Majority of Patients With Mental Illness Will Experience Some Form of Violence

People with a serious mental illness are likely to be affected by violence in some way—an understanding that should inform clinical practice, wrote John Monahan, Ph.D. (pictured left), a professor of law, psychiatry, and psychology at the University of Virginia in Charlottesville, and colleagues in an article published yesterday in Psychiatric Services in Advance.

The researchers analyzed data from the MacArthur Violence Risk Assessment Study on 951 patients discharged from acute inpatient psychiatric facilities and followed for a year. They found that one year after discharge 58% (n=555) of the patients experienced at least one form of violence. A total of 43% of the patients reported violent victimization by others, 28% reported acting violent toward others, and 23% reported violent self-victimization (defined as attempting hurting oneself). Over one-quarter (28%) of patients experienced at least two forms of violence, and 7% of patients experienced all three forms of violence.

Compared with patients who were not involved with violence, patients with a history of violence were more likely to have a diagnosis of alcohol or drug use disorder, to report being physically abused as children, and to have fathers who were arrested at least twice during their childhood. They were also more likely to have been homeless or unemployed for at least part of the one-year follow-up.

“[G]iven the substantial overlap among the three forms of violence studied here, clinicians should routinely screen patients who report one form for the occurrence of the other two forms of violence,” the authors wrote. “The co-occurrence of several forms of violence involvement may require a package of interventions with components geared to each.”

For more information, see the Psychiatric News article “How to Best Assess Violence Risk of Youth in Emergency Department,” by Ruth Gerson, M.D., director of the Bellevue Hospital Children’s Comprehensive Psychiatric Emergency Program, and Fadi Haddad, M.D., a child and adolescent psychiatrist at the New York University School of Medicine.

(Image: University of Virginia)