A Critical Evaluation of Whether Mental Illness Has an Inherent Link to Violent Behaviour

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A critical evaluation of whether mental illness has an inherent link to violent behaviour This essay will aim to explore whether mental illness has an inherent link to violent behaviour. Specifically it will critically evaluate the literature surrounding this contention. A definition of both mental illness and Violence will be offered before outlining the conflicting understanding regarding the inherent link. The essay will conclude that the issue of an inherent link between mental illness and violence is a complex one. That when controlling for substance use and other factors such as gender, age, race/ethnicity, individual and neighbourhood socio-economic status (SES), physical and sexual abuse, stressful life events, impaired social support the influence of mental illness upon violent conduct is minimal. However, many of these factors influence both mental illness and violence irrespective of the presence of both, making it difficult to tease apart the contribution of any factor in the resultant expression of violent behaviour. In addition, offence and victim characteristics appear to be different for mentally ill offenders than non-mentally ill offenders. For example where violence takes place in those with active psychotic symptoms the likelihood is that they will offend against family and friends rather than the public at large. This directly contradicts the unhelpful public perception that there is an increased risk of general violence by those experiencing mental illness. Silver et al (2008) add to this by suggesting that the violent acts committed by the mentally ill are greater in severity than those committed by non-mentally ill individuals.

Violence has been defined by Glasser (1998) as ‘a bodily response with the intended infliction of bodily harm on another person’. Mental Illness/disorder includes those ‘major’ disorders of affect and thought which form a subgroup of Axis I disorders in the Diagnostic and Statistical manual of mental disorder (4th Edition: DSM-IV) (American Psychiatric Association 1994) The inclusion of Personality Disorder, (Psychopathic Disorder Classification) traditionally caused controversy, however as it’s treatment and management has been included in the recent revision of the Mental Health Act (1983) it will be included for discussion here and difficulties in its inclusion in research on mental illness and violence will be highlighted.

Research into the link between Mental Illness and Violence began in 1990 (Stuart 2003). Initially, it was thought that those with mental illness were no more likely to be violent than those without mental illness (Phelan & Link 1998) However, Taylor & Gunn (1999) analysed the records of 1241 men remanded in Briton prison and found that in the group charged with homicide just over a third were psychiatrically ‘abnormal’. 11% of these were Schizophrenic and patients who had been violent towards others without resulting fatality exceeded the researcher’s expectations by 22 times. However, the relationship between mental illness and violence is not clear; there are a variety of factors influencing these data, for example which types of disorders and differential degrees of violence and shared aetiological factors between mental illness and violent conduct. Indeed Silver et al (2008) state that ‘the main problem in studying the relationship between mental illness and violence is the strong possibility that the relationship is spurious, that many of the life circumstances and experiences that affect the likelihood of violence also affect the likelihood of mental illness.’

To demonstrate this point it is useful to acknowledge the observations of Swanson et al (1990) they conducted a survey to assess the violence rate in people with and without mental illness. They found that major mental disorders correlated with at least a fivefold increase in rates of violence over a 1 year period, compared with rates among individuals with no disorder. Despite this...
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