What percentage of schizophrenics become violent?

What percentage of schizophrenics become violent?

For people who have schizophrenia, and don’t get treatment, the result is far too often that they end up homeless or in jail (most often due to minor offenses).

• Approximately 200,000 individuals with schizophrenia or manic-depressive (bipolar disorder) illness are homeless, constituting one-third of the approximately 600,000 homeless population (total homeless population statistic based on data from Department of Health and Human Services). These 200,000 individuals comprise more than the entire population of many U.S. cities, such as Hartford, Connecticut; Charleston, South Carolina; Reno, Nevada; Boise, Idaho; Scottsdale, Arizona; Orlando, Florida; Winston Salem, North Carolina; Ann Arbor, Michigan; Abilene, Texas or Topeka, Kansas.
• At any given time, there are more people with untreated severe psychiatric illnesses living on America’s streets than are receiving care in hospitals. Approximately 90,000 individuals with schizophrenia or manic-depressive illness are in hospitals receiving treatment for their disease.
  Source: Treatment Advocacy Center

Schizophrenia and Violence

People with schizophrenia are far more likely to harm themselves than be violent toward the public. Violence is not a symptom of schizophrenia.

News and entertainment media tend to link mental illnesses including schizophrenia to criminal violence. Most people with schizophrenia, however, are not violent toward others but are withdrawn and prefer to be left alone. Drug or alcohol abuse raises the risk of violence in people with schizophrenia, particularly if the illness is untreated, but also in people who have no mental illness. When violence does occur, it is most frequently targeted at family members and friends, and more often takes place at home.

Substance abuse (i.e. street drugs and alcohol) significantly raises the rate of violence in people with schizophrenia, as is also the case with people who do not have any mental illness. People with paranoid and psychotic symptoms, which can become worse if medications are discontinued, may also be at higher risk for violent behavior. For more information on this issue — please see:

• Predictors of Violence in People who have Schizophrenia.
• Crime and Schizophrenia — May, 2004 Research Report
• Ending Stigma by Ending Violence
• Families of mentally ill pay terrible toll: Psychiatric patients are killing and assaulting their families at an alarming rate
• Personal Story of Schizophrenia and Jail — Blog: Love Lost to the Department of Corrections
• Daily Schizophrenia Violence in the News — On any day you will find that many of the news articles (if not most) that include reference to schizophrenia relate to violence that is a result of schizophrenia. While only a small percent of people with schizophrenia are violent, when violence takes place (especially in the USA where the media focuses more heavily on crime and violence compared to other countries) any violence related to schizophrenia tends to be covered widely in the news media. Moreover, violence and fatalities in association with schizophrenia are much more common in the US due to the greater availability of hand guns and the greater difficulty of getting good treatment and services for people who have schizophrenia.

If you have a family member that has schizophrenia, is not taking medication and has a history of violence, we recommend you review the information on Assisted Treatment.

For more information on the preventable violence that is sometimes associated with untreated schizophrenia (and how people are working towards changing laws so that it can be avoided) please see the following web site: Treatment Advocacy Center

If you are interested in the issue of improving treatment opportunities for people with schizophrenia and reducing violence — be sure to subscribe to the free Treatment Advocacy Newsletter called «Catalyst»

In Out of the Shadows, published by John Wiley & Sons earlier this year, I estimated that there are now approximately 1000 homicides a year committed by individuals with schizophrenia and bipolar disorder, almost all of whom were not taking medication at the time of the homicide. My estimate was based on all cases in a metropolitan area of 4 million people for 1 year, then extrapolated to the whole country. Anecdotal evidence suggests that such cases are not unique to urban areas so I think such extrapolation is reasonable. To date, nobody has challenged this 1000/year estimate. Altogether in the US there are approximately 24,000 homicides a year.

Dr. E. Fuller Torrey

Note: I reviewed this in Surviving Schizphrenia (3rd ed., 1995), pp. 271-273. Since this was published, there have been at least three pertinent papers:

Heila et al., American J. Psychiatry 154:1235-1242, 1997

Amador et al., American J. Psychiatry 153:1185-1188, 1996

Fenton et al., American J. Psychiatry 154:199-204, 1997

Schizophrenia and Jail

The vast majority of people with schizophrenia who are in jail have been charged with misdemeanors such as trespassing.

