July 15, 2019

BEHAVIORAL AND PUBLIC HEALTH
PERSPECTIVES ON VIOLENCE PREVENTION: A
SURVEY OF ILLINOIS PRACTITIONERS

ILLINOIS CRIMINAL JUSTICE INFORMATION AUTHORITY
CENTER FOR JUSTICE RESEARCH AND EVALUATION

LILY GLEICHER, PH.D., RESEARCH ANALYST

Abstract: Violence is one of the top three leading causes of death for individuals
between the ages of 15 and 34 in the United States, and the American Public Health
Association and Centers for Disease Control have designated violence a public health
crisis. Important to combating this crisis are behavioral and public health
professionals and practitioners who directly work to prevent violence. The present
study sought to understand behavioral and public health providers’ competencies,
capacities, comfort, confidence, and preparedness in violence prevention. Results
from a survey of 152 respondents indicated there are areas for improving the
education and training around violence prevention, as well as legal and ethical
liabilities among practitioners. Further, few practitioners reported receiving client
referrals from law enforcement agencies.

 Introduction

Prevention of any kind—disease, violence, crime, and other public health concerns—
necessitates understanding factors that mitigate public safety concerns and community wellbeing, in addition to incorporating effective prevention and intervention responses. The goal of
public health is to protect and improve the health and well-being of individuals and their
communities through the promotion of awareness, education, research, and responses to public
health concerns,1 Important to successful prevention are the capabilities and capacities of
behavioral and public health professionals who provide the direct care and services to individuals
and their communities.2
This article focuses on behavioral health providers and public health practitioners who
have a direct impact on individuals within communities and are part of a broader violence
prevention and intervention framework. They play a crucial role in the lives of individuals who
may be at-risk for violence, suicide, or other behavioral health concerns.3 Behavioral health
providers and public health practitioners also are on the front lines of preventing violence and
enhancing community member well-being and resilience—thus, impacting overall community
well-being.
The present study attempted to identify practitioner comfort and confidence working in
the violence prevention space. In addition, researchers sought to gain practitioner understanding
of client confidentiality, duty to warn, and legal liability surrounding violence prevention and
targeted violence prevention. Researchers conducted a survey of behavioral and public health
professionals to gain understanding around practitioner capacity and competency to address
violence prevention in general as well as targeted violence specifically. This survey was
conducted as part of a larger project to inform the Illinois Criminal Justice Information
Authority’s (ICJIA) Targeted Violence Prevention Program (TVPP). Information gleaned from
this survey was used to help provide general insights to the to better understand what connecting
an individual to a behavioral or health practitioner, who may espouse ideologies or beliefs that
justify the use of violence as a means to further political, economic, or social objectives to a
provider in the community, and gain insight as to what providers know, feel comfortable with,
and are prepared for working with individuals who espouse beliefs or ideologies that justify the
use of violence. 4 In addition, practitioners were asked questions surrounding behavioral and
public health professionals’ knowledge on client confidentiality and duty to warn, as well as
questions regarding referrals from law enforcement and knowledge about client confidentiality
and duty to warn as it relates to those referrals.
Client confidentiality refers to the privileged, legally protected communications between
a provider and a client, and the very specific situations in which clinical practitioners can share
client information with (or without) the client’s consent.5
Duty to warn refers to the specific situation(s) in which a behavioral health practitioner
can disclose confidential information without legal liability for breaching confidentiality. 6
Usually, behavioral health practitioners must keep practitioner-client communications

