SAMHSA: Facts About Mental Illness and Violence

NYAPRS Note: Some very timely information for us to share with the media today and through the next few weeks.

Violence and Mental Illness: The Facts

Facts about Mental Illness and Violence

It is important to note that behavioral health research and practice over the last 20 years reveal that most people who are violent do not have a mental disorder, and most people with a mental disorder are not violent.*

In fact, studies indicate that people with mental illnesses are more likely to be the victims of violent attacks than the general population. *

Demographic variables such as age, gender and socioeconomic status are more reliable predictors of violence than mental illness. *

Misconceptions about mental illness can cause discrimination and unfairly hamper the recovery of the nearly 20 percent of all adult Americans who experience a mental illness each year.

Family, friends, employers and school personnel can be a line of "first response" if they notice a person is behaving differently and is of concern.  The choice to seek treatment is more likely if others are compassionate and supportive.   Mental health treatment can be effective and can enable a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.

Treatment is effective and people recover from mental illnesses to live productive lives in our communities.

The discrimination and stigma associated with mental illnesses largely stem from the link between mental illness and violence in the minds of the general public, according to Mental Health: A Report of the Surgeon General (1999). "For instance, 61 percent of Americans think that people with schizophrenia are likely to be dangerous to others," notes the report of the President’s New Freedom Commission on Mental Health, Achieving the Promise: Transforming Mental Health Care in America (2003).

This link is promoted by the news and entertainment media. For example, the National Mental Health Association reported that, according to a survey for the Screen Actors’ Guild, characters in prime time television portrayed as having a mental illness are depicted as the most dangerous of all demographic groups: 60 percent were shown to be involved in crime or violence (three times the average rate). In addition, “[s]tudies showed that as many as 75 percent of stories dealing with mental illness focus on violence (Shain and Phillips 1991). Although more recent research suggests the prevalence of these kinds of stories is diminishing (Wahl, et al. 2002), at least a third of stories continue to focus on dangerousness. Also, the vast majority of remaining stories on mental illness either focus on other negative characteristics related to people with the disorder (e.g., unpredictability and unsociability) or on medical treatments. Notably absent are positive stories that highlight recovery of many persons with even the most serious of mental illnesses (Wahl, et al. 2002)

The average citizen finds these images persuasive.  According to Americans’ Views of Mental Health and Illness at Century’s End: Continuity and Change, between 1950 and 1996, “the proportion of Americans who describe mental illness in terms consistent with violent or dangerous behavior nearly doubled.”

As a result, Americans are hesitant to interact with people who have mental illnesses: 38 percent are unwilling to be friends with someone having mental health difficulties, 64 percent do not want someone who has schizophrenia as a close coworker, and more than 68 percent are unwilling to have someone with depression marry into their family. (Pescosolido, et.al., 1996)

But, in truth, people have little reason for such fears. A consensus statement signed by more than three dozen lawyers, advocates, consumers/survivors, and mental health professionals reads in part: “The results of several recent large-scale research projects conclude that only a weak association between mental disorders and violence exists in the community. Serious violence by people with major mental disorders appears concentrated in a small fraction of the total number, and especially in those who use alcohol and other drugs.” (Monhan, J. and Arnold, J., 1996)

In addition:

  • "Research has shown that the vast majority of people who are violent do not suffer from mental illnesses." (American Psychiatric Association, 1994).
  • “Clearly, mental health status makes at best a trivial contribution to the overall level of violence in society” (Monahan, John, 1992).
  • “...[T]he absolute risk of violence among the mentally ill as a group is still very small and . . . only a small proportion of the violence in our society can be attributed to persons who are mentally ill.” (Mulvey, 1994)
  • “Most people who suffer from a mental disorder are not violent — there is no need to fear them. Embrace them for who they are — normal human beings experiencing a difficult time, who need your open mind, caring attitude, and helpful support.” (Grohol, 1998)
  • “Compared with the risk associated with the combination of male gender, young age, and lower socioeconomic status, the risk of violence presented by mental disorder is modest.” (Policy Research Associates, December 1994)

People with psychiatric disabilities are far more likely to be victims than perpetrators of violent crime. (Appleby, et.al., 2001)

