Citation

Maden T. Psychiatry 2004; 3(11): 1-4.

Copyright

(Copyright © 2004, Medicine Publishing Company Ltd.)

DOI

10.1383/psyt.3.11.1.53590

PMID

unavailable

Abstract

Large-scale epidemiological studies of community samples have confirmed a small but significant association between violence and schizophrenia. As a result, mental health services have been forced to address the problem of managing this infrequent but important complication of mental disorder. A series of homicide inquiries generated media attention and probably helped to attract additional resources for mental health, but they have also been blamed for poor morale and recruitment difficulties in the professions. The National Confidential Inquiry into Homicides and Suicides by People with Mental Illness has shifted the focus away from individuals, and is producing guidance on developing safer services. The management of violence risk has enormous political importance for mental health services and it is critical to maintaining public confidence in the service, but the risk must be kept in proportion. Mentally disordered homicides account for a decreasing percentage of homicides over time, as other types continue to increase. Killings of strangers by the mentally disordered are extremely rare. The mentally ill are more likely to be victims of violence than perpetrators, and the risk of suicide in mental illness far exceeds the risk of violence.