 confidential; however, state and federal laws have identified exceptions that protect a potential
victim from a client’s threat to the individual’s safety.7 In Illinois, there are two laws regarding
duty to warn:
1. 740 ILCS 110/11, which, among other provisions, allows for disclosure of
confidential information, “when, and to the extent, in the therapist’s sole discretion,
disclosure is necessary to warn or protect a specific individual against whom a
recipient has made a specific threat of violence where there exists a therapist-recipient
relationship or a special recipient-individual relationship.”
2. 405 ILCS 5/6-103 where there is, “no liability on the part of, and no cause of action
shall arise against, any person who is a physician, clinical psychologist, or qualified
examiner based upon that person’s failure to warn of and protect from a recipient’s
threatened or actual violent behavior except where the recipient has communicated to
the person a serious threat of physical violence against a reasonably identifiable
victim or victims.”
Present Study
ICJIA researchers surveyed behavioral and public health practitioners in Illinois about
their experiences, understanding, confidence, capacities, and concern regarding violence
prevention and intervention.8
Research questions included:
1. What are practitioners’ current confidence and comfort in suicide and violence
prevention?
2. What is the extent of practitioners’ knowledge in working with individuals who may:
a. Be referred to services by a law enforcement agency?
b. Have a history of violence?
c. Espouse beliefs that justify the use of violence?
3. What, if any, concerns do practitioners have with regard to working with individuals
who may espouse beliefs that justify the use of violence (e.g. legal liability,
confidentiality)?
4. What are the current practitioner capacities and competencies in violence and targeted
violence prevention and intervention?
Methodology
ICJIA researchers identified relevant local, regional, and statewide associations to ask for
their assistance in either emailing the survey and survey completion reminders directly to their
members or providing an association list for direct emailing from ICJIA researchers. Seven
entities participated as part of the survey, including four statewide associations and three
county/local organizations. Survey participants were recruited through local, regional, and
statewide associations serving social workers, psychologists and other behavioral health
professionals, and other service providers at hospitals and public health agencies. Only direct
behavioral and/or public health service providers in Illinois were asked to participate, and only

 those that indicated direct service provision were included in analyses. The study was approved
by ICJIA’s Institutional Review Board through exempt review; data collected via surveys did not
include identifying information. Demographic information on race, ethnicity, and gender was
limited.
An online survey was created in Qualtrics and consisted of 39 questions, including some
with multiple parts. The total number of questions answered may have differed based on skip
patterns. The survey questions included those related to:
•
•
•

•
•
•

Types of services, clientele, certifications, setting, and qualifications of the
respondent.
Types of referrals, insurance accepted, and attendance to any specialized training.
Comfort and preparation in assessing, preventing, and intervening with clients
who have previously committed violence, who have a history of violence, and/or
working with those who espouse beliefs that justify violence as a means to further
his/her end goal (e.g. social, economic, political).
Knowledge regarding violence prevention and targeted violence, specifically.
Types of assessments known, previously utilized, and/or currently used.
Information on legal liability regarding confidentiality, duty to warn, and law
enforcement referrals.

E-mails by ICJIA researchers to the designated association points of contact were sent on
the same day and the points of contact were also asked to distribute the survey using a scripted
recruitment e-mail on October 17, 2018. The same scripts were used when ICJIA researchers
directly distributed the survey. Two reminders were e-mailed using the same process of scripted
e-mails. The survey closed on January 9, 2019.
A total of 201 surveys were submitted, 152 of which were included in the final study
sample (49 respondents excluded). Surveys with a significant number of missing responses (i.e.
only the demographic information was filled out) were excluded, as were surveys from those
who did not provide direct service in the capacity of behavioral or public health (e.g., dental
assistants, substitute teacher, school administrators, administrative assistants, Medicaid/health
insurance navigators, other administrative personnel). Researchers were unable to calculate a
response rate, as there was an unknown base number for survey distribution. Minimally, 500
surveys were distributed through four of the seven associations; some individuals receiving the
survey were ineligible for study inclusion.
Of the 152 respondents, 82 percent identified as White (non-Latinx) and female (87
percent). Respondents most frequently indicated serving clients in Cook County (n=59) and
Champaign County (n=25). A total of 29 percent identified themselves as mental health
counselors, 12 percent identified themselves as social workers, and 11 percent identified
themselves case managers. In addition, 28 percent self-identified as “other,” which
predominately consisted of administrators and/or directors who reported some direct client
contact. Further, 25 percent of the sample indicated they were licensed clinical social workers
(LCSW) and 20 percent said they were licensed clinical professional counselors (LCPC). A total

