Psychiatrists and other mental health professionals tend, quite naturally, to deny the risk of personal injury associated with their work, writes a US psychiatrist. Serious mental illness is already profoundly stigmatising. Who wants to add to it by labelling patients as unpredictable and violent? But denying the risk won't help professionals or their patients tackle a problem that may be small but is no less real. Mental health professionals are much more likely than other people to be attacked at work, he writes: the latest survey from the US Department of Justice reported an annual rate of work related violent crime of 68 per 1000 workers for mental health professionals, compared with 16/1000 for all doctors and 12.6/1000 for all occupations. Other studies suggest that people with major depression, schizophrenia, or bipolar disorder are two to three times more likely to be violent than people who are well.
Although most people with serious mental illnesses never commit a single violent act—the lifetime prevalence is about 16%—mental health professionals should acknowledge the possibility of rare events and be alert to the factors that increase the risk, he says. Substance misuse is one of the most powerful. Untreated psychosis is another.
References
- N Engl J Med 2006;355:2064-617108340 [Google Scholar]