Mental illness and violence...What does the data say?

Photo credit: New York Times

Photo credit: New York Times

When incidents such as yesterday’s school shooting in Florida occur, I’m sick and tired of the immediate calls for more gun control as well as the insinuation that mental illness is to blame. When we perpetuate the idea that mental illness is a root cause of the violence in schools we do children and adults with mental illness and their families a disservice.

It feels like our society is looking for a quick and easy solution that allows us to maintain our denial of the root cause of the violence that has visited our schools with alarming frequency.

As church leaders, we have a responsibility to speak with integrity regarding what she know to be true from the available research.

I was asked by one of our local Christian stations to come on the air specifically to discuss the relationship between mental illness and violence. I did a literature search to examine the research on the topic, and put together some key takeaway points based upon my findings…

  • The available research suggests that persons with mental illness are two to three times more likely to exhibit violent behavior than those without mental illness, but the vast majority (93-98%) never become violent.
  • In one large study, 2.9% of persons with serious mental illness alone committed violent acts in a year, compared with 0.8% of people with no mental disorders or substance abuse. Persons with cooccurring substance use disorder and serious mental illness had a higher rate of violence (10.0%)
  • Mental illness and violence are related primarily through the accumulation of multiple risk factors – historical (past violence, juvenile detention, physical abuse, parental arrest record), clinical (substance abuse, perceived threats), dispositional (young, male) and contextual (recent divorce, unemployment, victimization) among the mentally ill.
  • One large study of adult psychiatric outpatients with serious mental illness being served in the public mental health system without a history of violent victimization or exposure to neighborhood violence who were not abusing drugs or alcohol, had annual rates of violent behavior similar to the general population without mental illness – about 2%.
  • Mental illness is strongly associated not with an increased risk of homicide, but with an increased risk of suicide. Each year approximately 32,000 people in the U.S. are killed with guns-about 19,000 of them by their own hand.
  • A huge disconnect exists between public perception and reality regarding the risk of violent behavior related to mental illness. A 2013 national public opinion survey found that 46% of Americans believed that persons with serious mental illness were “far more dangerous than the general population.”
  • Psychiatrists lack the ability to accurately predict which of their patients will become violent. One study examining psychiatrists’ predictions of violence based on clinical assessments performed in emergency rooms demonstrated they were only slightly more accurate than flipping a coin and no better than chance in predicting violence in female patients. In order to prevent one stranger homicide, 35,000 patients with schizophrenia judged to be at high risk of violence would need to be detained.

The bottom line…If we could eradicate all mental illness, we would reduce acts of violence by approximately 4%. 96% of the violence that currently occurs in the general population would continue to occur.

If you’re interested in reading further on the topic of mental illness and violence, the two best review articles I found were this paper from Dr. Jeffrey Swanson of Duke University and a more concise review published in 2016 in the Journal of Epidemiology and Community Health.



Interested in being part of a book study led by Dr. Grcevich on  Mental Health and the Church:  A Ministry Handbook for Including Children and Adults with ADHD, Anxiety, Mood Disorders, and Other Common Mental Health Conditions?

Beginning February 20th, he’ll be posting daily discussion questions, sharing interesting links and resources and, from time to time, interactive video chats. To join this free (but closed) Facebook group, type “Mental Health and the Church Study Group” in your Facebook search box, ask to join the group and answer the two questions about why you want to join.

Mental Health and the Church is available now at AmazonBarnes and Noble, ChristianBook and other fine retailers everywhere.