Young men who are members of street gangs are more likely to have psychiatric illnesses and access mental health services, according to new research from the UK published online in the July 12th issue of the American Journal of Psychiatry.

Lead author Professor Jeremy Coid, Director of the Forensic Psychiatry Research Unit at Queen Mary, University of London, says in a statement this is the first time researchers have investigated a possible link between gang violence and psychiatric illness, apart from substance misuse and the burden it places on mental health services.

"Here we have shown unprecedented levels among this group, identifying a complex public health problem at the intersection of violence, substance misuse, and mental health problems among young men," says Coid.

Inner-city areas tend to have higher levels of crime and social problems.

The researchers say that in Britain, about 1% of men aged 18 to 34 are gang members, and this figure rises to 8.6% in the London Borough of Hackney, where 20% of black men reported being in a gang.

Study grouped men into three groups

For their study, they surveyed 4,664 men aged 18 to 34 living in Britain. They note that they deliberately oversampled men from areas with high levels of violence and gang activity, that were more deprived and with a higher-than-average proportion of ethnic minority residents.

The survey was based on standard screening methods and asked the men about gang membership, violence, use of mental health services, and psychiatric diagnoses.

It found that 70.4% of the men (3,284 individuals) reported they had not been violent in the last five years, 27.3% (1,272) said they had been in a fight or assaulted someone, and 2.1% (108) reported being a current gang member.

The researchers then put the men into three groups: gang member, violent, and non-violent, and analyzed the rest of the survey results according to these groups.

These showed that violent men and gang members tended to be younger than non-violent men. They were also more likely to be born in the UK and less likely to have a job.

Violent men and gang members were also significantly more likely to report having a psychiatric illness and to be using mental health services than non-violent men.

There was, however, one exception: depression. This illness was less common among violent men and gang members than non-violent men. The researchers say:

"Violent ruminative thinking, violent victimization, and fear of further victimization accounted for the high levels of psychosis and anxiety disorders in gang members, and with service use in gang members and other violent men."

Psychosis is a term used to describe a range of mental health problems that cause loss of contact with reality, such as hallucinations and delusions (or "having a psychotic episode").

Anxiety disorders within gangs

The survey results showed that of the 108 gang members, over half were drug dependent, two-thirds were alcohol dependent and over 85% had an antisocial personality disorder.

They also found that over half of the gang members had an anxiety disorder and one in three had attempted suicide.

The researchers propose that post-traumatic stress disorder (PTSD), the most common psychiatric condition to result from exposure to violence, may account for the high levels of anxiety disorder and, at least partly, for the high levels of psychosis among gang members.

As street gangs are on the increase in UK cities, the researchers suggest young men in areas where gang activity is high who seek mental health services should be routinely assessed for gang membership.

The elevated levels of attempted suicide among gang members could be linked to psychiatric illness, say the authors, but they also suggest it could be linked to the idea that impulsive violence can be directed at oneself as well as others.

Coid says the survey may have missed some important features of gang membership because they limited the sample to men between the age of 18 and 34, and the average age of a gang member is around 15:

"So gang members in this study should be considered 'core' gang members who have not stopped in early adulthood."

He says more studies following young men should now be done to confirm if their findings are specific to this group.

The research was funded by the The National Institute for Health Research (NIHR) and the Maurice and Jacqueline Bennett Charitable Trust.

In a federally funded study that explored the benefits of gang membership in the US, researchers discovered that children who join gangs feel safer despite a greater risk of being assaulted or killed.

Written by Catharine Paddock PhD