As many as one in five (20%) of the 2.1 million Americans in jail and prison are seriously mentally ill, far outnumbering the number of mentally ill who are in mental hospitals, according to a comprehensive study. Source: Human Rights Watch

The American Psychiatric Association estimated in 2000 that one in five prisoners were seriously mentally ill, with up to 5 percent actively psychotic at any given moment.

In 1999, the statistical arm of the Justice Department estimated that 16 percent of state and federal prisoners and inmates in jails were suffering from mental illness. These illnesses included schizophrenia, manic depression (or bipolar disorder) and major depression.

The figures are higher for female inmates, the report says. The Justice Department study found that 29 percent of white female inmates, 22 percent of Hispanic female inmates and 20 percent of black female inmates were identified as mentally ill.

Many individuals with schizophrenia revolve between hospitals, jails and shelters. In Illinois 30% of patients discharged from state psychiatric hospitals are rehospitalized within 30 days. In New York 60% of discharged patients are rehospitalized within a year. Source: Surviving Schizophrenia

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People with schizophrenia rarely kill strangers

NEW YORK (Reuters Health) — Despite some highly publicized incidents in recent years, people with schizophrenia rarely commit random homicide, research shows.

Pooling data from seven studies in four countries, researchers found that the odds of a person with schizophrenia killing a stranger were 1 in 14 million people per year.

The risk appears even lower if the disorder is being treated with antipsychotic medication, the investigators report in the Schizophrenia Bulletin.

When they looked at 42 incidents in which someone with schizophrenia killed a stranger, they found that nearly two-thirds of those offenders had never been treated with medication.

They conclude that it is “exceptionally rare” for someone with schizophrenia to kill a stranger — and that earlier and continued treatment of the disorder could make these events rarer still.

Schizophrenia is a brain disorder that causes people to break from reality, with symptoms such as hallucinations, paranoia and unusual thoughts and perceptions.

Most people with schizophrenia are not violent, but studies show that they are more likely than people without the disorder to commit violent crimes. This is especially true if a person with schizophrenia abuses drugs or alcohol, or had a history of violence before developing the brain disorder.

People with schizophrenia are responsible for a disproportionate number of homicides; while they account for about 0.5 percent of the world’s population, they are estimated to commit 6.5 percent of homicides worldwide, according to Dr. Olav Nielssen of the University of Sydney in Australia, the lead researcher on the new study.

Most of the victims, though, are family members, Nielssen told Reuters Health in an email, and in nearly half of these cases, the person’s schizophrenia had never been treated.

The current findings are based on seven studies from Europe and Australia looking at homicides by people with schizophrenia. The estimated annual rate of “stranger homicides” ranged anywhere from 1 in 7 million to 1 in 18 million people per year.

The researchers also compared 42 cases of stranger homicide with 42 in which the victim was a family member. They found that the former were more likely to be committed by a schizophrenic individual who was homeless, or had a history of severe childhood or adult behavioral problems, including violence.

In both groups, more than half of the offenders had never been admitted to a psychiatric hospital or placed on antipsychotic medication. Of the 42 who killed a stranger, 64 percent had never received drug treatment.

Some highly publicized homicides in Canada, the U.S. and the UK in recent years have led to law changes designed to compel people seen by mental health services to take any prescribed antipsychotic medications.

However, Nielssen said, “Because a large proportion of both stranger and family homicides occur prior to initial treatment, laws designed to ensure continued treatment of known patients will not have much effect in preventing homicides.”

Instead, he asserted, a more effective approach would be to get people treated sooner, when their initial psychotic symptoms arise. In wealthier countries, Nielssen noted, the lag time between first symptoms and initial treatment is one year, on average.

He and his colleagues argue that a key obstacle to early treatment is so-called “dangerousness” laws, which require that a person be deemed a danger to himself or others before involuntary treatment is an option. Such laws are in place in most U.S. and Australian states, half of Canadian provinces and in several European countries, Nielssen noted.

He said that instead of focusing on a patient’s potential danger, mental health laws should be based on the individual’s need for treatment and competency to refuse it.

