Mental Health Problems and Violence: The Reality


People who experience mental health problems frequently report that societal stigma can be and often is as difficult to deal with as the illness itself. One of the most frequently cited misconceptions is that people with experience of mental health problems are prone to violence.

This fear on the part of the public is one of the strongest contributory factors to the stigma and discrimination faced by people with experience of mental health problems.

Fear of violence from people with experience of mental ill-health is widespread and persistent. Research has shown that the public’s desire to maintain social distance from people with mental health problems increased significantly after publicised attacks and never returned to its previous level.

In reality, the perceived understanding of violence and mental health is vicarious and is experienced predominantly through films depicting crazed killers or through dramatic news reports.

Is this fear of violence valid?

Research has shown that the risk of violence from someone with a mental health problem is very low. A study into indicators of future violence found that severe mental illness alone does not predict future violence. However, mental illness when associated with substance abuse did increase the risk of future violence.

Factors such as substance abuse, age, gender and poverty are thought to play a bigger role in determining whether someone will engage in violent behaviour than the existence of a mental health problem. The MacArthur Violence Risk Assessment Study in the USA found that the prevalence of violence among those with a serious mental health problem who did not abuse substances was no different than from their neighbours without mental health problems. Even among people with substance abuse and mental health problems, the risk of violence remains very low.

Studies of violent incidents within clinical settings have found that social and structural factors have been a contributory factor. Issues such as ward atmosphere, clinical leadership, overcrowding, restrictions, and lack of activities have been associated with violent incidents (Katz 1990Shepherd 1999Powell 1994).

In fact people with mental health problems are far more likely to be victims of violence than perpetrators. People with mental health problems are up to 11 times more likely to be a victim of violence than the general population.

There is a need for further research into the determinants of violent behaviour. However, it is clear that the widespread belief that people with a mental health problem are violent is not supported by the research and that the relationship between mental health problems and violence is hugely exaggerated.

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