Conflict places the mentally ill at risk of harm

September 18, 2002

Individuals with serious mental disorders have an increased chance of becoming victims of violence because their relationships with others are more likely to provoke conflict, according to a Penn State criminologist.

"The risk of victimization was found to be particularly strong when mental dysfunction was accompanied by illegal drug use," says Dr. Eric Silver, assistant professor of crime, law and justice and sociology.

"People with serious mental disorders, particularly those experiencing delusional beliefs or hallucinations, or those with substance abuse disorders, tend to arouse negative responses from those around them, even among family members and friends. This is because persons with mental disorders often lack social graces while they engage in conduct that appears crude, bizarre or even threatening to others," Silver notes.

Those around them frequently interpret their behavior as offensive when it is not meant to be, and respond by taking control measures that may lead to arguments, and sometimes to violence, he adds.

The situation may be exacerbated by the fact that threatened or actual violent encounters often cause mentally disordered people to be avoided or rejected by others. This reduces the odds that these individuals will enjoy the social buffer of capable, caring guardianship and places them at even more serious risk of confrontation and victimization.

"My study points to a critical need for persons interacting with the mentally ill to develop skills or competencies in dealing with them," Silver adds. "Counseling services could teach managerial techniques to family members, friends, neighbors and even members of the medical and criminal justice professions. The ultimate objective is to help families, caretakers and others to cope with the mentally disordered individual while at the same time avoiding conflicts with them that may lead to victimization."

Silver is author of the paper, "Mental Disorder and Violent Victimization: The Mediating Role of Involvement in Conflicted Social Relationships," which appeared in a recent issue of the journal Criminology. The Penn State researcher is one of the few criminologists whose ongoing research focuses on the victimization of the mentally ill.

Using the MacArthur Foundation's 1992-95 Violent Risk Assessment Study, Silver collected data from a survey group of 270 psychiatric patients discharged from the Western Psychiatric Institute and Clinic in Pittsburgh. He also interviewed a sample of 477 family members, significant others, friends, acquaintances, coworkers, neighbors and professional staffers from the neighborhoods into which the patients had been released. Silver's analysis concentrated on the first 10 weeks after the release of each patient and tracked all records of hospital readmissions and criminal arrests.

To take part in the study, patients had to be diagnosed with one of the following types of major mental disorders: schizophrenia, depression, mania, psychosis, delusions, substance abuse disorder or personality disorder.

"Deeds of violence committed by study participants included acts of battery that resulted in physical injury, sexual assaults, assaultive acts that involved the use of a weapon and threats made with a weapon in hand," Silver says.

"During the first 10 weeks, 7 percent of the subjects reported having been hit or beaten up; 3 percent reported having been forced to have sex; and 2 percent reported having been threatened or attack with a knife or gun," says Silver, a member of the National Science Foundation's National Consortium on Violence Research and senior data analyst for the Violence Risk Assessment Study. He also is a research associate of Penn State's Population Research Institute
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Penn State

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