A reassessment of the link between mental disorder and violent behaviour, and its implications for clinical practice.

OBJECTIVE AND METHOD

This review examines the central studies which, over the last decade, have investigated the association between mental illness and rates of violent behaviours. The clinical and public policy implications of such research is then examined.

RESULTS

Recent research appears to have established a modest association between having a mental illness and an increased propensity to violence.

CONCLUSIONS

The increased risk of violence is mediated, in part at least, by the active symptoms of illness. The most effective response to the risks of dangerous behaviour in the mentally ill is not to return to policies of greater control and containment but to improve the care, support and treatment delivered to patients in the community. Those at high risk need to be targeted for priority follow-up and intensive support. We need, as a profession, to become as aware of the risks in our patients of violence towards others as we currently are of the risks of suicidal behaviour. We also need to develop responses which effectively manage such patients, to their benefit and ultimately to the benefit of potential victims.