Victims Not Perpetrators

Being a victim of crime, particularly a violent crime is a serious and frightening matter and deserves to be investigated thoroughly.

There are however relatively few studies of mentally ill victims of crime in Britain – and the conclusions of these studies are contradictory.

Equal numbers of victims and perpetrators
Some of the best studies in Britain of mentally ill victims of crime come from a research trial of 700 psychotic patients (UK 700 group). Two studies in 2003 and 2007 found between 16 to 23% reported being a victim of violence.

However an earlier study of this same group of patients found almost exactly the same number (22%) were also perpetrators of violence.

So whilst 23% of psychotic patients said they were victims of violent crime, 22% were committing violent crime and had physically attacked another person.

The difference is statistically negligible.

Little evidence mental illness causes patients to be victimised.
And whilst some international studies appear to show high rates for people with mental illness to be victims of violent crime, there is little evidence this is related to their mental illness.

It’s not unusual for people with severe mental illness to live in poorer urban areas, to use street drugs, to be unemployed, and have problems living in settled accommodation. In such an environment people will arguably experience higher levels of violent crime than in the rest of the country – regardless of whether they have mental illness or not.

In these studies there is often no comparison or control for levels of violence experienced by people living in similar areas, with similar problems, but without co-existing severe mental illness.

No corroboration – self reports
Many studies of serious crime committed by the mentally ill can usually rely on a whole raft of police and criminal evidence, court reports and medical notes.

Much of the evidence for the mentally ill being victims of violence comes from personal interview with the patients themselves – the rate of violence experienced is self reported, and there is rarely any external corroboration.

Firmly held paranoid and persecutory thoughts are symptoms of some forms of severe psychosis, so it is not surprising that some members of this patient group will feel victimized regardless of the existing reality.

Without external confirmation it is difficult to assess how credible some of these claims of victimization may be in severely ill people.

No robust evidence on mentally ill homicide victims
The most extreme form of violence is murder. As yet there is currently no robust or definitive study of how many people with mental illness are victims of a homicide in Britain.

A Danish study in 2001 showed apparently high levels for the mentally ill to be at risk of homicide, though provided no information on the perpetrators, living environment, or circumstances of the homicide – nor of the homicide rate for comparable subjects living in the same areas but without mental illness.

A British study by the University of Manchester (NCISH) is currently underway.

Conclusions

Whilst mentally ill people undoubtedly do experience violence, there is currently little evidence this is directly related to their illness.

Rigorous studies have shown equal numbers of seriously ill people are both the victims and perpetrators of violence.

As there is no evidence yet on mentally ill victims of homicides, it is not accurate to say the mentally ill are more likely to be victims rather than perpetrators of serious violence.

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