Are the Mentally Ill Really Violent?

Presents information on the association of mental illness and violence. Symptoms of mental disorder; Factors to consider in assessing whether a mentally ill person has propensity for violence; Tools in mandating treatment for mentally ill persons.

By Edward P. Mulvey, Jess Fardella, published on November 01, 2000

Of course, mandated treatment based simply on a refusal to accept professional help is a crude tool for preventing violence; it targets both the relatively small percentage of the mentally ill who might engage in violence, as well as those with psychological disorders whose only sin is to refuse treatment. Civil libertarians and consumer groups--advocates for the mentally ill, often themselves mental health patients--believe that the supposed link between violence and mental illness is at best exaggerated, and that such linkage stigmatizes the mentally ill and threatens them with an unwarranted loss of freedom. Some experts are concerned that a relaxation of involuntary commitment standards or other forms of coercion may result in appropriate treatment, particularly in less striking cases of mental disturbance. Mandated treatment and its frequent emphasis on medication discourage society from putting more resources into treatments that rely less on pills but may be more effective in the long run.

A Fairer Approach

Rather than allowing states to intervene in the lives of the mentally ill or expanding the rights of mentally ill persons to reject intervention, a middle ground might provide a more effective solution. In light of recent research, public policy may best be served if clinicians focus more intently on those most likely to be violent, instead of wasting their efforts on more harmless individuals.

We still need to sharpen our understanding of violent behavior and its relationship to mental illness. But what the public needs to realize is that not all mentally ill people are prone to acting out, shooting strangers or stalking family members. And the ones who are prone to violence may not be the people we might think. Recent studies have been valuable in reminding us that the cause and prevention of violence is not a simple issue. They question misconceptions that may push mental patients farther away from community life when what they often need is better integration with it.

Researchers may not be able to allay the public's fear that tragedy can randomly strike on a city street, subway platform or office elevator. Our hope, however, is that the developing body of knowledge will contribute to reducing outbreaks of violence, making the general public feel safer. In the process, the long-held stigma against the mentally ill may finally dissolve, allowing them to participate more fully in mainstream society.