"Policy planners and clinicians [and Non Profit supportive housing operators] 1 responsible for the treatment of patients with schizophrenia, organic brain syndrome and other nonaffective psychoses need to recognize the increased in risk these disorders confer for sex offending and for other forms of aggressive behaviour." 2
"Statistically speaking, the mentally ill are no more violent than members of the general public and are, in fact, five to six times more likely than the average person to be victims of violence because they are a vulnerable population."
This answer carefully evades the question because the answer refers to the mentally ill generally, not just the severely mentally ill (schizophrenia and other psychoses, bipolar disorder, or personality disorder.) Again there is a further evasion of the question with the deflecting statement "more likely than average person to be victims of violence because they are a vulnerable population."
The severely mentally ill are more likely to be in supportive housing than those who are not. Estimates vary from 25 to 75% 3 of the mentally ill in Vancouver are also drug addicts. Currently, in British Columbia, there are no secure medium or long term care facilities for the severely mentally ill who have episodes of aggression and violence towards themselves or others. After a short period in the local general hospital the severely mentally ill patient is discharged and usually returned to the referring service, which could mean, more than likely, your local supportive housing.
Are the severely mentally ill more likely to commit violent crimes than the general population? The short answer is yes. Throughout the past twenty years there is a growing body of evidence that you can read which clearly shows that the severely mentally ill do commit more crime. (see Further Reading below »).
In 2006, the American Journal of Psychiatry published an article by Fazel and Grann entitled "The Population Impact of Severe Mental Illness on Violent Crime." From the Swedish national registries 4 for all hospital admissions and criminal convictions, the authors collected, over 13 years all patients who were discharged from hospital with a diagnoses of severe mental illness (98,082) and "matched" it to the criminal convictions registry. From this they calculated the proportion of violent crimes 5 in the whole population that could be attributed to patients with a severe mental illness.
"The number of individuals with severe mental illness who committed at least one violent crime over the time period was 6510. Therefore, all patients with severe mental illness 6.6% had a violence conviction. This compared with 103,421 individuals, or 1.8% of the general population, who had a violence conviction." 6
"The contribution of female patients with severe mental illness to violent crime in Sweden was very small." 7
"Overall, the population attributable risk fraction (the proportion of violent crimes that can be attributed to individuals with mental illness) was 5%, suggesting that patients with severe mental illness commit 1 in 20 violent crimes." 8
In November 2007, Alden et al published in the Archives of General Psychiatry "Psychotic Disorders and Sex Offending in a Danish Birth Cohort." This was the first study to examine the rate of sex offending comparing psychotic disorders (schizophrenia, organic brain disorder, affective psychosis and other psychoses) with the general population. The Danish study included all individuals born in Denmark between Jan 1944 and Dec 1947: 358,180 persons (173,559 men).
"Men who had been hospitalized with a psychotic disorder at least once by the middle of their fifth decade of life, compared with those who had never been hospitalized, were almost 4 times more likely to have been arrested for any sexual offense, 4 times more likely to be arrested for any sexual offense and for physically aggressive sexual offenses 9and three times more likely to have been arrested for a non-physically aggressive sexual offense." 10, 11
"Psychotic disorders not accompanied by a PD [personality disorder] or an SUD [substance use disorder, addiction] were not associated with an increased risk of arrest for offenses involving any sexual offense and for physically aggressive sexual offenses. The presence of a PD [personality disorder] or an SUD [addiction] significantly increased the risk of arrest for any sexual offense and for physically aggressive sexual offenses and non aggressive sexual offenses." 12
"This finding is consistent with evidence from studies that show an increase prevalence of violent crime among men with psychotic disorders compared with the general population where they live." 13
"... the few example reports suggest that clinical practice is based on the presumption that treating the psychotic illness will prevent further sex offending. The findings of the present investigation indicate that this may be a faulty assumption." 14
"Policy planners and clinicians [and Non Profit supportive housing operators] responsible for the treatment of patients with schizophrenia, organic brain syndrome and other nonaffective psychoses need to recognize the increased in risk these disorders confer for sex offending and for other forms of aggressive behaviour." 15
- Are you housing or planning to house anyone with a history, past or present of addiction, substance misuse, aggression, violence or criminality?
- How often have the patients housed in the apartment been hospitalized? (Hospitalizations in men have been shown to be a risk factor for violent offending.)
- Are there any patients with personality disorders and schizophrenia or concurrent disorders (dual diagnosis, mentally ill drug addict)? These combinations of mentally illnesses and/or addiction have been shown to have greater arrests rates for sex offenses and violence. How many are there in the supportive housing building?
- What specific proven effective steps and supports are you, the Non Profit provider of the supportive housing doing to mitigate the risks to the surrounding neighbourhood? Where’s your evidence of effectiveness?
Published March 10, 2008.