 of 36 percent listed an “other” degree or certification, which predominately consisted of a
bachelor’s degree.
Study limitations. The study used a convenience sample and the sample size was small,
incorporating just seven community mental health centers/agencies of more than 160 in Illinois.9
The largest percentage of respondents served clients in two urban cities. Because of the
convenience sample and limited responses from other areas across the state, the results are not
generalizable to all mental, behavioral, and public health practitioners across the state. Further,
some administrators or supervisors were included in the survey as they identified working on a
limited basis directly with some clients. This is a limitation as they likely see fewer clients, on
average, than those who provide direct service as non-administrators. Future research could
benefit from collecting information on the specificity about type of work and number direct
client contact hours of providers, as well as information about the direct service setting and
employment level within the organization (e.g. administration, line staff, auxiliary staff).
Study Findings
Below are the findings from the survey of 152 behavioral and public health practitioners
in Illinois.
Clients, Services, and Referrals
Table 1 provides the breakdown of the respondents’ identified clientele. Respondents
identified serving a wide range of clients from varying socioeconomic classes, race/ethnicities,
and age ranges.
Table 1
Characteristics of Clients Served by Respondents (N=152)
Clients
% (n)
People of color
86 (131)
Females
82 (124)
Adults (Ages 25+)
80 (122)
Young adults (Ages 18 – 24)
69 (105)
Co-occurring disorders
66 (100)
LGBTQI
66 (101)
Families
65 (98)
Justice-involved
61 (93)
Homeless
59 (89)
Youth (Ages 11 – 17)
56 (85)
Children (Ages 10 or younger)
51 (77)
Non-English speakers
43 (65)
Intellectually disabled
41 (62)
Undocumented immigrants
41 (62)
Source: ICJIA analysis of survey data.

 Most frequently, respondents indicated providing services within community-based
organizations (38 percent, n=57) and community mental health centers (38 percent, n=57).
Figure 1 lists settings in which respondents indicated they provide services to clients.
Figure 1
Settings for Service Provision (N=152)
Community MH center
Community-based org.
Public health org.
School
Clinic
Institutional facility
Hospital
Private practice office
Residential facility
In homes
University
Other government agency

38%
38%
16%
16%
9%
9%
9%
8%
7%
4%
3%
3%

Source: ICJIA analysis of survey data.

Table 2 gives the breakdown of respondents’ provision of services. Over half of the
respondents indicated they provide individual counseling, mental health assessments, and/or case
management services.

 Table 2
Services Provided (N=152)
Services
% (n)
Individual counseling
66 (100)
Mental health assessments
55 (84)
Case management
55 (84)
Group counseling
40 (60)
Family counseling
34 (52)
Evaluations
24 (36)
Parenting classes/counseling
22 (34)
Substance use disorder treatment/services
21 (32)
Child abuse counseling/services
13 (19)
Intimate partner violence/domestic violence services 12 (18)
Community Support Team Services (CST)
11 (17)
Violence prevention/education
9 (14)
Psychiatric care
8 (12)
Art therapy
7 (10)
Assertive Community Treatment (ACT)
3 (5)
Psychoanalysis
1 (2)
Partner Abuse Intervention Program (PAIP)
1 (2)
Other
Crisis services
System navigation
Other relevant services
Peer support services
Other health services

3 (5)
3 (5)
3 (5)
1 (3)
1 (2)

Source: ICJIA analysis of survey data.
Notes: Other relevant services include mental health consultation to teachers, career counseling, bereavement
services, and anger management/trauma-informed parenting.

Survey respondents indicated that they (or their agencies) accept a range of insurance and
payment options. The majority of respondents reported taking Medicaid clients (72 percent) and
over half reported taking uninsured clients (55 percent). In addition, many reported taking clients
who have PPOs (49 percent), HMOs (43 percent), and Medicare (40 percent). A total of 47
percent of respondents indicated they provide the option to pay for services on a sliding scale.
Few respondents indicated they took out-of-network insurance for client services (9 percent).
Most clients were self-referred (Figure 2).

 Figure 2
Percentage of Client Referrals by Type of Referral (N=152)
76%
59%

Self referrals

Physician
referrals

58%

Hospital
referrals

48%

Criminal
justice
referrals

46%

43%

School
referrals

Colleague
referrals

36%

Law
enforcement
referrals

Source: ICJIA analysis of survey data.

