Violence and Mental Health

In the context of highly publicized episodes of mass violence in this country, the question often arises as to the role of mental illness as a factor impelling the perpetrators of violence. Therefore, it is important to clarify this matter for the general public and those who establish public policy.

The vast majority of violence in our society is not perpetrated by persons with psychiatric illness. Violent behavior attributable to mental disorder accounts for only 4-5% of the violence in the United States. Substance abuse substantially increases the risk of violence by anyone, and particularly by persons with mental illness. However, certain other disorders which affect the brain, especially head trauma, strokes, brain tumors, infections, degenerative and metabolic diseases may predispose patients to violent behavior. Importantly, although some mental illnesses may increase the likelihood of violence, the best long-term predictors of violence are not mental illness, but factors such as a history of violence, history of general antisocial behavior, substance abuse, young age, male gender, and poor social adjustment, especially beginning in childhood. A history of violence is the single best predictor of future violence. Attempting to predict imminently violent behavior is notoriously difficult and unreliable.

Mentally ill persons are far more likely to be the victims rather than the perpetrators of violence. Furthermore, individuals with mental illness engaged in regular treatment are considerably less likely to commit violent acts than those in need of, but not engaged in, appropriate mental health care, including treatment for substance abuse.

Therefore, the New Jersey Psychiatric Association recommends:
Promoting public education as to the true nature, causes and treatments of mental illnesses to reduce stigma.
Supporting research into the predominant causes of violence in our society, which lie elsewhere, and implementing effective means of prevention.

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