Hollywood and the general media have a morbid fascination with violence and mental illness, especially psychosis and “madness.” This fascination sells tickets, but it also maintains the stigma and negative image that society holds towards people with mental illness and schizophrenia.

Studies in Australia found that mentally disordered TV characters were 10 times more likely to be displayed as violent as compared to non-mentally disordered ones. Television has also influenced people to believe that having someone with a mental disorder as a neighbour, would endanger them.

This trend crosses the Atlantic where in the States, 75% of a survey believed that people with severe mental illness were dangerous.

But the question is… does schizophrenia deserve this bad reputation?

The answer is “yes” and “no”.

This same survey in the States found that severe mental disorders was associated with increased rates of violence (assault, sexual assault, arson) but that this was only significant when there was CO-OCCURRING substance misuse.

The strongest predictors of violence was largely the same as those without serious mental illness, namely young age, history of violence, male gender, history of juvenile detention, recent separation or divorce, history of physical abuse, parental criminal history, substance misuse and unemployment.

Other studies have linked other factors with mental disorders and violence. These include an antisocial lifestyle and attitude, poor compliance with medication, poor parental models and chaotic social life styles.

The take-home message and answer is that “yes”, schizophrenia and severe mental illness is linked with increased rates of violence but that these rates are not markedly elevated. The increased rates of violence amongst individuals with schizophrenia is not linked to the disease itself, but mostly due to comorbid substance abuse and other longstanding antisocial behaviour and attitudes.

Overall the incidence of violence in the general population is low and serious mental disorder increases the risk 3 times. In comparison having an alcohol and drug use disorder increases the risk 9 times. Having both serious mental disorder and an alcohol and drug use disorder increased the risk 13 times.

The stigma of schizophrenia will only be challenged when people are educated and informed. Schizophrenia is a surprisingly common disorder, affecting about 1 percent of the population, which means that an awfully large number of people are stigmatized, based largely on this “propensity to violence” But as seen in this article, violence in people with severe mental illness is caused mostly personality and social factors.

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