by Dr. Meenakshy Varier on  December 24, 2016 at 2:32 PM Health Watch
  • Certain indicators like homelessness and substance abuse, increase the risk of violence among the mentally ill.
  • These indicators can cause the person to become either a victim or a perpetrator of violence.

Mentally ill are at an increased risk of becoming victims or perpetrators of violence.

The study from North Carolina State University, RTI International, Arizona State University and Duke University Medical Center finds key indicators that are associated with this risk.
Risk of Violence Higher Among the Mentally Ill

"This work builds on an earlier study that found almost one-third of adults with mental illness are likely to be victims of violence within a six-month period," says Richard Van Dorn, a researcher at RTI and lead author of a paper describing the work.

"In this study, we addressed two fundamental questions: If someone is victimized, is he or she more likely to become violent? And if someone is violent, is he or she more likely to be victimized? The answer is yes, to both questions." Richard added.


For the study, database of 3,473 adults with mental illnesses was analyzed.

The researchers assessed the mental health and violence history at the beginning of the study and, then tracked each participant for up to 36 months.

Some key indicators that the researchers assessed as both indicators and outcomes of the participants being victims or perpetrators of violence are:
  • Being homeless
  • Being at an inpatient mental-health treatment facility
  • What the psychological symptoms of mental illness are
  • Substance use

The researchers found that indicators played a role as both the cause of violence as well as the effect of violence.

"We found that all of these indicators mattered, but often in different ways," says Sarah Desmarais, an associate professor of psychology at NC State and co-author of the paper. "For example, drug use was a leading indicator of committing violence, while alcohol use was a leading indicator of being a victim of violence."

The researchers also found that the affective symptoms was closely associated with violence.

Affective symptoms including anxiety, depressive symptoms and poor impulse control.

Someone was likely to both commit violence and be a victim of violence, if the affective symptoms were more pronounced.

It is important to treat the underlying mental illness that is associated with these affective symptoms.

Cascading Effect

The research also highlighted how one violent event could cascade over time.

Being a victim of violence triggered other effects, such as psychological symptoms, homelessness and becoming perpetrators of violence which in turn triggered other additional effects.

"It's a complex series of interactions that spirals over time, exacerbating substance use, mental-health problems and violent behavior," Van Dorn says.

"Investing in community-based mental health treatment programs would significantly reduce violent events in this population," says Desmarais.

"That would be more effective and efficient than waiting for people to either show up at emergency rooms in the midst of a mental-health crisis or become involved in the legal system as either victims or perpetrators of violence. We have treatments for all of these problems, we just need to make them available to the people that need them," Desmarais says.

The work highlights the importance of interventions to treat mental-health problems in order to reduce community violence and instances of mental-health crises.

The paper was published in the journal Psychological Medicine.


  1. Richard Van Dorn et al. Leading indicators of community-based violent events among adults with mental illness. Psychological Medicine; (2016) DOI:

Source: Medindia

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