Underscoring the importance of mental health, a Swedish study finds that the mentally ill are 5X more likely to be victims of homicide. As with every other health risk, the poor carry the heaviest burden.
As the editorial in the same issue notes
“Popular media reporting portrays mental illness as posing a threat to the safety of others, and these continual stigmatising portrayals may make the violent victimisation of an already marginalised section of society more likely. These new research findings therefore deserve to be disseminated widely, so that professional groups and agencies working in mental health, as well as the media and general public, are aware that mentally ill people are at increased risk of becoming victims of someone else’s violence.”
Mental disorders and vulnerability to homicidal death: Swedish nationwide cohort study
Objective To determine the risk of people with mental disorders being victims of homicide.
Results 615 homicidal deaths occurred in 54.4 million person years of follow-up. Mortality rates due to homicide (per 100 000 person years) were 2.8 among people with mental disorders compared with 1.1 in the general population. After adjustment for sociodemographic confounders, any mental disorder was associated with a 4.9-fold (95% confidence interval 4.0 to 6.0) risk of homicidal death, relative to people without mental disorders. Strong associations were found irrespective of age, sex, or other sociodemographic characteristics. Although the risk of homicidal death was highest among people with substance use disorders (approximately ninefold), the risk was also increased among those with personality disorders (3.2-fold), depression (2.6-fold), anxiety disorders (2.2-fold), or schizophrenia (1.8-fold) and did not seem to be explained by comorbid substance use. Sociodemographic risk factors included male sex, being unmarried, and low socioeconomic status.
Conclusions In this large cohort study, people with mental disorders, including those with substance use disorders, personality disorders, depression, anxiety disorders, or schizophrenia, had greatly increased risks of homicidal death. Interventions to reduce violent death among people with mental disorders should tackle victimisation and homicidal death in addition to suicide and accidents, which share common risk factors.