Violence and Mental Illness

Question 1

are the mentally ill more violent on a population level

Answer 1

Large scale meta-analyses have shown that even categorizing individuals at “high risk” of violence had very little effects of predicting violence on a population level. One study demonstrated that to prevent one homicide, 35,000 “high-risk” schizophrenia patients would need to be detained

Question 2

list biological factors that can increase an individual’s risk for violence

Answer 2

male gender

temperament/IMPULSIVITY

family history of violence

Question 3

list psychological factors that can increase an individual’s risk for violence

Answer 3

antisocial attitudes

poor problem solving approaches

Question 4

list social factors that can increase an individual’s risk for violence

Answer 4

poor parent-child relations

poor social learning or antisocial behaviour

victimization in childhood

Question 5

what are the top 3 factors implicated in those who have a higher risk of violence compared with the general population

Answer 5

1. SEVERE mental illness
2. SUBSTANCE use and/or dependence
3. a PAST HISTORY of violence

severe mental illness alone does not predict risk of violence… those who have all THREE risk factors are at distinctly higher average risk of violence

Question 6

list factors that have been shown to be predictors of violent behaviour in the INPATIENT setting

Answer 6

young age

male sex

hx psychiatric illness

comorbid substance use

+ sx psychotic disorder

Question 7

what is a structured tool to assess violence risk in the clinical setting

Answer 7

Historical Clinical Risk Management - 20 (HCR-20)

allows clinicians to define static and dynamic risk factors for violence

is validated for adults above 18