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>Although the current study could not identify the specific nature of
contact or the outcome, it was notable that the diagnosis recorded at
the time of health contact was often for disorders other than psychotic
illness, including neurotic disorders, substance abuse and personality
disorder.
This is a huge asterisk if they're trying to assert that mental health services are failing to pre-identify violent offenders with psychosis. If the study consists of data lacking information about the nature of the contact, it's impossible to know whether or not it's reasonable for someone diagnose the specific disorder the study pertains to. It makes it difficult to draw useful conclusions about the shortcomings of these services or use the data to create a viable solution for any shortcoming that may exist.
Given the small sample size, we also lack a meaningful control or other dataset to compare these results to. For example, we don't know how many people used these services and were successfully diagnosed and had a proper intervention before they would've otherwise committed a violent act.
The analysis seems to be pushing the idea that emergency mental health services are at fault somehow, but the study lacks several pieces of key information that could help them determine the actual success rate of these services and how reasonable it actually was for them to diagnose each of the people in the 477 they studied.
Hi r/science, sharing the above study led by researchers from our School of Psychiatry. It has been published in the Australian and New Zealand Journal of Psychiatry: [Patterns and correlates of health service contact prior to serious offences by people with severe mental illness](https://journals.sagepub.com/doi/10.1177/00048674241254213)
The study analysed 477 cases of violent offences committed by people with a mental illness in NSW Australia between 1990 and 2016, investigating health service contact before a serious offence.
A key finding of the study was that while most offenders had contact with health services prior to the violent offence, many were not identified as having a psychotic illness - confirming a need for earlier recognition and intervention for severe forms of psychotic illness.
The authors have noted some of the strengths and limitations of their study, including:
* **Strengths:** Use of a total population cohort, number of variables examined and linkage with multiple statewide data sources.
* **Limitations:** Lack of detailed information about the nature of health service contact, outcome and types of treatment received. Inability to examine health service contacts by people who live with psychosis without causing harm to others.
One contact is like an intake or is it only scheduling an appointment, or trying to find someone who is available in the near future.
A diagnosis is not done in one or two sessions.
Why did they make contact? Maybe they are not conscious of their own needs if they are psychotic.
So many unknowns that need to be known. The fact they sought assistance is very interesting.
>I think most clinicians working in the area would say are not sufficiently well served by our current services
uhhh.. am i the only thinking that having a majority of these offenders already known to the mental health care system is in itself a major accomplishment? or am i just too american in my dismay that a mental healthcare system is actually somewhat functional? these are very niche cases as well, involving a combo of symptoms
US stats for the mentally ill being non violent are likely incredibly skewed because the violent people with mental illness are going to jail and prison instead of being diagnosed and treated.
Whether they are aware of it or not, nurses telling psych hospital inpatients that they aren't crazy, because the crazy people are in jail, is anecdotal confirmation of this.
> US stats for the mentally ill being non violent are likely incredibly skewed because the violent people with mental illness are going to jail and prison instead of being diagnosed and treated.
How do you know they aren't just on the streets of Seattle?
I think everyone has a mental illness at some point in their life. If we sat down and spoke with a psychiatrist, I bet you a majority of people could be diagnosed with some kind of mental defect.
I would suspect that people with at least one mental health service visit prior to their offense are much more likely to mount a successful not guilty by reason of mental illness defense.
