Q. A friend of mine from high school has since become a paranoid schizophrenic. He has been homeless and on the streets for years, jobless, and has been addicted to multiple drugs and an alcoholic since I have known him. I try to keep contact with him limited, although I recently found out from his family that he is traveling hundreds of miles of foot to see me because he believes that I can help him. He is not on medication and seems to be in an ongoing “episode” that never stops. He is extremely paranoid and delusional, and the drug addiction doesn’t help matters any. He has a long history of family physical abuse and has been arrested for abuse of a girlfriend. He has never taken any medication or been treated, because he doesn’t believe that he truly is schizophrenic. I am wondering how much of a threat he is to me, and how much danger I am in? I have received conflicting information- that paranoid schizophrenics are rarely violent, and on the other hand that, unmedicated, they are frequently prone to violence and that the violence is usually directed at loved ones, which I would be considered a “loved one” to him. Any information you have is appreciated, although I assure you I am taking extra precautions to protect myself in the event that he does find me and possibly try to harm me. Thank you.
A. You have asked an intriguing and difficult to answer question. From my research and personal experience, it is my contention that individuals with schizophrenia are no more dangerous than the average person except when they are actively psychotic, unmedicated, unable to recognize that they are ill and are using drugs and alcohol. Your friend has all four of these risk factors simultaneously putting him at a high risk for violence. This in no way means that he will become violent towards you; it only means that he has an increased risk for becoming violent. Another helpful indicator in determining his risk for violence is whether or not he has acted out violently towards others in the past. Studies show that past violence is a good predictor of future violence. The other risk involved with your friend is that he may also try to harm himself.
The truth of the matter is that it is extremely difficult and practically impossible to predict your friend’s future behavior towards you, himself or anyone else. What is most important in this situation is trying to get him into treatment. I realize that this is a monumental task, one in which you may not be up to fighting. Civil commitment laws in most states make it nearly impossible to for someone like your friend to get help BEFORE something bad happens. It is almost always the case that something bad has to happen before an individual would be eligible for psychiatric help. Despite this, I would strongly encourage you to try to get him help before he hurts himself or someone else. If you are not willing to try to get him help, then I would advise you to take extra precautions (as you are already doing) and to call the police anytime you feel it is necessary. I am not telling you to call the police to have him arrested; it is just that the police, in many communities, are often the first-line responders in situations regarding individuals with psychiatric disorders. Police show up at the scene and call for help usually from trained, mental health crisis assistance teams. The mental health crisis teams try to get individuals into treatment and are trained to work with individuals just like your friend. I hope this helps to answer your question. Please write again if you have any more questions or needed further clarification about my answer. Take care.
Last reviewed: By John M. Grohol, Psy.D. on 16 Mar 2007
Randle, K. (2007). Are people with schizophrenia violent?. Psych Central. Retrieved on March 12, 2014, from http://psychcentral.com/ask-the-therapist/2007/03/16/are-people-with-schizophrenia-violent/