SOURCE: Schizophrenia Bulletin, October 12, 2009.

Schizophrenia statistics 2023

20 million people have schizophrenia but less than a third receive treatment. These schizophrenia statistics illustrate the prevalence and treatment gap of the disorder.

By SingleCare Team | Updated on Feb. 3, 2023 Medically reviewed by Marissa Walsh, Pharm.D., BCPS-AQ ID

The word “schizophrenia” comes from Greek origins, with “schizo” meaning “split” and “phrene” meaning “mind.” Schizophrenia is different from dissociative identity disorder, previously known as split personality disorder, which is a common misconception. There are many symptoms of schizophrenia, and individuals can experience them in different ways. Schizophrenia statistics show that the severe mental illness usually develops in early adulthood and although symptoms are worse at the onset of the condition, treatment of schizophrenia is available and effective.

What is schizophrenia?

Schizophrenia is a chronic and severe mental disorder that affects a person’s thoughts, feelings, and behaviors. This disorder affects a person’s perception of reality, social interactions, and thought processes. Symptoms of schizophrenia include hallucinations—which may be visual or auditory (seeing things that aren’t there, hearing voices)—delusions, cognitive impairment manifesting as an unusual way of thinking or disorganized speech, and difficulty in social relationships. Scientists have found that certain chemical imbalances in the brain, genetic traits, and environmental factors such as early life stress are risk factors for schizophrenia. The major types of schizophrenia include paranoid schizophrenia, catatonic schizophrenia, undifferentiated schizophrenia, and schizoaffective disorder.

“Research suggests a combination of physical, genetic, psychological, and environmental factors can make a person more likely to develop the condition,” says Judy Ho , Ph.D., a clinical neuropsychologist based in California and host of SuperCharged Life podcast. “The condition runs in families, but no single gene has been found to be responsible.”

Schizophrenia symptoms

Negative symptoms are those that take away behaviors or processes that are considered normal. Melissa Mueller-Douglas , LMSW, a therapist on the University of Rochester Medical Center’s Strong Ties Project ACT Team describes these symptoms:

• Poverty of speech: Minimal speech or giving short-responses to questions.
• Anhedonia: Lack of pleasure from things they used to enjoy, decreasing interests. This leads to decreased involvement in a person’s community, affecting quality of life.
• Affect deficits: A significantly reduced intensity in emotional expression. This can affect personal relationships with family and friends.
• Lack of motivation: A person may not have the internal motivation to follow through with tasks in everyday life, such as getting ready in the morning.

The symptoms of schizophrenia can impact the flow of everyday life such as, “their ability to work, have functional relationships, or take care of themselves,” says Ho. “Individuals with floridly psychotic states almost always see their activities of daily functioning fall to the wayside and they often times will need structured intervention (i.e., via psychiatrist or psychologist) for most of their lives to keep symptoms at bay and to make sure their [support] team is in place in case they have a resurgence.”

How common is schizophrenia?

• Schizophrenia affects 20 million people worldwide. (Global Burden of Disease, 2017)
• The annual number of new cases of schizophrenia is 1.5 per 10,000 people. ( Epidemiol Reviews , 2008)
• Schizophrenia is one of the top 15 leading causes of disability worldwide. (Global Burden of Disease, 2016)
• Approximately 5% of people with schizophrenia die by suicide, usually with a higher risk at the onset of the mental illness. ( Archives of General Psychiatry, 2005)
• About 20% of people with schizophrenia attempt suicide at least once. (The Recovery Village, 2020)

Schizophrenia statistics in the United States

• The prevalence of schizophrenia among U.S adults is estimated to be 1.5 million people per year. (National Alliance on Mental Illness, 2019)
• Schizophrenia is often diagnosed in young people during their late teens to early 30s with symptoms commonly presenting earlier in males than in females. (National Institute of Mental Health, 2018)
• The average life lost for individuals with schizophrenia in the U.S. is 28.5 years. ( JAMA Psychiatry , 2015)

