Dallas Morning News:
Association Between Violence, Mental Illness Disputed
By Tom Siegfried and Sue Goetinck
When an ex-mental patient commits a crime, headline writers
News accounts rarely say if a murder suspect has diabetes or
cancer, is a vegetarian or Episcopalian. But any sign of mental
illness - say, a bottle of antidepressants in the Unabomber
suspects cabin - jumps to the top of the story.
High-profile crimes involving mental patients - from John
Hinckleys attempted assassination of President Ronald Reagan in
1981 to the murder of two nuns this year in Maine - reinforce the
notion that mental illness equals violence.
But some studies show that people with mental illness are no
more violent than people in general. And studies that do show an
elevated risk of violence find an increase no greater than the
difference in violent tendencies between men and women, or
teen-agers and adults.
"If you want to protect yourself from violence, you would
do just as well to avoid men and teenagers as you would to avoid
people with mental illness," says Bruce Link, a psychiatric
epidemiologist at the Columbia University School of Public Health
in New York.
Drug and alcohol abuse are much more likely than other mental
illnesses to be linked with violence, new data indicate.
Furthermore, research shows that aggressive community
treatment-prevention programs result in low repeat offense rates
for mental patients who do commit crimes. Such programs require
additional funds for social service agencies up front, but far
less than the money spent to process repeat offenders through the
criminal justice system, says psychologist Sheilagh Hodgins.
"Mental health professionals do know what to do in order
to prevent violence, but they have to have the resources to be
able to do that," she says.
Yet, mental health advocates say, the misperception of the
mentally ill as violent and dangerous diminishes support for such
"There's only so much of the social service pie, and the
stigma and misunderstanding about mental illnesses...enables a
lot of neglect," says Michael Faenza, president of the
National Mental Health Association, based in Alexandria, Va.
Impressions from headlines contribute to the stigma and
neglect, Faenza believes. But research tells a different story,
showing that major mental illnesses add little to the nations
"Mental illness is a very small contributor to overall
levels of violence," Link said in Baltimore at a recent
meeting of the American Association for the Advancement of
Science. "It is sensationalized and vastly overemphasized in
Link and colleagues recently conducted a large-scale study of
mental disorders and violent behavior in Israel. Nearly 5,000
citizens were interviewed to determine psychiatric data and the
incidence of violence. The findings there were similar to those
in a previous study in urban areas of the United States: Somewhat
higher rates of violent behavior, such as fights or weapon use,
among people who have been treated for or diagnosed with mental
The study found rates of such violence for people with mental
illness to be about three to four times the rate for people
"I have a concern that findings like that can be taken as
ammunition for people who want to stigmatize or reject people
with mental illness," Link said.
"The point is that three to four times higher is similar
to how much higher men are than women, or how much higher
18-year-olds than 50-year-olds. So it's not a rational basis for
rejecting or discriminating against people with mental
The elevated level of violence, Links research suggests,
occurs mainly in a subset of patients, those with symptoms
involving feelings of threat or loss of self-control.
"Believing that others are out to harm you - or the
experience of having your mind controlled by external
forces...are the types of symptoms that will lead to
violence," he said.
"If you believe others intend to harm you, you may act on
that belief in such a way that you initiate violence."
©1996, Dallas Morning News
Modified December 25, 2002