A demographic theory of similarity-biased social learning.

Being diagnosed with a mental disorder is associated with a significantly increased risk of a range of forms of police and legal trouble, including arrest and imprisonment. US population survey data suggest that people with mental illness are five times as likely as people with no mental disorder to have been in serious police or legal trouble over the previous 12 months (Buchanan, Moore, Pittman, & McKee, ). The size of this effect varies according to diagnosis. The effect is greater when mental illness is accompanied by substance use or personality disorder, where community surveys report odds ratios of over 10 compared with the general population (Grann, Danesh, & Fazel, ; Van Dorn, Volavka, & Johnson, ). Other replicated correlates of police and legal trouble in people with mental disorders include younger age, male sex, and a history of arrest or violence (Fazel et al., ; Fazel & Grann, ; Swanson, Holzer, Ganju, & Jono, ; Swanson et al., ; Whiting, Lichtenstein, & Fazel, ). Awareness of these statistical correlations, however, does not on its own make clinical and risk management interventions more effective. One additional type of information that would assist clinicians relates to temporal effects. People’s symptoms do not remain constant but are subject to ebbs and flows. To date, attempts to demonstrate associations between violence and the presence of individual symptoms or constellations of symptoms have generally been unsuccessful (Appelbaum, Robbins, & Monahan, ; Buchanan et al., ; Skeem et al., ). One understudied question with implications for clinical management is whether people with mental disorders are more likely to get into trouble with the law during periods of overall clinical deterioration.