Psychotic symptoms and schizophrenia diagnosis by race-ethnicity

• The lifetime prevalence of self-reported psychotic symptoms is highest in black Americans (21.1%), Latino Americans (19.9%), and white Americans (13.1%). ( Psychiatric Services , 2013)
• The lifetime prevalence of self-reported psychotic symptoms is lowest in Asian Americans (5.4%). ( Psychiatric Services , 2013)
• Research has found that black Americans are three to four times more likely than white Americans to receive a Schizophrenia diagnosis. ( World Journal of Psychiatry , 2014)

Schizophrenia and violence statistics

• Patients diagnosed with schizophrenia are four to six times more likely to commit a violent crime than the general population. ( International Journal of Clinical Neurosciences and Mental Health , 2015)
• 6% of homicide acts are committed by schizophrenia patients in Western countries. ( International Journal of Clinical Neurosciences and Mental Health , 2015)
• One study in Sweden found that 13.2% of patients with schizophrenia had at least one violent offense. ( Journal of the American Medical Association , 2009)
• Within the first five years of a schizophrenia (or related) diagnosis, 10.7% of men and 2.7% of women were convicted of a violent offense in Sweden. ( Lancet Psychiatry , 2014)
• The rate of violent offense among patients with schizophrenia and related disease was nearly five times higher than among their siblings and almost seven times higher than matched individuals in the general population in Sweden. ( Lancet Psychiatry , 2014)

Co-occurring disorders and schizophrenia

People with schizophrenia can also have co-occurring medical conditions. The following figures represent the percentage of people with schizophrenia that have the specified co-occurring mental health issue:

• Depressive symptoms: 30%-54%
• Post-traumatic stress disorder: 29%
• Obsessive-compulsive disorder: 23%
• Panic disorder: 15%

(The Recovery Village, 2020)

Treating schizophrenia

Unfortunately, the minority of people with schizophrenia (31%) have been identified as receiving healthcare, suggesting more than two-thirds are suffering from a gap in treatment; the highest percentage of people not receiving care were found to fall into the lowest income population, according to the Bulletin of the World Health Organization .

“Almost every individual who is diagnosed with schizophrenia will require medication treatment, usually with an antipsychotic medication,” says Ho. She says that atypical antipsychotics can manage symptoms of schizophrenia such as hallucinations and delusions.

“Currently, clozapine is the most effective antipsychotic in terms of managing treatment-resistant schizophrenia, and many times, patients will have to go through at least a couple of different medication trials to find the right type of medication and dosage for them,” Ho explains.

Cognitive behavioral therapy (CBT) with a mental health professional is the most effective in treating schizophrenic patients, according to Ho. She explains that CBT teaches a patient how to manage their thoughts and behaviors as well as identify triggers for a psychotic episode.

Early intervention can have a significant impact on people with schizophrenia. Schizophrenia symptoms are often worse in the early stages of the illness, which is when the risk of suicide is highest. The majority of people with schizophrenia get better over time, not worse. In fact, 20% of people will get better within five years of developing symptoms. Because schizophrenia may be genetic, people with family members who have schizophrenia or a history of psychotic symptoms may seek mental health services to detect schizophrenia and begin treatment as early as possible.

Schizophrenia research

• Schizophrenia , National Institute of Mental Health (NIMH)
• Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 , Global Burden of Disease (GBD)
• Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 , GBD
• Premature mortality among adults with schizophrenia in the United States , JAMA Psychiatry
• The lifetime risk of suicide in schizophrenia: a reexamination , Archives of General Psychiatry
• Schizophrenia facts and statistics , The Recovery Village 2020
• Racial disparities in psychotic disorder diagnosis: A review of empirical literature , World Journal of Psychiatry
• Racial and Ethnic Differences in the Prevalence of Psychotic Symptoms in the General Population , Psychiatric Services
• Schizophrenia: a concise overview of incidence, prevalence, and mortality , Epidemiol Reviews
• Mental Health By the Numbers , National Alliance on Mental Illness
• Schizophrenia, Substance Abuse, and Violent Crime , Journal of the American Medical Association
• Violent crime, suicide, and premature mortality in patients with schizophrenia and related disorders: a 38-year total population study in Sweden , Lancet Psychiatry
• Are people with schizophrenia more violent than the general population? – A look towards the stigma on mental illness , International Journal of Clinical Neurosciences and Mental Health