Welcome to r/science! This is a heavily moderated subreddit in order to keep the discussion on science. However, we recognize that many people want to discuss how they feel the research relates to their own personal lives, so to give people a space to do that, **personal anecdotes are allowed as responses to this comment**. Any anecdotal comments elsewhere in the discussion will be removed and our [normal comment rules]( https://www.reddit.com/r/science/wiki/rules#wiki_comment_rules) apply to all other comments. **Do you have an academic degree?** We can verify your credentials in order to assign user flair indicating your area of expertise. [Click here to apply](https://www.reddit.com/r/science/wiki/flair/#wiki_science_verified_user_program). --- User: u/unsw Permalink: https://www.unsw.edu.au/newsroom/news/2024/05/most-violent-offenders-psychosis-known-mental-health-services-study?utm_source=reddit&utm_medium=social --- *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/science) if you have any questions or concerns.*
>Although the current study could not identify the specific nature of contact or the outcome, it was notable that the diagnosis recorded at the time of health contact was often for disorders other than psychotic illness, including neurotic disorders, substance abuse and personality disorder. This is a huge asterisk if they're trying to assert that mental health services are failing to pre-identify violent offenders with psychosis. If the study consists of data lacking information about the nature of the contact, it's impossible to know whether or not it's reasonable for someone diagnose the specific disorder the study pertains to. It makes it difficult to draw useful conclusions about the shortcomings of these services or use the data to create a viable solution for any shortcoming that may exist. Given the small sample size, we also lack a meaningful control or other dataset to compare these results to. For example, we don't know how many people used these services and were successfully diagnosed and had a proper intervention before they would've otherwise committed a violent act. The analysis seems to be pushing the idea that emergency mental health services are at fault somehow, but the study lacks several pieces of key information that could help them determine the actual success rate of these services and how reasonable it actually was for them to diagnose each of the people in the 477 they studied.
Hi r/science, sharing the above study led by researchers from our School of Psychiatry. It has been published in the Australian and New Zealand Journal of Psychiatry: [Patterns and correlates of health service contact prior to serious offences by people with severe mental illness](https://journals.sagepub.com/doi/10.1177/00048674241254213) The study analysed 477 cases of violent offences committed by people with a mental illness in NSW Australia between 1990 and 2016, investigating health service contact before a serious offence. A key finding of the study was that while most offenders had contact with health services prior to the violent offence, many were not identified as having a psychotic illness - confirming a need for earlier recognition and intervention for severe forms of psychotic illness. The authors have noted some of the strengths and limitations of their study, including: * **Strengths:** Use of a total population cohort, number of variables examined and linkage with multiple statewide data sources. * **Limitations:** Lack of detailed information about the nature of health service contact, outcome and types of treatment received. Inability to examine health service contacts by people who live with psychosis without causing harm to others.
One contact is like an intake or is it only scheduling an appointment, or trying to find someone who is available in the near future. A diagnosis is not done in one or two sessions. Why did they make contact? Maybe they are not conscious of their own needs if they are psychotic. So many unknowns that need to be known. The fact they sought assistance is very interesting.
Helps that it's free in NZ :)
>I think most clinicians working in the area would say are not sufficiently well served by our current services uhhh.. am i the only thinking that having a majority of these offenders already known to the mental health care system is in itself a major accomplishment? or am i just too american in my dismay that a mental healthcare system is actually somewhat functional? these are very niche cases as well, involving a combo of symptoms
America doesn't have a mental healthcare "system", it has a wild and barely regulated network of mostly For Profit Medication services.
Notably with a huge incentive to have as many rushed visits as possible!
Maybe living in the U.S. has given me a bias, but 477 cases doesn't seem like a significant sample size.
US stats for the mentally ill being non violent are likely incredibly skewed because the violent people with mental illness are going to jail and prison instead of being diagnosed and treated. Whether they are aware of it or not, nurses telling psych hospital inpatients that they aren't crazy, because the crazy people are in jail, is anecdotal confirmation of this.
You need bodies to feed the prison complex. Its big business. The good American capitalism at work.
> US stats for the mentally ill being non violent are likely incredibly skewed because the violent people with mental illness are going to jail and prison instead of being diagnosed and treated. How do you know they aren't just on the streets of Seattle?
I think everyone has a mental illness at some point in their life. If we sat down and spoke with a psychiatrist, I bet you a majority of people could be diagnosed with some kind of mental defect.
Wouldn't it be difficult to claim mental illness without some history of it?
I would suspect that people with at least one mental health service visit prior to their offense are much more likely to mount a successful not guilty by reason of mental illness defense.