Mental Illness, Violent Criminal Behavior, and the MediatingInfluence of Homelessness

全国各地的数据表明，在精神病患者中，无家可归与犯罪行为的增加有关。迄今为止的研究文献表明，无论是精神障碍还是无家可归，都不足以解释暴力犯罪风险的增加。然而，将无家可归的精神病患者与暴力犯罪联系起来的研究提出了无家可归和精神障碍以某种不稳定的方式相互作用的可能性。怎样才能解释这种关系？与无家可归相关的因素可能会增加精神病患者暴力犯罪行为的风险。或者，无家可归的精神病患者可以简单地接受刑事司法和法医精神卫生系统的区别对待。犯罪学理论表明，造成这些模式的不是危险行为风险的增加，而是逮捕风险的增加。本研究采用病例对照设计，试图系统地探讨这一问题。计划进行两项子研究。第一个项目通过探索无家可归对精神病患者的暴力犯罪行为的影响来检验“风险”。150名无家可归者和150名居住在当地的精神障碍罪犯的数据将被审查。第二个项目通过区分两组无家可归的精神病患者来探索“刑事化”：150名有犯罪行为史的人和150名没有犯罪行为史的对照人员。这些数据将来自法庭记录、医院记录、患者和家属访谈以及标准诊断仪器。这项研究有望大大增加我们对无家可归在精神疾病和暴力犯罪行为之间的联系中所扮演的角色的了解。它不仅将开辟新的领域，而且还将为今后对社会暴力原因的前瞻性研究奠定基础。

Across the country there are data suggesting that, among the mentally ill, homelessness is associated with increased criminal behavior. The research literature to date suggests that neither mental disorder nor homelessness alone adequately accounts for an increase in risk for violent crime. Studies, however, linking the homeless mentally ill with violent crime raise the possibility that homelessness and mental disorder interact in some volatile way. What might explain this relationship? It is possible that factors associated with homelessness may place the mentally ill at increased risk for violent criminal behavior. Alternatively, the homeless mentally ill may simply receive differential treatment by the criminal justice and forensic mental health systems. Criminological theory suggests that it is not increased risk of dangerous behavior, but an increased vulnerability to arrest that accounts for these patterns. Using a case-control design, this study seeks to explore this issue systematically. Two sub-studies are planned. The first project examines "risk" by exploring the contribution of homelessness to violent criminal behavior in the mentally ill. Data from 150 homeless and 150 domiciled mentally disordered offenders will be examined. The second project explores "criminalization" by discriminating between two groups of homeless mentally ill persons: 150 who have a history of criminal behavior and 150 matched control persons who do not. The data will be derived from court records, hospital records, patient and family interviews, and standard diagnostic instruments. This study promises to add substantially to our knowledge of the role of homelessness in mediating the link between mental illness and violent criminal behavior. It will not only break new ground but also lay the foundation for future prospective studies of the causes of violence in society.