another person. 
Overall, the prevalence of violence was 13 percent. Among participants who 
did not have any of the three risk factors cited above, less than 2 percent 
reported acting violently. Those who had a combination of two of the risk 
factors had nearly a 10 percent likelihood of violent behavior during a 
one-year period. Adding a third risk factor tripled the likelihood of 
violent behavior to about 30 percent.

“The prevalence and pattern of violent behavior found in this study supports 
previous research findings on the link between violence and mental illness,” 
said Swanson. “A great deal of the violence in our mentally-ill participants 
appears to be attributable to factors outside of their illness. Those acts 
of violence are quite uncommon overall, and there are typically a number of 
other factors involved, like living in an impoverished high-crime 
neighborhood. However, when violence does occur, it requires that a 
disproportionate amount of public resources be spent on treatment in 
institutional settings -- which are the most restrictive and also the most 
expensive.”

Swanson said many of the tragedies caused by violent behavior of people with 
mental illness are preventable with the appropriate resources. Yet many 
individuals with serious and disabling psychiatric disorders are not 
receiving the treatment and support that might enable them to live 
productive lives in the community, especially as states restrict their 
services in response to budget pressures.

“If we’re worried about violence among people with serious mental illness, 
we need to pay far more attention to finding safe housing in decent 
neighborhoods, mitigating the effects of physical and sexual victimization, 
and aggressively treating substance-abuse issues,” said Marvin Swartz, M.D., 
professor of psychiatry at Duke and an author on the study.

According to the NIMH, about one in five Americans suffers from some form of 
mental illness, and even the most severe forms of mental illness such as 
schizophrenia, bipolar disorder and major depression are highly treatable 
with medication and therapy. Commonly used medications include atypical 
antipsychotics and selective serotonin reuptake inhibitors, newer classes of 
drugs that have fewer side effects than older alternatives.

According to a 1999 Surgeon General’s report 
<http://www.surgeongeneral.gov/library/mentalhealth/home.html>, the indirect 
costs of all mental illness imposed a nearly $79 billion loss on the U.S. 
economy in 1990, the most recent year for which such estimates are 
available. Most of that amount reflects loss of productivity because of 
illness, premature death, incarceration and lost work time of individuals 
providing care to a family member or loved one with mental illness.

Other authors on the study include H. Ryan Wagner, Ph.D. and Keith Meador, 
M.D. of Duke University Medical Center; Susan Essock, Ph.D. of Mount Sinai 
School of Medicine and the Veterans Affairs New York Healthcare System; Fred 
Osher, M.D. of the University of Maryland School of Medicine, Baltimore; 
Lisa Goodman, Ph.D. of Boston College and the University of Maryland, 
College Park; and Stanley Rosenberg, Ph.D. of Dartmouth Medical School.

contact sources : Jeffrey Swanson , (919) 682-4827
jeffrey.swanson@duke.edu

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**In accordance with Title 17 U.S.C. section 107, this
material is distributed without charge or profit to
those who have expressed a prior interest in receiving
this type of information for non-profit research and
educational purposes only.**

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-------End of forward-------

Morgan <norsehorse@hotmail.com>
Morgan W. Brown
Montpelier Vermont USA



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