1. Family violence by persons with serious mental illness
Travis Labrum, PhD, LCSW
Labrum, T., & Solomon, P. L. (2016). Factors associated with family violence by persons with psychiatric disorders. Psychiatry Research, 244,

2. Introduction Most persons with SMI do not commit violence
2 to 8 times more likely to commit violence
Only 14% of violence towards strangers
At least 50% of all victims family members
Family members more likely to incur repeated violence and severe injuries

3. Prevalence
“among family members with high levels of contact with their relative with psychiatric disorders, the best available estimate is that 20% to 35% have been the victim of violence by their relative with psychiatric disorders in the past 6 to 12 months and at least 40% have been the victim of such violence since their relative’s onset of illness”
Labrum, T., & Solomon, P. L. (2015). Rates of victimization of violence committed by relatives with psychiatric disorders. Journal of Interpersonal Violence. Advance online publication. doi: /

4. Consequences of family violence
Injuries and death
Psychological distress & trauma symptoms
Damaged and disconnected relationships
Incarceration of persons with SMI
Stigma of mental illness

5. Factors related to violence
The Social-Ecological Model

6. Individual: Perpetrator Factors
Younger age
Male Gender
Lower income
Drug and alcohol use
History of crime/arrest
Frequency of hospitalization
Paranoia
Medication and treatment non-adherence
Impaired social and other cognition

7. Individual: Victim Factors
Younger age
Lower income
Having a mental illness

8. Interaction Factors Co-residence Frequency of contact
Financial assistance
Money management
Caregiving
Limit-setting
Criticism, hostility, not feeling “listened to”
Re IPV, mutual physical & psychological abuse

9. Community Factors Living in a community with
Greater poverty and social disadvantage
More community violence
Less access to mental health treatment

10. Societal Factors* Favorable attitudes towards violence
Policies that perpetuate inequality
Stigma towards people with mental illness and their families

11. Practice Implications
Risk of violence and conflict should be assessed
CBT and cognitive remediation may be effective
Decreasing risk of violence with clients
Importance of SA & MH treatment. Increase palatability of treatment.
Refer to and advocate for greater services (housing assistance, intensive case management, richer welfare benefits)

12. Implications (cont.) Refer to NAMI’s “Family to Family”
Involve family members in tx
Most persons want involvement
With both parties, discuss communication patterns, perceived hostility, incendiary communication, & not feeling “listened to”.

13. Implications (cont.)
Assist relatives in decreasing or modifying the use of limit-setting practices
Assess whether persons with SMI perceive limits as ill- intended or coercive
Educate families on financial literacy & how representative payeeship operates
Facilitate collaboration in financial decision-making

14. The end