violence-and-mental-disorders

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Henry J. Steadman, Ph.D. February 28, 2013


“Violence” v s. “ Violent C rime”


Amount of Violence / Violent Crime in U.S. By Persons with Serious Mental Disorders

3 – 5%


“That means 96% of violent crimes – defined by the FBI as murders, robberies, rapes, and aggravated assaults – are committed by people without any mental health problems at all.”

Just One Minute 2/13/03


“People with mental illnesses are no more violent than people without mental illnesses.”

Bazelon Center for Mental Health Law Statement on Sandy Hook Shooting (12/17/12)


Sample ¡

Men/Women, 18-40, White, African-American, Hispanic

¡

All diagnoses except retardation

¡

Voluntary/Involuntary, with/without prior violence

Sites ¡

Pittsburgh, PA; Worcester, MA; Kansas City, MO

¡

n = ∼1,000


¡

Thrown something at anyone?

¡

Pushed, grabbed, or shoved anyone?

¡

Slapped anyone?

¡

Kicked, bitten, or choked anyone?

¡

Hit anyone with a fist or object or beaten up anyone?

¡

Tried to physically force anyone to have sex against their will?

¡

Threatened anyone with a knife or gun or other lethal weapon?

¡

Used a knife or fired a gun at anyone?

¡

Done anything else that might be considered violent (if so, what?)


Violence ¡

Weapon use

¡

Threat with a weapon in hand

¡

Sexual assault

¡

Battery resulting in physical injury

Physical injury includes bruises, cuts, broken bones/teeth, stab/gunshot and/or death. Does not include spanking, violence in self-defense or institutional violence.


Number of Violent Incidents

Number of Discharged Patients

0

689

1

145

2

50

3

29

4

17

5

8

6

4

7 or more

9

Total incidents = 608

Total persons with violence = 262 (27.5%)


Violence (%) A. Types of Violence and Other Aggressive Acts (n = 608) Throwing object Push-grab-shove slap

12.0

Kick-bite-choke Hit-beat up

49.3

Force sex

5.3

Weapon threat Weapon use

29.3

Other, type unknown

4.1


Violence (%) B. Targets of Violence and Other Aggressive Acts (n = 558) Family

51.1

Spouse

23.3

Girlfriend/Boyfriend

13.8

Parental Figure

2.5

Child

2.5

Other Family

9.0

Friend/Acquaintance

35.1

Stranger

13.8


First 20 weeks

1 year

Major Mental Disorder, No Substance Abuse

Major Mental Disorder and Substance Abuse

Other Mental Disorder and Substance Abuse

Total Sample

10.1

22.3

32.6

18.7

17.9

31.1

43.0

27.5


30

% Violent

25 20 15 10 5 0 10

20

30 Weeks

40

Major Mental Disorders and No Substance Abuse Major Mental Disorders and Substance Abuse Other Mental Disorders and Substance Abuse

50


Overall

Without Substance Diagnosis

With Substance Diagnosis

Depression

18.8

10.3

27.9

Schizophrenia

8.1

5.4

11.8

Bipolar

15.2

14.3

16.7

Other Psychotic

17.2

12.5

23.1

Alcohol/Drug

28.8

N/A

28.8

Primary Research Diagnosis



% Violent

Delusions

First 20 Weeks

1 Year

A.  Any Delusions No Yes

20.0 (n = 135) 15.5 (n = 41)

29.4 (n = 201)* 22.8 (n = 61)

B. TCO Delusions No Yes

20.4 (n = 155)** 11.7 (n = 21)

29.4 (n = 226)** 19.7 (n = 36)

TCO = Threat/control override. * p = .05 ** p = .01.


% Violent Hallucinations

First 20 Weeks

1 Year

A.  Any No Yes

18.9 (n = 129) 19.0 (n = 47)

27.4 (n = 189) 29.0 (n = 73)

B. Command No Yes

18.5 (n = 147) 21.8 (n = 29)

27.1 (n = 219) 32.3 (n = 43)

C. Command to be Violent No Yes

16.6 (n = 32)* 27.7 (n = 18)

23.9 (n = 47)*** 44.6 (n = 29)

* p < .05 *** p < .001.


Percent Violent After Discharge Prior Violence and Criminality

First 20 Weeks

1 Year

Frequency of prior arrests – self-report None Once/twice Three or more

9.9*** 17.5 32.0

16.5*** 30.7 43.3

16.0*** 27.7

21.4*** 39.1

15.4*** 24.7

23.1*** 35.7

Official arrest: crimes against person(s) No Yes Official arrest: crimes against property No Yes

* p < .05 ** p < .01 *** p < .001.


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