Can Treatment Prevent Violence?

While findings from the CATIE study on violence cannot be disputed—3 percent to 6 percent of people with schizophrenia in the sample engaged in serious violence in the six months before a baseline interview (see article above)—the issue of how those findings should be applied to people with serious mental illness is a divisive one.

Treatment Advocacy Center Director Mary Zdanowicz, J.D., and Bazelon Center for Mental Health Law Director Robert Bernstein, Ph.D., agreed that the study is important because it sheds light on the correlates of violence among people with schizophrenia.

But while Zdanowicz believes that the findings should support laws that mandate treatment for people who are a danger to themselves or others, Bernstein does not.

The Treatment Advocacy Center is a nonprofit organization dedicated to eliminating barriers to treatment; it advocates for assisted outpatient treatment. The Bazelon Center describes its mission as protecting and advancing the rights of people with mental illness.

“This study isn't designed to create an argument for legal intervention,” Bernstein told Psychiatric News. Since the CATIE study does not establish a causal relationship between violence and patients' clinical characteristics, “any attempt to jump to a conclusion that we can prevent violence is preposterous,” he said.

Zdanowicz noted that the study “helps us better understand the specific array of symptoms that increase the risk of violence,” and said the study provides clinicians and others with “the hope of identifying who is at risk for violence and managing that risk by ensuring that they get the treatment they need.”