The Character of Danger in Psychiatric Practice: Are the ÿ en tally Ill Dangerous?

This paper explores the question of dangerousness and the mentally ill. Research for this paper was stimulated by the death by homicide of two psychiatrists in Oregon in 1985. The paper reviews three distinct areas in the psychiatric literature: the arrests of mental patients, assaults against psychiatrists and other mental health professionals, and assaultive behaviors exhibited by patients in hospitals and other psychiatric settings. The author concludes that the risks are real but are dependent, for the most part, on setting and the acuteness of illness. Realism in regard to risk is critical for the mentally ill, their families, professional caregivers, and society in general. During the first six months of 1985 two Oregon psychiatrists were killed by psy-chiatric patients. On February 6th a psy-chiatrist died on a general medical in-patient ward in a community hospital after being assaulted by an acutely psy-chotic inpatient he had met for the first time only hours before. On June 26th another psychiatrist was shot to death in his private office by a chronically men-tally ill former patient with a known history of violence associated with his mental illness. The death of these colleagues left many psychiatrists in Oregon with a sense of confusion regarding the ques-tion of whether the mentally ill are dan-gerous. Genuine confusion about thi