Combination of factors drive up danger, researchers say
By Carla K. Johnson, Associated Press
In the Pioneer Press, St Paul Minnesota
CHICAGO — A new large study challenges the idea that mental illness alone is a leading cause of violence.
Researchers instead blame a combination of factors, specifically substance abuse and a history of violent acts, that drives up the danger when combined with mental illness in what they call an “intricate link.”
People with serious mental illness, without other big risk factors, are no more violent than most people, according to the study of more than 34,000 U.S. adults. The research was released Monday in Archives of General Psychiatry.
“Mental illness can provide the knee-jerk explanation for the Virginia Tech shootings,” but it’s not a strong predictor of violence by itself, said lead author Eric Elbogen of the University of North Carolina at Chapel Hill School of Medicine.
Elbogen compiled a “top 10” list of things that predict violent behavior, based on the analysis.
Youth topped the list. History of violence came next, followed by male gender, history of juvenile detention, divorce or separation in the past year, history of physical abuse, parental criminal history and unemployment in the past year. Rounding out the list were severe mental illness with substance abuse and being a crime victim in the past year.
After the 2007 Virginia Tech killings by a student ordered to get psychiatric treatment, some states considered laws adding mental health questions to background checks for gun buyers or denying weapons to people who’ve been involuntarily committed for mental health treatment.
The new research, which bolsters other similar findings, raises questions about such laws, experts said. Such legislation may be both ineffective and discourage people who need help from getting treatment.
“We are being misled by our own fears,” said Columbia University psychiatry professor Dr. Paul Appelbaum, who wasn’t involved in the new study. “We ought to be concerned about providing good treatment and helping people lead fulfilling lives, not obsessed with protecting ourselves from phantom threats that appear to be unrelated to mental illness.”
U.S. systems to treat mental illness and substance abuse are separate, uncoordinated and could do a better job treating people with both problems, Appelbaum said.
For the new study, the researchers analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions. The original survey in 2001-2002 involved more than 43,000 face-to-face interviews with a representative sample of American adults. Three years later, many of the same people, more than 34,000, were interviewed again.
From the responses, the researchers determined what elements raised the risk of violent behavior.
There were 3,089 people deemed to have severe mental illness — schizophrenia, bipolar disorder and major depression — but no history of either violence or substance abuse. They reported very few violent acts, about 50, between interviews.
But when mental illness was combined with a history of violence and a history of substance abuse, as in about 1,600 people, the risk of future violence increased by a factor of 10. The relationship between mental illness and violence is there, “but it’s not as strong as people think,” Elbogen said.
