Article

Perpetration of violence, violent victimization, and severe mental illness: Balancing public health concerns

Psycho-Legal Studies Program, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
Psychiatric Services (Impact Factor: 1.99). 03/2008; 59(2):153-64. DOI: 10.1176/appi.ps.59.2.153
Source: PubMed

ABSTRACT This review examined U.S. empirical studies published since 1990 of the perpetration of violence and of violent victimization among persons with severe mental illness and their relative importance as public health concerns.
MEDLINE, PsycINFO, and Web of Science were searched for published empirical investigations of recent prevalence or incidence of perpetration or victimization among persons with severe mental illness. Studies of special populations were included if separate rates were reported for persons with and without severe mental illness.
The search yielded 31 studies of violence perpetration and ten studies of violent victimization. Few examined perpetration and victimization in the same sample. Prevalence rates varied by sample type and time frame (recall period). Half of the studies of perpetration examined inpatients; of these, about half sampled only committed inpatients, whose rates of perpetration (17%-50%) were higher than those of other samples. Among outpatients, 2% to 13% had perpetrated violence in the past six months to three years, compared with 20% to 34% who had been violently victimized. Studies combining outpatients and inpatients reported that 12% to 22% had perpetrated violence in the past six to 18 months, compared with 35% who had been a victim in the past year.
Perpetration of violence and violent victimization are more common among persons with severe mental illness than in the general population. Victimization is a greater public health concern than perpetration. Ironically, the discipline's focus on perpetration among inpatients may contribute to negative stereotypes.

0 Bookmarks
 · 
161 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: To examine the relationship between psychiatric disorders and violence in delinquent youth after detention. The Northwestern Juvenile Project is a longitudinal study of youth from the Cook County Juvenile Temporary Detention Center (Chicago, Illinois). Violence and psychiatric disorders were assessed via self-report in 1,659 youth (56% African American, 28% Hispanic, 36% female, aged 13-25 years) interviewed up to 4 times between 3 and 5 years after detention. Using generalized estimating equations and logistic regression, we examined the following: the prevalence of violence 3 and 5 years after detention; the contemporaneous relationships between psychiatric disorders and violence as youth age; and whether the presence of a psychiatric disorder predicts subsequent violence. Rates of any violence decreased between 3 and 5 years after detention, from 35% to 21% (males), and from 20% to 17% (females). There was a contemporaneous relationship between disorder and violence. Compared to the group with no disorder, males and females with any disorder had greater odds of any violence (adjusted odds ratio [AOR] = 3.0, 95% CI = 1.9-4.7, and AOR = 4.4, 95% CI = 3.0-6.3, respectively). All specific disorders were associated contemporaneously with violence, except for major depressive disorder/dysthymia among males. Substance use disorders predicted subsequent violence. Males with other drug use disorder and females with marijuana use disorder 3 years after detention had greater odds of any violence 2 years later (AOR = 3.4, 95% CI = 1.4-8.2, and AOR = 2.0, 95% CI = 1.1-3.8, respectively). Aside from substance use disorders, the psychiatric disorders studied may not be useful markers of subsequent violence. Violence assessment and reduction must be key components of ongoing psychiatric services for high-risk youth. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
    Journal of the American Academy of Child & Adolescent Psychiatry 01/2015; 54(4). DOI:10.1016/j.jaac.2015.01.002 · 6.35 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose - Institutional staff encounter juveniles with complex problems (externalizing and internalizing) which calls for adequate formal education/training and professional experience to deliver quality treatment, contributing to an effective organization and increasing public value. The purpose of this paper is to investigate staff's formal education, professional experience and the institutions' organizational strategies providing knowledge and clinical training to staff. Design/methodology/approach - The study includes staff questionnaires from eight wards (n=102). In addition, 39 in-depth interviews were conducted with management and staff members. Findings - Results show that institutions lack clearly defined target groups, 70 percent of staff members lack college education, 30 percent has never been offered education within the organization, and the vast majority of staff does not feel competent in performing their daily work. Practical implications - The results from this study shed light on an overlooked area in institutions, detention centers and prison settings, and are important to policy makers and governmental organizations responsible for coercive care of juveniles. Originality/value - Unlike previous studies, treatment and detention organizations are emphasized as similar to manufacturing industry and profit organizations, and the results are discussed with departure in organizational theory.
    International Journal of Prisoner Health 11/2014; 10(4):239-251. DOI:10.1108/IJPH-04-2013-0018
  • [Show abstract] [Hide abstract]
    ABSTRACT: Four assumptions frequently arise in the aftermath of mass shootings in the United States: (1) that mental illness causes gun violence, (2) that psychiatric diagnosis can predict gun crime, (3) that shootings represent the deranged acts of mentally ill loners, and (4) that gun control "won't prevent" another Newtown (Connecticut school mass shooting). Each of these statements is certainly true in particular instances. Yet, as we show, notions of mental illness that emerge in relation to mass shootings frequently reflect larger cultural stereotypes and anxieties about matters such as race/ethnicity, social class, and politics. These issues become obscured when mass shootings come to stand in for all gun crime, and when "mentally ill" ceases to be a medical designation and becomes a sign of violent threat. (Am J Public Health. Published online ahead of print December 12, 2014: e1-e10. doi:10.2105/AJPH.2014.302242).
    American Journal of Public Health 12/2014; 105(2):e1-e10. DOI:10.2105/AJPH.2014.302242 · 4.23 Impact Factor