Mental Illness and Violence Study

A recent study by Elbogen EB, Johnson SC (2009) called, “The intricate link between violence and mental disorder: results from the national epidemiologic survey on alcohol and related conditions” in the Archives of General Psychiatry purported to show, serious mental illness ”alone was not statistically related to future violence in bivariate or multivariate analyses.”Like with the Study, McArthur Foundation: Violence and mental illness the results were skewed by methodological flaws. The issue is important because some are using these studies to promote a belief that serious mental illness is not related to violence. This is belied by the large numbers of mentally ill in prisons and jail.

Richard Van Dorn, Phd, Jan Volavka and Norman Johnson reanalyzed the data used by Elbogen and Johnson with a focus on causal relationships between serious mental illness and violence, rather than the statistical prediction of violence. Their study was called, “Mental disorder and violence: is there a relationship beyond substance use?” and was published by Soc Psychiatry Psychiatr Epidemiol DOI 10.1007/s00127-011-0356-x It showed there is a connection between serious mental illness and violence”


Those with serious mental illness, irrespective of substance abuse status, were significantly more likely to be violent than those with no mental or substance use disorders. This finding held in both bivariate and multivariable models. Those with comorbid mental and substance use disorders had the highest risk of violence. Historical and current conditions were also associated with violence, including childhood abuse and neglect, household antisocial behavior, binge drinking and stressful life events.


These results, in contrast to a recently published report, show that the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) data are consistent with the consensus view on mental disorder and violence: there is a statistically significant, yet modest relationship between SMI (within 12 months) and violence, and a stronger relationship between serious mental illness with substance use disorder and violence. These results also highlight the importance of premorbid conditions, and other contemporaneous clinical factors, in violent behavior.

Complete Study: PDF of Mental Illness and Violence