People with mental disorders are often afraid of violence against them. Over a quarter of individuals accessing community mental health services in a US inner-city area are victims of at least one violent crime in a given year, a proportion eleven times higher than the inner-city average. The proportion is many times greater in every category of crime, including rape/sexual assault, other violent assaults, and personal and property theft. Findings consistently indicate that it is many times more likely that people diagnosed with a serious mental illness living in the community will be the victims rather than the perpetrators of violence.

However, fear of unpredictable violent acts by people with mental illness is also common. One US national survey indicated that a far higher percentage of Americans rated individuals described as displaying the characteristics of a mental disorder (for example Schizophrenia or Substance Use Disorder) as “likely to do something violent to others” compared to those described as being ‘troubled’. Research indicates, on balance, a higher than average number of violent acts by some individuals with certain diagnoses, notably antisocial or psychopathic personality disorders, but conflicting findings about specific symptoms (for example links between psychosis and violence in community settings) - but the mediating factors of such acts are most consistently found to be mainly socio-demographic and socio-economic factors such as being young, male, of lower socio-economic status and, in particular, substance abuse (including alcohol). For the most serious crimes, such as homicide, some diagnoses are over-represented in arrests/convictions; however, although high-profile cases have lead to fears that this has increased due to deinstitutionalization, this does not reflect the evidence.

Violence related to mental disorder typically occurs in the context of complex social interactions, often in a family setting rather than between straingers. It is also an issue in healthcare settings[78] and the wider community