VIOLENCE BY PEOPLE DISCHARGED FROM ACUTE PSYCHIATRIC INPATIENT FACILITIES AND BY OTHERS IN THE SAME NEIGHBORHOODS

Background: The public perception that mental disorder is strongly ass ociated with violence drives both legal policy leg, civil commitment) and social practice leg, stigma) toward people with mental disorders. This study describes and characterizes the prevalence of community vio lence in a sample of people discharged from acute psychiatric faciliti es at 3 sites. At one site, a comparison group of other residents in t he same neighborhoods was also assessed. Methods: We enrolled 1136 mal e and female patients with mental disorders between the ages of 18 and 40 years in a study that monitored violence to others every 10 weeks during their first year after discharge from the hospital. Patient sel f-reports were augmented by reports from collateral informants and by police and hospital records. The comparison group consisted of 519 peo ple living in the neighborhoods in which the patients resided after ho spital discharge. They were interviewed once about violence in the pas t 10 weeks. Results: There was no significant difference between the p revalence of violence by patients without symptoms of substance abuse and the prevalence of violence by others living in the same neighborho ods who were also without symptoms of substance abuse. Substance abuse symptoms significantly raised the rate of violence in both the patien t and the comparison groups, and a higher portion of patients than of others in their neighborhoods reported symptoms of substance abuse. Vi olence in both patient and comparison groups was most frequently targe ted at family members and friends, and most often took place at home. Conclusions: ''Discharged mental patients'' do not form a homogeneous group in relation to violence in the community. The prevalence of comm unity violence by people discharged from acute psychiatric facilities varies considerably according to diagnosis and, particularly, cooccurr ing substance abuse diagnosis or symptoms.