The majority of people with mental illness do not commit violent acts. A number of studies support the finding that a mere 4% of violence toward others in the U.S. can be attributed to people diagnosed with mental illness. There are, however, specific severe mental illness diagnoses linked to slightly higher rates of violence – schizophrenia, which is characterized by disorganized thoughts and behavior and perhaps a loss of touch with reality, along with the major mood disorders, bipolar disorder and major depression. The truth is, persons with mental illness are more likely to be victims than perpetrators of violence. Mental illness does, however, carry an increased risk of violence toward oneself – suicide.
We also know that alcohol and drug use and abuse significantly increase risk for violence toward self and others in both mentally ill and non-mentally ill populations.
Mental illness, then, is not the sole cause of school violence. Roughly 1 in 4 people in the U. S. have a diagnosable mental illness and most of them do not feel compelled to act violently. Mental illness is just one risk factor, and the presence of risk factors does not necessarily result in a specific outcome. Many factors are involved in this process.
How can we reliably determine which individuals are at risk for perpetrating violence in our schools?
The practice of threat assessment, developed over the past twenty years, is the tool we use to investigate and determine the level of risk posed by a given individual. Its focus is not on predicting, but on preventing violence.
Quite simply, we can get a glimpse into someone’s mind by observing precisely what the individual says and does. We review all risk factors, behavioral warning signs, and violence inhibitors, to obtain a more complete picture of whether the individual is heading toward violence. Then, we can intervene, get help for the person, and manage the possible threat in a way that will keep others safe. If we find that we do have concerns about the individual’s mental health, this is the time to summon the person’s support system and refer him or her for assistance.
This discussion would not be complete without acknowledging that in the aftermath of a number of school shooting attacks, previously overlooked indicators of undiagnosed mental illness were uncovered. While the incidence of school shooting is rare, and the link between mental illness and violence is tenuous, we always want to watch for signs of possible mental health issues, and attend to them swiftly.
Other risk factors and warning signs of violence include access to weapons, substance use/abuse, noncompliance with psychiatric medication or treatment, fascination/preoccupation with weapons and violence, a commando mentality, holding onto grievances, a model or script for using violence to solve problems, feelings of envy, anger, rage and hopelessness, a sense of being entitled to revenge for a perceived wrong, and a feeling of marginalization from peers. Can a distorted sense of reality or skewed thought patterns be behind some of these factors? Absolutely!
There are also specific protective factors shown to inhibit violence. These may or may not be present in a given individual’s life. It is the totality of the situation that ultimately determines the outcome.
Small steps we can take each day to keep our schools safe include making vital personal connections with our students, fostering a positive, equitable school climate, educating others and ourselves about the risk factors and warning signs of mental illness, suicide, and violence, and keeping a watchful eye on students. We can develop a process in our schools for referral, assessment, and intervention to provide the help our students need. With all of these preventive measures in place, we can trust that we’ve made our schools a much safer place to learn.
This post originally appeared as a guest blog at SafeandSoundSchools.org
 Friedman, Richard A., M.D. The New York Times, December 17, 2012.
 Brekke JS, Prindle C, Bae SW, Long JD. Risks for individuals with schizophrenia who are living in the community. Psychiatric Services. 2001; 52(10):1358–1366. [PubMed]
 University of Washington School of Social Work http://depts.washington.edu/mhreport/facts_suicide.php
 Singh, Pavita, MPH. Huffpost Media, Jan 28, 2016
 Langman, Peter. School Shooters: Understanding High School, College, and Adult Perpetrators, Rowan & Littlefield, January 2015