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Modest link between mental illness and violence

Contrary to popular belief, the relation between mental dis-order and violence is modest, say John Monahan and colleagues of the MacArthur Foundation Research Network on Mental Health and the Law. Their US$8-million research was presented at a conference on mental-health law in Phoenix, Arizona, USA, on Jan 9-10. The findings, which will be fully available in July, are the culmination of 8 years of research in which 1000-plus patients with mental disorders were assessed in the hospital and periodically in the community to measure violence during the first year of their release. This was then compared for violence with a large random sample of people in the general population.
 
The researchers found the link between mental disorder and violence to be only modestly greater than chance. Previous research which confirmed this however, could not be put to use to improve the accuracy of clinical assessments. The researchers pointed out that better ways had to be found to improve clinical risk assessment, enhance the effectiveness of clinical risk management, and provide information for the reform of mental-health law and policy. Accordingly, the researchers proposed risk-factors for violence in a public-health setting (panel).
 
Monahan and colleagues asked two further questions. How does the rate of violence by former mental patients compare with the rate of violence by other members of the community, and are the risk factors for violence any different among former mental patients than among other community members?
They did a second study of 500 people from the same community in which former patients lived and found that patients with mental illness, and those with major mental illness, such as schizophrenia, were no more violent in absolute terms than people in the general population. However, patients with mental illness who undertook substance abuse were more likely to show violent behavior. Satvinder Juss
 
DJ Jaffe, NAMI Board member brings up the following good points:
 
Comment by DJ on the above:
It looks like it might have the same fault as much other research, in that it looks at people in hosp and in community. This means that folks in jail suicided homeless or in prison are excluded. Excluding these folks is one way people get violence stats artificially low.

The other question is how did they define mental illness? Did they assume 25% of pop is mentally ill (sic) or did they look at the 2.8% with chronic and persistent NBDs. IOTW, their research may be right if applied to the 20% of pop, but not if applied to the 2.8% of adults over 18 w/nbd.


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