NAMI Ask the Expert: An Evidence-Based Conversation on Violence and Mental Illness OD023

An on-demand video and transcript of the presentation are available here [opens in new tab].

About The National Alliance on Mental Illness (NAMI)

The National Alliance on Mental Illness (NAMI) is the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. They are an alliance of more than 650 local Affiliates and 49 State organizations who work in your community to raise awareness and provide support and education to people with mental illness and their loved ones. Through awareness, advocacy and education, NAMI is committed to building stronger communities and a better future for everyone affected by mental illness.

Course Summary

This course, based on the Ask the Expert webinar series by NAMI, examines what the research actually shows about the relationship between violence and mental illness and how public narratives can overstate this link. Drawing on large cohort studies, the MacArthur Violence Risk Assessment Study, and national threat assessments, the session emphasizes co-occurring factors (e.g., substance use, access to firearms, environmental stressors) that are stronger predictors than psychiatric diagnosis alone and highlights evidence-informed prevention strategies (e.g., threat assessment, IPV prevention, place-based interventions). When mass attacks are analyzed, mental illness is not among the most frequent risk factors, underscoring the need for broader, evidence-based violence-prevention approaches

The course, with an intended audience of social workers, psychologists, marriage and family therapists, and counselors, then presents practical ways clinicians can translate this evidence into safety-focused assessment, de-stigmatizing communication, and multi-factor care planning across settings.

Course Format

This course contains a participant guide, practice test, and on-demand video. When you’re ready, purchase the course by clicking the “Add To Cart” or “Enroll” button. This will let you take the test, complete the course evaluation and receive your certificate for CE credits.

Learning Objectives

1. Identify violence risk factors that show stronger associations than psychiatric diagnosis alone.
2. Describe how exaggerated public narratives about “mental illness and violence” can increase stigma and distract from effective prevention.
3. Apply evidence-informed strategies (e.g., IPV prevention resources, threat assessment principles, place-based interventions, anger-focused CBT/DBT skills) to case examples in clinical settings.

Course Syllabus

• Perception vs. Evidence: What the Literature Shows About Mental Illness and Violence
• Multifactor Risk: Substance Use, Prior Violence, Stressors, Access to Firearms
• Prevention in Practice: Threat Assessment, IPV Prevention, and Environment-Level Strategies
• Reducing Stigma and Improving Safety: Clinical Communication and Care Coordination

Current References

Abu Khait, A., Mrayyan, M. T., & Algunmeeyn, A. (2023). Thematic analysis of mental health nurses’ views of contributing factors fueling workplace violence in psychiatric hospitals: Insights from unsung soldiers. Journal of the American Psychiatric Nurses Association, 31(2), 100–110. https://doi.org/10.1177/10783903231199114[opens in new tab]

Appelbaum, P. S., Robbins, P. C., & Monahan, J. (2000). Violence and delusions: Data from the MacArthur Violence Risk Assessment Study. American Journal of Psychiatry, 157(4), 566–572. https://doi.org/10.1176/appi.ajp.157.4.566[opens in new tab]

Branas, C. C., South, E., Kondo, M. C., Hohl, B. C., Bourgois, P., Wiebe, D. J., & MacDonald, J. M. (2018). Citywide cluster randomized trial to restore blighted vacant land and its effects on violence, crime, and fear. Proceedings of the National Academy of Sciences, 115(12), 2946–2951. https://doi.org/10.1073/pnas.1718503115[opens in new tab]

Centers for Disease Control and Prevention. (2017). Intimate partner violence: Prevention Resource for Action: A compilation of the best available evidence (Revised April 2025). National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. https://www.cdc.gov/violence-prevention/media/pdf/resources-for-action/IPV-Prevention-Resource_508.pdf[opens in new tab]

Ciesinski, N. K., Sorgi-Wilson, K. M., Cheung, J. C., Chen, E. Y., & McCloskey, M. S. (2022). The effect of dialectical behavior therapy on anger and aggressive behavior: A systematic review with meta-analysis. Behaviour Research and Therapy, 154, 104122. https://doi.org/10.1016/j.brat.2022.104122[opens in new tab]

Cui, J., Jensen, S. T., & MacDonald, J. (2021). The effects of vacant lot greening and the impact of land use and business presence on crime. Environment and Planning B: Urban Analytics and City Science, 49(3), 1147–1158. https://doi.org/10.1177/23998083211050647[opens in new tab]

Elbogen, E. B., & Johnson, S. C. (2009). The intricate link between violence and mental disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 66(2), 152–161. https://doi.org/10.1001/archgenpsychiatry.2008.537[opens in new tab]

Garvin, E. C., Cannuscio, C. C., & Branas, C. C. (2013). Greening vacant lots to reduce violent crime: A randomized controlled trial. Injury Prevention, 19(3), 198–203. https://doi.org/10.1136/injuryprev-2012-040439[opens in new tab]

Heller, S. B. (2014). Summer jobs reduce violence among disadvantaged youth. Science, 346(6214), 1219–1223. https://doi.org/10.1126/science.1257809[opens in new tab]

