Study shows increased symptoms lead mentally ill to become victims of violence

Contrary to common stereotypes, individuals with major mental disorders are more likely to become victims of violent crimes when they are experiencing an increase in symptoms than they are to commit crime, according to a new study by Brent Teasdale, an assistant professor of criminal justice at Georgia State University.

Teasdale found that patients experiencing delusions, hallucinations and generally worsening symptoms are most likely to become victims of violence. In addition, individuals with mental disorders are particularly vulnerable for victimization during times of homelessness and when suffering from alcohol abuse.

“They actually have higher rates of victimization than they have of violence commission, which I think is counter to the stereotype that highly symptomatic, obviously delusional, visibly mentally disordered people are dangerous, unpredictable and violent,” Teasdale said. “There’s no one size fits all approach to these delusions, but the odds of victimization are multiplied almost by a factor of two when a person experiences these delusions.”

Teasdale analyzed data from the MacArthur Violence Risk Assessment Study, a longitudinal study of psychiatric patients released from three psychiatric hospitals in Pittsburgh, Kansas City, Mo., and Worchester, Mass. During the MacArthur study, participants were interviewed every 10 weeks for one year about violence committed against them, stress, symptoms and social relationships.

When individuals with mental disorders experience increases in delusions, symptom severity and alcohol problems they may be more focused on their internal states and have fewer cognitive resources available to devote to interactions with other people, Teasdale said. Other research suggests that victimization happens because caretakers may be driven away, leaving the disordered unprotected.

“If the stigma is that those are people we need to protect ourselves from, one of the ways in which we might do that is self defensive violence. We might strike first and that would lead to the victimization of these folks,” Teasdale said. “If there’s a person that could intercede before that happens, that may be one strategy for reducing victimization risk.”

The findings of the study are important for clinicians who must pay attention to warning signs of worsening disorders as potential risk markers for violent behavior committed by their client, Teasdale said. They could also aid in the creation of assessment tools that focus on victimization risk and classes that better educate families about caring for the mentally ill.

Clinicians also could provide clients suggestions for reducing victimization risk when they notice patients exhibiting greater than usual symptoms, Teasdale said. For instance, during these times clinicians may recommend spending less time in public spaces, increases in guardianship or mandated community treatment programs.

“Most of us know people who have mental disorders. These are our family members and our friends and so we should care about their victimization experience,” Teasdale said. “The stereotypes persist because people are unaware of the victimization risk to people with mental illness. If they learned that victimization risk were higher than the violence commission rates, I think that would help alleviate some of that stigma and help people think about people with mental disorders in a different way.”

The study, “Mental Disorder and Violent Victimization,” was published in the 2009 edition of Criminal Justice and Behavior.

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Justice Department Reaches Settlement With Georgia Regarding State's Seven Psychiatric Hospitals

/PRNewswire-USNewswire/ -- The Justice Department announced Janaury 15 that it has reached a settlement with the State of Georgia regarding the conditions at Georgia's seven psychiatric hospitals. The Department opened its investigation of Georgia's psychiatric hospitals in 2007 and issued findings regarding Georgia Regional Hospital at Atlanta on May 30, 2008. The Department subsequently entered into negotiations regarding remedies the State was required to implement to correct unconstitutional conditions at all the hospitals. The other state facilities involved in today's settlement include: Georgia Regional Hospital at Savannah, Central State Hospital in Milledgeville, Southwestern State Hospital, East Central State Hospital, West Central State Hospital, and Northwest Georgia Regional Hospital at Rome.

"When a state undertakes to care for persons with mental illness and developmental disabilities, it accepts responsibility to protect them from harm," said Grace Chung Becker, Acting Assistant Attorney General for the Civil Rights Division. "The Department commends Governor Sonny Perdue, State Attorney General Thurbert Baker, and the Georgia Department of Human Resources for their willingness to work aggressively to address the conditions at these seven psychiatric hospitals. The leadership of the State in amicably resolving this matter has been paramount to today's exceptional result on behalf of the people of the State of Georgia. We are pleased that we have cooperatively achieved a settlement agreement that will benefit the lives of persons with mental health problems and developmental disabilities in Georgia's psychiatric hospitals."

Under the terms of the settlement agreement, the State will work to ensure that patients at the seven hospitals are safe and receive the care and services necessary to meet their individualized needs. Specifically, the State has agreed to undertake a variety of measures, including improving medical and mental health care and ensuring that patients are free from undue bodily restraint. The State will also improve discharge planning and ensure that each patient is served in the most integrated setting appropriate.

Today's settlement with the State of Georgia is the result of a cooperative effort by State entities and the Justice Department to reach a settlement that will make meaningful changes to improve the care and treatment of patients at Georgia's seven psychiatric hospitals. This Administration is firmly committed to the vigorous protection of the rights of persons with disabilities.

The Civil Rights Division is authorized to conduct investigations of public psychiatric hospitals under the Civil Rights of Institutionalized Persons Act (CRIPA). This statute allows the federal government to identify and root out systemic abuses such as those discovered in Georgia. The Civil Rights Division has successfully resolved similar investigations in other in-patient mental health facilities in the District of Columbia, Vermont, and California, among other states. The Civil Rights Division has open investigations of mental health facilities in Delaware, New Jersey, New York, North Carolina and Oregon.

CRIPA authorizes the Attorney General to investigate conditions in certain institutions owned or operated by, or on behalf of, state or local governments. These institutions include nursing homes, residential facilities serving people with mental or other developmental disabilities, mental health facilities, jails, prisons, and juvenile justice facilities.

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