Incidents of public violence can leave anyone feeling vulnerable, and it’s natural to try to make sense of seemingly senseless acts. Oftentimes, news stories suggest that those who commit crimes have mental illnesses. As the narrative goes, those mental illnesses are the underlying factor in acts of violence. To further confuse the issue, some studies indicate that people with mental illnesses are three to five times more likely to become violent than members of the general public. What really is the nature of the relationship, if any, between violence and mental health?
Facts About Violence and Mental Illness
Taken out of context, the above statistic can be troubling. However, it’s important to understand how these studies define violence, as well as where these acts of violence take place. Violence, for instance, refers to any action that hurts or could potentially hurt another person, such as hitting, kicking, shoving or threatening to cause harm. In most cases, violent behavior is aimed at friends or family and takes place in the individual’s home. Very rarely does this behavior involve strangers in public places.
One of the most reliable predictors of whether an individual is likely to commit an act of violence is whether they have a history of violence, regardless of their mental health status. Drug and alcohol use are also among the top contributors to violent behavior.
The truth is that statistically, those living with mental illnesses are far more likely to be victims of acts of violence rather than perpetrators. According to current research, those with major mental illnesses are about 2.5 times more likely to be victims of violence than someone without a mental illness. This is especially true if substance use, poverty and housing instability are factors.
Thinking of people with mental illnesses as dangers to society is not only inaccurate, it can expose those living with mental disorders to more acts of violence. While there are some mental illnesses that are more likely to be characterized by violent tendencies, robust treatment can help the individual gain more control and reduce the likelihood of them acting on dangerous impulses.
How Tragic Events Put the Focus on Mental Health
Taking an assault weapon into a school, shopping mall or movie theater with the intention of harming as many individuals as possible is unthinkable for most people. It makes sense to believe that those who commit these acts must have a mental illness that’s causing them to behave in such a way.
Attributing mass shootings to mental illnesses provides an easy explanation along with a seemingly clear solution: address mental health issues in a meaningful way, and the country can stop reading about new instances of gun violence week after week.
Unfortunately, the reasons behind public acts of violence are far more complex, and while there may be certain common denominators, mental illness isn’t one of them. In 2021, the Columbia University Department of Psychiatry conducted a study that looked at 1,315 mass murders from all over the world. The study found that despite preconceived ideas regarding violence and mental illness, only 11 percent of all mass murders and eight percent of mass shooters had mental illnesses. Among mass shooters in the United States, individuals were more likely to misuse drugs and alcohol, have a history of being victims of abuse or have a history of legal issues than to have a serious mental illness.
When commenting on the study, Dr. Gary Brucato, one of the study’s lead researchers, said, “The findings from this potentially definitive study suggest that emphasis on serious mental illness, such as schizophrenia or psychotic mood disorders, as a risk factor for mass shootings is given undue emphasis, leading to public fear and stigmatization.”
In fact, when researchers control for variables such as economic stability, stress, substance use and legal history, the rate of mass murders among those with mental illnesses is about the same as those without a mental illness.
The Dangers of Attributing Crime and Violence to Mental Illness
Putting resources towards mental health services and having screening tools in place to help identify individuals with mental illnesses and get them the care they need is essential for strong communities. However, there isn’t a substantial connection between mental illness and violence.
There are many stigmas surrounding mental health disorders, and misconceptions regarding causes, symptoms and dangers to public safety are prevalent. According to one group of researchers who looked at studies published since 1990, 31 studies focused on those with severe mental illnesses as being perpetrators of violence. Only 10 studies focused on those with mental illnesses being victims of violent acts.
It’s important to combat misperceptions regarding mental illness and crime, as misconceptions can have a direct impact on how society treats those with mental health disorders. Regarding people with mental illnesses as dangerous reduces support for community-based mental health care initiatives that could have a positive impact.
Do Certain Disorders Make You More Violent?
In general, those with mental illnesses don’t pose a danger to society. However, there is research to indicate that those with serious mental illnesses such as major depressive disorder, schizoaffective disorder and schizophrenia are slightly more likely than members without mental illnesses to commit violent acts.
One study conducted by Richard A. Van Dorn, PhD, and colleagues found that out of a sample of 34,653 people, 2.9 percent of people with serious mental illnesses committed acts of violence between two and four years following the study’s baseline. By comparison, 0.8 percent of those without a mental illness committed a violent act. More significantly, 10 percent of those who had a serious mental health disorder and a substance use disorder committed a violent act.
The most important takeaway from the study may be that when someone with a mental health disorder commits an act of violence, there are generally other factors at play. Co-occurring substance use, in particular, is a key factor in whether the individual will display violence or aggression.
Some studies observed that violent tendencies were more common in those who experienced command hallucinations (auditory hallucinations that instructed the individual to harm someone) or psychopathy (characterized by poor impulse control and a lack of empathy). However, other factors were just as likely to contribute to violence, such as whether the individual had been abused as a child or if they had a parent with a substance use disorder.
Grandiosity, which is a key trait for those with bipolar disorder, can contribute to acts of violence. Those living with this condition may be excited by their own sense of power, and they may be unable to empathize with others. This may cause them to have violent outbursts. Antisocial personality traits such as deceitfulness and disregard for others can also lead to violent acts.
When it comes to how much more likely a person with a mental health disorder is to commit an act of violence, current research is a mixed bag. Some studies find significant links between mental health and violence while others show no connection at all. Ultimately, it’s important to remember that a diagnosis isn’t enough to tell whether someone is likely to act in a violent way. Factors such as substance use disorder, economic instability and high stress levels are better predictors of violence.
Promoting Access to Mental Health Services
Mental illnesses are complex, but most people see a significant improvement in their symptoms with regular treatment. For example, among people with schizophrenia, those who took antipsychotics as prescribed were less likely to be violent than those not receiving treatment.
Research also shows that robust community-based treatment and prevention programs reduce the likelihood of future violent acts among those with a history of violence. Correcting misconceptions is an important step to take in creating safer environments both for those with mental illnesses and those without.