A new study by researchers at North Carolina State University and Duke University has found that people with severe mental illness — schizophrenia, bipolar disorder or psychosis — are 2 1⁄2 times more likely to be attacked, raped or mugged than the general population.” (— Chamberlain, Claudine. “Victims, Not Violent: Mentally Ill Attacked at a Higher Rate,” ABC News

Hiday et al., 2001 V.A. Hiday, J.W. Swanson, M.S. Swartz, R. Borum and H.R. Wagner, Victimization: A link between mental illness and violence?, International Journal of Law and Psychiatry 24 (2001), pp. 559–572. SummaryPlus | Full Text + Links | PDF (99 K) | Abstract + References in Scopus | Cited By in Scopus, Hiday et al., 1998 V.A. Hiday, M.S. Swartz, J.W. Swanson, R. Borum and H.R. Wagner, Male and female differences in the setting and consruction of violence among people with severe mental illness, Social Psychiatry and Psychiatric Epidemiology 33 (1998), pp. 68–74.

References

American Psychiatric Association. (1994). Fact Sheet: Violence and Mental Illness.” Washington, DC: American Psychiatric Association.
Appleby, L.,  Mortensen, P. B., Dunn, G., and Hiroeh, U., Death by homicide, suicide, and other unnatural causes in people with mental illness: a population-based study.” The Lancet, Vol. 358, iss. 9299, (2001), 2110-2112.

 

Corrigan, P.W., Markowitz, F.E., & Watson, A.C. “Structural levels of mental illness stigma and discrimination.” Schizophrenia Bulletin. Washington: 2004. Vol. 30, iss. 3;  481-492.

Grohol, J. M. “Dispelling the violence myth.” Psych Central. (June, 1998).

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. 

Monahan, J. “Mental Disorder and Violent Behavior: Perceptions and Evidence.” American Psychologist vol. 47 iss.4 (1992): 511-521.

Monahan, J. & Arnold, J. “Violence By People With Mental Illness: A Consensus Statement By Advocates and Researchers.” Psychiatric Rehabilitation Journal vol.19, iss.4 (Spring 1996): 67-70.

Mulvey, E. P. “Assessing the Evidence of a Link Between Mental Illness and Violence.” Hospital and Community Psychiatry vol. 45 iss.7 (July 1994): 663-668.

National Mental Health Association. American Opinions on Mental Health Issues. Alexandria: NMHA, 1999. Pescosolido, Bernice A., et al. Americans’ Views of Mental Health and Illness at Century’s End: Continuity and Change. Americans’ Views of Mental Health and Illness at Century’s End: Continuity and Change. Public Report on the MacArthur Mental health Module, 1996 General Social Survey.  Bloomington: Indiana Consortium forMental Health Services Research and Joseph P. Mailman School of PublicHealth, Columbia University, 2000.

New Freedom Commission on Mental Health, Achieving the Promise: Trasnforming Mental Health Care in America. Final Report. DHHS Pub. No. SMA-03-3832. Rockville, MD:  2003. Pescosolido, B.A., Martin, J.K., Link, B.G., et.al.  Americans’ Views of Mental Health and Illness at Century’s End: Continuity and Change. Public Report on the MacArthur Mental health Module, 1996 General Social Survey. Bloomington: Indiana Consortium forMental Health Services Research and Joseph P. Mailman School of PublicHealth, Columbia University, 2000.www.mentalhealthcommission.gov/reports/reports.htm

Pescosolido, B.A., Martin, J.K., Link, B.G., et.al.  Americans’ Views of Mental Health and Illness at Century’s End: Continuity and Change. Public Report on the MacArthur Mental health Module, 1996 General Social Survey. Bloomington: Indiana Consortium forMental Health Services Research and Joseph P. Mailman School of PublicHealth, Columbia University, 2000.

 Policy Research Associates, “What do we know about mental disorder and violence?” December 1994.

For more information about how to address discrimination and stigma, contact the SAMHSA Resource Center to Address Discrimination and Stigma (ADS Center), e-mail stopstigma@samhsa.hhs.gov, or call 800-540-0320, a program of the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.

http://www.samhsa.gov/mentalhealth/understanding_Mentalllness_Factsheet.aspx