The relationship between violence, level of functioning, and treatment outcome in psychiatric inpatients



Irram Walji, Vincent Egan, Andres Saez Fonseca, Adam Huxley

The Journal of Forensic Practice




There is a clear association between the diagnosis of a mental illness and behaving violently. Individuals diagnosed with severe and enduring mental health problems who display violent behaviour have inferior treatment outcomes when compared with their non-violent counterparts. Violent behaviour within care settings impacts on general functioning, adherence to treatment plans, and inhibits wider recovery goals.


This research studied 95 inpatients with a primary diagnosis of severe mental illness with and without a history of violence and compared how levels of global functioning and risk impacted on recovery. Patients were divided into two groups, those with and without a previous or current history of violence. The two groups were compared on measures of global functioning; symptomatology, and risk at baseline and twelve month follow up.


Both violent and non-violent groups showed increased global functioning over time, with no significant difference between the groups. Neither group showed significant reductions in risk over time. Patients in the violent group had significantly fewer prior and current symptoms of mental illness than non-violent individuals.

Research limitations/implications

Despite evidence that suggests that a history of, or current violence leads to impaired outcomes amongst people with diagnoses of mental illness, the findings of this study suggest a history of violent behaviour was not a predictor of poor progress within inpatient settings.

Practical implications

Disconfirming previous hypotheses, we suggest that in itself violent behaviour does not always significantly impair outcomes for individuals diagnosed with mental illnesses and that many other variables contribute to successful recovery.


Whilst there are previous studies that investigate outcomes for violent and non-violent inpatients diagnosed with mental illness, there is a dearth of research comparing equivalent groups in the same facility over the same time period. This study directly compared inpatients with or without a history of violence in the same psychiatric rehabilitation settings.









Human Services and Justice Coordinating Committee