Psychosis is commonly associated with an elevated risk of violence. Reducing the risk of violence perpetration is of interest to public health and criminal justice stakeholders. This population-based study of people diagnosed with psychosis in New South Wales, Australia, found that 15% committed a violent offence, most commonly within four years following diagnosis. 

Psychosis is a psychological condition that can include a range of symptoms characterised by impaired reality perception. 

One increasingly implemented violence prevention tool for those with severe mental illness who are living in the community is the community treatment order (CTO). In Australia, CTOs are legal orders made by a magistrate or Mental Health Review Tribunal that mandate mental health treatment for people with mental illness in the community who require involuntary oversight for their care. 

The findings provide useful direction for violence reduction, as they give time-based targets for prevention and early intervention, which are key principles from a public health preventative perspective.

Key findings

• Those who had offended tended to have histories of non-violent offending, to have been diagnosed at a younger age, to have substance-related psychosis and to have several risk factors associated with criminal behaviour.
• Being subject to a community treatment order was generally associated with a higher risk of violence, but results suggest a delay in violent offending for those subject to these orders.
• The findings suggest a heightened need for violence prevention efforts in the first four years following a person’s receipt of a psychosis diagnosis.