MENTAL ILLNESS AND VIOLENCE

What about mental illness and violence? Based on recent findings by Dr. Paul Mullen (2006), most people with a mental illness are not violent. For instance, of the 1 in 100 people who have schizophrenia, only 0.1% are sometimes violent. There is good evidence to show that people with mental illness who are receiving treatment are no more likely to perpetrate violence than people in general. The risk of someone who is being treated for schizophrenia, for instance, harming or killing another person is almost exactly the same as for the general population. One in ten people with schizophrenia, however, will suicide. This is ten times the risk compared to the general population. In fact, people with a mental illness, according to research, are more than twice as likely to be the victims of violence than the general population. “Schizophrenia is unnecessarily feared by many people in our community without basis. People with schizophrenia have more to fear from us than we do from them. Stigma and discrimination are still rampant in a society which, ironically, adopts the ‘fair go’ ethos. Because of this stigma and discrimination, many people affected by schizophrenia find it so difficult to cope that they unnecessarily end their own lives”. Hon Judge Frank Walker – President of the Schizophrenia Fellowship of NSW, 2003

Why do people become violent? People in general might become violent when they are stressed, when they are not coping, when they lack the skills to cope with situations that confront them, or when they are unhappy. Violence can be used as a means to maintain control and dominance, or it can be used as a means of tackling (badly) an unpleasant situation. Much research has been done to explore why people use violence against other people. Prominent in the research data are the notions of learnt behaviour (a history of family violence is a strong predictor) and social roles (men perpetrate violence at an alarmingly higher rate than women and some traditional perspectives of male roles are seen to collude in this). What is clear is that violence is widespread.

Who in society is most vulnerable to perpetrating violence? Some parts of society are at greater risk of perpetrating violence than others. Groups that are at high risk include: • Males between the ages of 15 and 25 years • People who abuse alcohol and other drugs • People who have a history of violence either personally or as part of their family history. Where there are developmental and social difficulties • People with psychotic illness who are not receiving treatment. When this is coupled with problematic drug use, this becomes a high risk group. • Some disorders appear to predispose the person to violence, especially when the illness is active. People with some forms of dementia can sometimes experience violent episodes. For people diagnosed with Anti-social Personality Disorder there is an increased possibility of violence. Wherever there is a Personality Disorder comorbid with a psychiatric diagnosis the risk of violence increases. In people with Borderline Personality Disorder problems with anger are common, with the possibility of violent or agressive behaviour when angry (DSM IV). If violence is entirely out of character for a person and they do not fall into a higher risk category, it is advisable to have a thorough medical check-up.

 

 

 

References

World Health Organization. Strengthening Mental Health Promotion. Geneva, World Health Organization (Fact sheet no. 220), 2001.
U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services; Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999.
Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005;62:617–627.
Murray CJL, Lopez AD. The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries and Risk Factors in 1990 and Projected to 2020. Geneva, Switzerland;World Health Organization, 1996.
Chapman DP, Perry GS, Strine TW.The vital link between chronic disease and depressive disorders. Prev Chronic Dis 2005;2(1):A14.
Ryff CD, Keyes CLM. The structure of psychological well–being revisited. J Pers Soc Psychol 1995;69:719–727.
Ryff CD. Happiness is everything, or is it? Explorations on the meaning of psychological well–being. J Pers Soc Psychol 1989;57:1069–1081.
Keyes CLM. Social well–being. Soc Psychol Quart 1998;61:121–140.