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Deinstitutionalization and the rise of violence

Published online by Cambridge University Press:  16 February 2015

E. Fuller Torrey
E. Fuller Torrey*
Affiliation:
Department of Psychiatry, Uniformed Services University of the Health Sciences (USUHS), Bethesda, Maryland, USA; Stanley Medical Research Institute, Chevy Chase, Maryland, USA
*
*Address for correspondence, Dr. E. Fuller Torrey, Stanley Medical Research Institute, 8401 Connecticut Ave #200, Chevy Chase, MD 20815, USA. (Email: torreyf@stanleyresearch.org)
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Abstract

The deinstitutionalization of individuals with serious mental illness was driven by 4 factors: public revelations regarding the state of public mental hospitals, the introduction of antipsychotic medications, the introduction of federal programs to fund patients who had been discharged, and civil libertarian lawyers. The result is approximately 3.2 million individuals with untreated serious mental illness living in the community. Beginning in the 1970s in the United States, there began to be reported increasing incidents of violent behavior, including homicides, committed by these untreated individuals. Such incidents became more numerous in the 1980s and 1990s, and have further increased since the turn of the century. Existing studies suggest that individuals with untreated severe mental illness are responsible for at least 10% of all homicides and approximately half of all mass killings. Studies have also shown that when these individuals are treated, the incidence of violent behavior decreases significantly. Examples of treatment mechanisms that have proven effective include assisted outpatient treatment (AOT), conditional release, and mental health courts.

Keywords

Deinstitutionalizationmental illnessschizophreniatreatmentviolence
Type
Review Articles
Information
CNS Spectrums , Volume 20 , Special Issue 3: Violence in the Psychiatric Setting , June 2015 , pp. 207 - 214
Copyright
© Cambridge University Press 2015 

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