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Predicting who will be violent nearly impossible

BY SCOTT FITZGERALD, The Southern

Friday, May 16, 2008 11:28 PM CDT

CARBONDALE - As more random acts of violence occur, the mental health profession gets targeted more and more with the responsibility of protecting the community against danger that is sometimes unfairly associated with mental illness.

What's nearly impossible in this task is predicting who is susceptible to committing violence and who is not.

Mixing a predictability equation with the responsibility of treatment is like mixing oil with water - it doesn't work. In fact, violence prediction should be eliminated all together, said Douglas Mossman, professor and director of the Division of Forensic Psychiatry at the Wright State University Boonshoft School of Medicine and administrative director of the Glenn W. Weaver Institute of Law and Psychiatry at the University of Cincinnati College of Law.

"I'm suggesting we treat patents' conditions. We can't predict; it doesn't work. We should implement precautions. Treatment does deter violence. For those who stay in treatment, we believe it helps," Mossman said.

Mossman's presentation, "The Imperfections of Protection Through Detection and Intervention: Lessons from Three Decades of Research on the Psychiatric Assessment of Violence Risk," concluded a daylong program, part of the 10th Annual Health Policy Institute sponsored by Southern Illinois Healthcare and Southern Illinois University at the SIU School of Law, on Friday.

Breaking up his presentation with a humorous song that he performed on the piano, Mossman looked at the context of violence in America portrayed through popular culture mediums such as guns being a solution to all problems portrayed by Clint Eastwood in his Dirty Harry movies of the 1970s and Sylvester Stallone in his Rambo productions.

But it was the Tarasoff Supreme Court ruling in 1976 that shifted a great burden of the responsibility on the mental health profession on risk assessment of people prone to commit violent acts.

Much of the thrust of Mossman's presentation was looking at scientific studies using math as a way to determine predictability. As the numbers increased, the probability factor widened, showing it's nearly impossible to determine who will commit a violent act.

"What we would like to do is separate the violent from the nonviolent, but the reality is that only a partial separation of violent and nonviolent populations can occur," Mossman said.

Echoing what some researchers have stated earlier, Mossman said accurate psychiatric assessment, timely services, evidence-based interventions and diligent follow-ups are proven buffers to thwart people from committing violent acts.

scott.fitzgerald@thesouthern.com

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