The MacArthur Community Violence Study
The Network realized that while the MacArthur Violence Risk Assessment Study might provide much new information about the risk of violence among released mental patients, as designed it would not be able to address another question of great relevance to mental health law and policy: How does the rate of violence by former mental patients compare with the rate of violence by other members of the community? To address this question, the Network designed the MacArthur Community Violence Risk Study as a supplement to its ongoing work.
In this research, approximately 500 adults from one of the three sites of the Violence Risk Assessment Study (Pittsburgh) were recruited as subjects. A stratified random sample of persons -- between the ages of 18 and 40, and of either white or African American ethnicity -- living in the same neighborhoods in which the former patients resided was obtained. Persons in the Community Violence Risk Study were interviewed once. The principal assessment instruments given to the patients were also administered to this general population sample, and the same questions about violence in the past 10 weeks asked of the patients were also asked here. Interviews with collaterals, usually family members, were obtained, and police record checks were made. Among the conclusions from this study are the following:
"People discharged from psychiatric hospitals" is not a homogeneous category regarding violence. People with a major mental disorder diagnosis and without a substance abuse diagnosis are involved in significantly less community violence than people with a co-occurring substance abuse diagnosis.
The prevalence of violence among people who have been discharged from a hospital and who do not have symptoms of substance abuse is about the same as the prevalence of violence among other people living in their communities who do not have symptoms of substance abuse.
The prevalence of violence is higher among people -- discharged psychiatric patients or non-patients -- who have symptoms of substance abuse. People who have been discharged from a psychiatric hospital are more likely than other people living in their communities to have symptoms of substance abuse.
The prevalence of violence among people who have been discharged from a psychiatric hospital and who have symptoms of substance abuse is significantly higher than the prevalence of violence among other people living in their communities who have symptoms of substance abuse, for the first several months after discharge.
Violence committed by people discharged from a hospital is very similar to violence committed by other people living in their communities in terms of type (i.e., hitting), target (i.e., family members), and location (i.e., at home).
Steadman, H., Mulvey, E., Monahan, J., Robbins, P., Appelbaum, P., Grisso, T., Roth, L., & Silver, E. (1998). Violence by people discharged from acute psychiatric inpatient facilities and by others in the same neighborhoods. Archives of General Psychiatry, 55, 393-401.
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