Abstract

Violent offending committed by people with schizophrenia has been a public concern. The present study aims to examine the incidence of violent offending among people with schizophrenia and its correlations with mental health resources and economic factors. In this study, an examination of violent offending by people with schizophrenia and those identified as not criminally responsible on account of mental disorder (NCRMD) between 2010 and 2019 in China’s Hunan province was undertaken. Principal component analysis (PCA) and regression analyses were used to explore the association of violent offending in people with schizophrenia and those identified as NCRMD with violent offending in the general population, mental health medical resources, and provincial GDP. Between 2010 and 2019, a total of 2,093 people with schizophrenia committed violent offending in Hunan province, including 1,374 (65.6%) cases identified as NCRMD. Over the period, the incidence of violent offending in people with schizophrenia and those identified as NCRMD has been decreasing. The incidences were positively correlated with the incidence of violent offending in the general population and negatively associated with mental health resources and provincial GDP. These findings may be valuable in helping to develop strategies for violence prevention and risk management for people with schizophrenia.

Introduction

Violence related to mental disorders has been a public health concern across the world. Evidence suggests that the risk of violent offending in people with schizophrenia is higher than that in the general population ( Fazel et al., 2014 ; Whiting et al., 2022 ), although most people with schizophrenia never engage in violence throughout their life ( Nielssen and Large, 2010 ; Strassnig et al., 2020 ). The consequences of violent behavior perpetrated by people with schizophrenia may impose a high economic burden on public healthcare services ( Senior et al., 2020 ). Therefore, it is critical to understand the trends in violent offending by people with schizophrenia as well as the systems-level factors including health and socio-economic characteristics, which will be valuable in helping to develop strategies for violence prevention and risk management for people with schizophrenia.

Existing studies examining the trends and patterns of violent offending related to mental disorders are mainly based in Western developed countries, and they also yielded inconsistent results. Earlier evidence suggested that the incidence of homicide related to mental disorders tended to remain stable, regardless of whether the overall rate of homicide in the general population decreased ( Flynn et al., 2021 ; Penney et al., 2018 ) or increased ( Taylor and Gunn, 1999 ). Some other studies have shown that the incidence of mental illness-related homicide rises in tandem with an increase in homicides in the general population ( Gottlieb et al., 1987 ; Gudjonsson and Petursson, 1986 ). A 40-year study based in the Chuvash Republic of the Russian Federation revealed that the rate of homicide associated with schizophrenia was significantly correlated with that in people without schizophrenia over this period ( Golenkov et al., 2021 ).

Conclusions

Our study showed that the incidences of violent offending in people with schizophrenia and those identified as NCRMD have been decreasing from 2010 to 2019 in Hunan Province, China. The incidences were found to be significantly correlated with the incidence of violent offending in the general population over this period. The increase in mental health resources and the developing economy may play important roles in reducing violent offending associated with schizophrenia. This indicates that the prevention of violent offending in people with schizophrenia involves not only providing enhanced mental health resources and reinforcing treatment measures, but also addressing factors influence general violent offending. Our findings may have critical implications for the prevention and management of violent offending in people with schizophrenia.