Are people experiencing psychosis dangerous to others?

Content warning: this article may contain references to violence and trauma

Key points:

• On April 12, 2024, 40-year-old Joel Cauchi stabbed and killed six and injured a further twelve people in the Westfield Bondi Junction shopping centre

• Joel Cauchi was diagnosed with schizophrenia at the age of 17, according to reports — a psychosocial disability that may lead to episodes of psychosis

• People with schizophrenia or have previously experienced episodes of psychosis are no more violent than the general population when treated for their symptoms

Psychosis is a symptom that afflicts many people with psychosocial disability or mental health conditions, including people with schizophrenia, bipolar disorder and psychotic depression.

Approximately three percent of people will experience a psychotic episode at some point in their life. In any given 12-month period, just under one in every 200 Australian adults will experience a psychotic illness.

Australian media outlets have reported that the perpetrator of the Westfield Bondi Junction shopping centre attacks is 40-year-old Joel Cauchi, who was diagnosed with schizophrenia at the age of 17.

People with schizophrenia and schizoaffective disorder may face stigma surrounding their psychosocial disability, as those with schizophrenia often experience human rights violations both inside mental health institutions and in community settings, according to the World Health Organization.

Symptoms of schizophrenia include:

• hallucinations — hearing or seeing something that isn’t real;
• delusions — believing something that can be proven to be untrue;
• confused thinking — jumbled thoughts or difficulty understanding what others are saying;
• ‘negative’ symptoms, such as low motivation, difficulties with memory or attention and fewer expressed emotions.

For people with a psychotic disorder — such as schizophrenia — these symptoms may seem scary, debilitating or deeply tied to both one’s mortality and quality of life.

Delusions, hallucinations and the way that psychosis can affect a person’s ability to be involved in their community are often poorly understood, according to multiple studies and advocacy groups.

Effective medical, community and psychological treatment is available and a person who experiences schizophrenia can live a fulfilling life with the right support.

People who live with psychosis or schizophrenia are more likely to hurt themselves than others and are more likely to express their aggression, agitation or frustration towards themselves or to family and friends — rarely to strangers.

Although research has determined that there is an increased risk of violence among people experiencing psychosis, people experiencing symptoms can lead successful lives and avoid exacerbating their symptoms through substance use.

Data has suggested that people with schizophrenia are far more likely to take their own lives than those of other people. 

If you or someone you know is experiencing a mental health crisis, access professional help, such as a mental health professional or a support helpline:

Lifeline 13 11 14 — 24/7 support

Kids Help Line 1800 551 800 — 24/7 support

Suicide Call Back Service 1300 659 467 — 24/7 support

SuicideLine 1300 651 251 — 24/7 support

If the person is at serious risk of suicide, stay with them if possible and contact the psychiatric emergency team at your local hospital or call 000.

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