National Threat Assessment Center. (2023). Mass attacks in public spaces: 2016–2020. U.S. Secret Service, U.S. Department of Homeland Security.https://www.secretservice.gov/sites/default/files/reports/2023-01/usss-ntac-maps-2016-2020.pdf[opens in new tab]

Palmier‐Claus, J., Golby, R., Stokes, L. J., Saville, C. W. N., Velemis, K., Varese, F., Marwaha, S., Tyler, E., & Taylor, P. (2025). The relationship between childhood adversity and affective instability across psychiatric disorders: A meta‐analysis. Acta Psychiatrica Scandinavica, 151(1), 33–45. https://doi.org/10.1111/acps.13745[opens in new tab]

Pien, L. C., Wang, C. H., Cheng, W. J., Lin, Y. H., Chou, K. R., & Hsu, C. Y. (2025). The relationship between resilience and mental health status among nurses with workplace violence experiences: A cross‐sectional study. International Journal of Mental Health Nursing, 34(1), e13497. https://doi.org/10.1111/inm.13497[opens in new tab] 

Pierre, J. M. (2025). Conspiracies gone wild: A psychiatric perspective on conspiracy theory belief, mental illness, and the potential for lone actor ideological violence. Terrorism and Political Violence, 37(4), 550–569. https://doi.org/10.1080/09546553.2024.2329079[opens in new tab]

Smart, R., Morral, A. R., Ramchand, R., Charbonneau, A., Williams, J., Smucker, S., Cherney, S., & Xenakis, L. (2023). The science of gun policy: A critical synthesis of research evidence on the effects of gun policies in the United States (3rd ed.). RAND Corporation. https://www.rand.org/pubs/research_reports/RRA243-4.html[opens in new tab]  

Smart, R., Morral, A. R., Murphy, J. P., Jose, R., Charbonneau, A., & Schell, T. L. (2026). The science of gun policy: A critical synthesis of research evidence on the effects of gun policies in the United States (5th ed.). RAND Corporation. https://www.rand.org/pubs/research_reports/RRA4360-2.html[opens in new tab]

Semenza, D. C., Bond, A. E., Ziminski, D., & Anestis, M. D. (2025). Frequency, recency, and variety of gun violence exposure: Implications for mental health and suicide among US adults. Social Science & Medicine, 366, 117672. https://doi.org/10.1016/j.socscimed.2025.117672[opens in new tab]

Steadman, H. J., Mulvey, E. P., Monahan, J., Robbins, P. C., Appelbaum, P. S., Grisso, T., Roth, L. H., & Silver, E. (1998). Violence by people discharged from acute psychiatric inpatient facilities and by others in the same neighborhoods. Archives of General Psychiatry, 55(5), 393–401. https://doi.org/10.1001/archpsyc.55.5.393[opens in new tab]

Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 NSDUH (HHS Publication No. PEP20-07-01-001, NSDUH Series H-55). https://library.samhsa.gov/product/results-2019-national-survey-drug-use-and-health-nsduh-key-substance-use-and-mental-health[opens in new tab]

Swanson, J. W., Holzer, C. E., Ganju, V. K., & Jono, R. T. (1990). Violence and psychiatric disorder in the community: Evidence from the Epidemiologic Catchment Area surveys. Hospital and Community Psychiatry, 41(7), 761–770. https://doi.org/10.1176/ps.41.7.761[opens in new tab]

Whiting, D., Lichtenstein, P., & Fazel, S. (2021). Violence and mental disorders: A structured review of associations by individual diagnoses, risk factors, and risk assessment. The Lancet Psychiatry, 8(2), 150–161. https://doi.org/10.1016/S2215-0366(20)30262-5[opens in new tab]

Instructors

Eric Elbogen, PhD, Professor of Psychiatry, Duke University

Eric Elbogen is a Professor of Psychiatry and Behavioral Sciences at the Duke University School of Medicine and a psychologist at the U.S. Department of Veterans Affairs (VA). He has done clinical work in mental health facilities for over thirty years and has conducted research at the intersection of law and mental health and authored over 200 scientific articles. He is board certified in forensic psychology and serves on the editorial boards of scholarly journals, including Law and Human Behavior and the International Journal of Forensic Mental Health.

Nicole Errickson, LCSW

Nicole is a Licensed Clinical Social Worker (LCSW) in the state of Georgia. She brings over 19 years experience in the social work field, primarily working in school systems as a school social worker and with the McKinney-Vento grant. Over her career, Nicole has had several opportunities to help develop and execute professional development events. Nicole has a bachelor’s degree in psychology from the University of South Alabama and a Masters in Social Work from the University of Alabama.

Accreditation Approval Statements

CE4Less.com is approved by the American Psychological Association to sponsor continuing education for psychologists. CE4Less.com maintains responsibility for this program and its content.

CE4Less.com, provider #1115, is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: 8/8/24-8/8/27.

Social workers completing this course receive 1 general continuing education credit.

We are committed to providing our learners with unbiased information. CE4Less never accepts commercial support and our authors have no significant financial or other conflicts of interest pertaining to the material.