Unless factors unique to serious mental illness can be specifically associated with behavior leading to incarceration, the criminalization hypothesis should be reconsidered in favor of more powerful risk factors for crime that are widespread in social settings of persons with serious mental illness.

The stigma associated with mental illness is a major concern for patients, families, and providers of health services. One reason for the stigmatization of the mentally ill is the public perception that they are violent and dangerous. Although, traditionally, mental health advocates have argued against this public belief, a recent body of research evidence suggests that patients who suffer from serious mental conditions are more prone to violent behaviour than persons who are not mentally ill. It is a point of contention, however, whether the relationship between mental illness and violence is only one of association, or one of causality; that mental illness causes violence. A proven causal association between mental illness and violence will have major consequences for the mentally ill and major implications for caregivers, communities, and legislators. This paper outlines the key methodological barriers precluding casual inferences at this time. The authors suggest that a casual inference about mental illness and violence may yet be hasty. Because a premature statement advocating a causal relationship between mental illness and violence could increase stigma and have devastating effects on the mentally ill the authors urge researchers to consider the damage that may be produced as a result of poorly substantiated causal inferences.

Permanent supportive housing (PSH) is an evidence-based health intervention for persons experiencing homelessness, but the impact of individual mechanisms within this intervention on health requires further research. This study examines the longitudinal impact of the mechanism of supportive housing within a peer-delivered PSH model on overall health and mental health (as measured by psychological distress and self-report of bothersome symptoms) outcomes in an ethnically diverse population. The 237 participants in the study included persons who were homeless or at risk of homelessness and who also had been diagnosed with a serious mental illness. Sixty-one percent of all participants received supportive housing. All 3 outcomes were significantly associated with quality of life indicators, recovery, and social connectedness. In addition, overall health was significantly associated with employment, age, and psychological distress. Psychological distress was associated with gender, type of housing, and history of violence or trauma. Experiencing bothersome symptoms was associated with drug use, history of violence or trauma, and psychological distress. Longitudinal models of these 3 outcomes showed that supportive housing was significantly associated with good to excellent health 6 months after baseline (odds ratio = 3.11, 95% confidence interval [1.12, 8.66]). The models also demonstrated that the supportive housing and comparison groups experienced decreased psychological distress after baseline. The results of this study demonstrate the importance of supportive housing within the context of PSH, particularly for the overall health of participants, and the positive overall impact of PSH on mental health in a diverse population. (PsycINFO Database Record

Context-Ethnoracial differences may exist in exposure to trauma and post-traumatic outcomes. However, Asian-Americans and Native Hawaiians/Other Pacific Islanders (NHOPI) are vastly underrepresented in research pertaining to trauma and health status sequelae.Objective-To determine whether there are ethnoracial disparities in sexual trauma exposure and its sequelae for health and functioning among Asian-Americans and NHOPI.Design, Setting, Participants-We examined data on sexual assault exposure from the [2006][2007] Hawai`i Behavioral Risk Factor Surveillance System (H-BRFSS), cross-sectional adult community-based probability sample (n = 12,573). Data were collected via computer-assisted random-digit landline telephone survey. Survey response rate was found to be about 48% in 2006 and 52% in 2007. Main Outcome Measures-Demographic information, the Sexual Violence Module regarding unwanted sexual experiences, and questions about health lifestyles, chronic diseases and disability, and health status and quality of life.Results-Participants were 42.3% White, 14.4% NHOPI, and 39.3% Asian-American. NHOPI had a higher 12-month period prevalence (2.24 per 100, CI=1.32-3.78) of any unwanted sexual experience, but a lower prevalence estimate and odds ratio for any lifetime unwanted sexual experience (prevalence: 9.38 per 100, CI=7.59-11.55; odds ratio: 0.61, CI=0.47-0.81) relative to Whites, after adjusting for age, gender, income and education level. Asian-Americans had lower prevalence estimates for 12-month period prevalence (0.78 per 100, CI=0.44-1.39), and lower lifetime prevalence estimates and odds ratios (prevalence: 3.91 per 100, CI=3.23-4.72; odds ratio: 0.27, CI=0.21-0.34). 12-month and lifetime prevalence estimate any unwanted sexual experiences for Whites were 0.71 per 100 (CI=0.45-1.12) and 12.01 per 100 (CI=10.96-13.14), respectively. Sexual assault experiences were highly associated with adverse health status sequelae (e.g., disability, poor general health), but there were no significant ethnoracial disparities on selfreported health outcomes among those with a lifetime history of unwanted sexual experiences. (2) or collapse different minority groups together in a way that may obscure disparities between groups (3). This is of concern because interpersonal violence has dramatic adverse effects on mental and physical health, and is a major risk factor for a range of medical comorbidities (4-7). Lower socioeconomic status is a risk factor for assaultive violence (4); in turn, ethnic minorities are disproportionally of lower socioeconomic status, thus placing some members of ethnic minority groups at higher risk for exposure to violence.Because of wide variation in the percentage of regional representation in the U.S. population, some ethnoracial minorities, such as Asian-Americans and Pacific Islanders, typically appear in insufficient numbers in nationally-representative epidemiological samples to permit meaningful conclusions. Additionally, few studies have been designed to examine trauma in A...

Additional research is needed to improve our understanding of this issue and inform change efforts. Future research should include: epidemiological studies to improve our knowledge of risk factors and correlates of victimization; prospective studies to determine causality between trauma victimization and mental illness or other adverse outcome; and intervention studies to examine strategies for reducing violence and traumatic victimization inside correctional facilities, effective treatments for posttraumatic psychopathology, and improved re-entry outcomes.