Violence and Mental Illness

Published December 2019

The Psychiatric Services Editor’s Choice provides essential curated collections from recent issues of Psychiatric Services.  Each month, Editor Lisa Dixon and the Early Career Psychiatrist Advisory Committee offer a curated collection from the rich resource of articles published in the journal. Updates will focus on one area, summarizing for the researcher, clinician, and policy analyst the latest information and seminal research with links to specific content from Psychiatric Services.

The relationship between violence and mental illness, as understood by the general public, is fraught with misinformation. The complexity and emotional valence surrounding violence coupled with the stigma associated with mental illness demands sound research and thoughtful dialogue. In this month’s collection, we present several articles exploring the relationship between violence and mental illness. The first section describes two risk assessment models: the COVR (Classification of Violence Risk), which is an actuarial tool, and violence risk self-assessment. The next section focuses on gun violence, presenting a Viewpoint on mental illness and gun violence and underscoring the relatively low rates of gun violence among individuals with mental illness. The following sections are organized by site of violent behavior (on inpatient units or in the community) and reveal the unique challenges of characterizing and preventing violence in each setting. The final article in this collection highlights an intervention to reduce and perhaps prevent future violence by individuals with both mental illness and criminal justice involvement.

Please note that not all articles in this curated collection are available without a subscription. For access, learn about subscribing to Psychiatric Services.


Violent Behavior and Gender of Swedish Psychiatric Patients: A Prospective Clinical Study
Joakim Sturup, Ph.D., John Monahan, Ph.D., Marianne Kristiansson, Ph.D.
2013, Volume 64, Issue 7, pp. 688–693

The Utility of Patients’ Self-Perceptions of Violence Risk: Consider Asking the Person Who May Know Best
Jennifer L. Skeem, Ph.D., Sarah M. Manchak, Ph.D., Charles W. Lidz, Ph.D., Edward P. Mulvey, Ph.D.
2013, Volume 64, Issue 5, pp. 410–415

Gun Violence Following Inpatient Psychiatric Treatment: Offense Characteristics, Sources of Guns, and Number of Victims
Aaron J. Kivisto, Ph.D.
2017, Volume 68, Issue 10, pp. 1025–1031

Gun Violence and Victimization of Strangers by Persons With a Mental Illness: Data From the MacArthur Violence Risk Assessment Study
Henry J. Steadman, Ph.D., John Monahan, Ph.D., Debra A. Pinals, M.D., Roumen Vesselinov, Ph.D., Pamela Clark Robbins, B.A.
2015, Volume 66, Issue 11, pp. 1238–1241

Mental Illness and Gun Violence: Disrupting the Narrative
Emma E. McGinty, Ph.D., M.S.
2018, Volume 69, Issue 8, pp. 842–843

Extreme Risk Protection Orders to Reduce Firearm Violence
William Frizzell, M.D., and Joseph Chien, D.O.
2019, Volume 70, Issue 1, pp. 75–77

Use of Multimodal Technology to Identify Digital Correlates of Violence Among Inpatients With Serious Mental Illness: A Pilot Study
Dror Ben-Zeev, Ph.D., Emily A. Scherer, Ph.D., Rachel M. Brian, M.P.H., Lisa A. Mistler, M.D., Andrew T. Campbell, Ph.D., Rui Wang, M.S.
2017, Volume 68, Issue 10, pp. 1088–1092

Association Between Restriction of Involuntary Medication and Frequency of Coercive Measures and Violent Incidents
Erich Flammer, Dr.Biol.Hum., Tilman Steinert, Prof.Dr.Med.
2016, Volume 67, Issue 12, pp. 1315–1320

Relationship Between Seclusion and Restraint Reduction and Assaults in Pennsylvania’s Forensic Services Centers: 2001–2010
Gregory M. Smith, M.S., Donna M. Ashbridge, R.N., M.S., Aidan Altenor, Ph.D., William Steinmetz, B.S., Robert H. Davis, M.D., Phil Mader, B.S., Dale K. Adair, M.D.
2015, Volume 66, Issue 12, pp. 1326–1332

Injurious Assault Rates on Inpatient Psychiatric Units: Associations With Staffing by Registered Nurses and Other Nursing Personnel
Vincent S. Staggs, Ph.D.
2015, Volume 66, Issue 11, pp. 1162–1166

Correlation Between Reduction of Seclusion and Restraint and Assaults by Patients in Pennsylvania’s State Hospitals
Gregory M. Smith, M.S., Donna M. Ashbridge, M.S., R.N., Robert H. Davis, M.D., William Steinmetz, B.S.
2015, Volume 66, Issue 3, pp. 303–309

Use of Security Officers on Inpatient Psychiatry Units
Ryan E. Lawrence, M.D., M.Div., Maria M. Perez-Coste, M.D., Stan D. Arkow, M.D., Paul S. Appelbaum, M.D., Lisa B. Dixon, M.D., M.P.H.
2018, Volume 69, Issue 7, pp. 777–783

Violence to Others, Violent Self-Victimization, and Violent Victimization by Others Among Persons With a Mental Illness
John Monahan, Ph.D., Roumen Vesselinov, Ph.D., Pamela Clark Robbins, B.A., Paul S. Appelbaum, M.D.
2017, Volume 68, Issue 5, pp. 516–519

Proximal Risk Factors for Short-Term Community Violence Among Adults With Mental Illnesses
Kiersten L. Johnson, M.S., Sarah L. Desmarais, Ph.D., Kevin J. Grimm, Ph.D., Stephen J. Tueller, Ph.D., Marvin S. Swartz, M.D., & Richard A. Van Dorn, Ph.D.
2016, Volume 67, Issue 7, pp. 771–778

Prospective Study of Violence Risk Reduction by a Mental Health Court
Dale E. McNiel, Ph.D., Naomi Sadeh, Ph.D., Kevin L. Delucchi, Ph.D., Renée L. Binder, M.D.
2015, Volume 66, Issue 6, pp. 598–603


  • Was this Helpful ?
  • YesNo

Join our #MissionForBetter now

Sign up for our newsletter. We’ll let you know about new resources, education, and more.