Figure 3 depicts the frequency with which respondents received referrals from law
enforcement agencies within the previous 12 months. Most often, respondents indicated never
receiving referrals from local (44 percent), state (69 percent), or federal (76 percent) law
enforcement. Over half of the survey respondents reported receiving self-referrals (76 percent),
physician referrals (59 percent), and hospital referrals (58 percent).

Figure 3
Client Referrals from Law Enforcement within the Past 12 Months (N=152)

76%
69%
Local law enforcement
44%

State law enforcement
Federal law enforcement
17%15%
8%

None

19%

Rarely

Source: ICJIA analysis of survey data.

8% 8%
Sometimes

15%
4% 5%
Often

4% 3% 3%
Always

 Respondent Training
In the survey, researchers asked behavioral and public health practitioners about the types
and frequency of training they receive, along with assessments used by practitioners to determine
client needs. Seventy-one percent reported receiving annual continuing education. Many reported
receiving training in suicide prevention, cultural competency (the ability to understand and work
with diverse cultures, values, and beliefs), and specialized violence prevention (Figure 4). While
most indicated receiving cultural competency training, less than a quarter of respondents
indicated participating in specialized violence prevention training.
Figure 4
Percentage of Respondents Who Received Each Type of Training (N=152)
Cultural competency

95%

Suicide prevention

Specialized violence prevention

65%

20%

Source: ICJIA analysis of survey data.

While over half of survey respondents received training on legal liability regarding
confidentiality and duty to warn through their agency, only one quarter of respondents reported
receiving training on legal liability regarding law enforcement referrals (Figure 5).
Figure 5
Percentage of Respondents Whose Agencies Provide Legal Liability Training, by Type (n=136)
Training on legal liability regarding confidentiality

73%

Training on duty to warn
Training on legal liability regarding law
enforcement referrals
Source: ICJIA analysis of survey data.

54%

26%

 Approximately one-fourth of respondents indicated moderate or extreme concern about their
duty to warn as it relates to individuals referred by a law enforcement agency, those who have a
history of violence, and those who espouse beliefs that justify targeted violence (Figure 6).
Figure 6
Percentage of Respondents Who Were “Moderately” or “Extremely” Concerned About Duty to
Warn (n=133)
Concern about duty to warn regarding clients
who espouse beliefs that justify targeted violence

Concern about duty to warn with clients who
have a history of violence

Concern about duty to warn with clients referred
by a law enforcement agency

24%

23%

21%

Source: ICJIA analysis of survey data.

Similarly, between one-fifth and one-fourth of respondents indicated moderate or
extreme concern about legal liability regarding confidentiality as it relates to individuals referred
by a law enforcement agency, those who have a history of violence, and those who espouse
beliefs that justify targeted violence (Figure 7).
Figure 7
Confidence Levels in Handling Other Concerns (N=152)
Handling concern expressed by client about
someone else

53%

Handling a concern expressed by client's
family or friend

50%

Concern with intervening for a client who
espouses beliefs that justify targeted violence
Not at all/Slightly

Somewhat

61%

24%
24%
19%

24%
27%
19%

Moderately/Extremely

Source: ICJIA analysis of survey data

Behavioral and public health practitioners also were asked about their use of client
assessments. Responses indicated little consistency in use of assessment tools across providers;

 however, assessment needs may vary depending on clientele and services provided. The most
commonly reported assessment tools in use by respondents and respondent agencies included:
•
•
•
•
•
•
•
•
•

Level of Care Utilization System (LOCUS).
Patient Health Questionnaire 9 (PHQ-9) and PHQ-2.
Illinois Medicaid Comprehensive Assessment of Needs (IM + CANS).
Beck Depression Inventory.
Trauma History Questionnaire.
Global Assessment of Functioning (GAF) Scale.
Daily Living Activities (DLA) Functional Assessment.
Ohio Scales.
Columbia Scales.

Practitioner Knowledge on Targeted Violence
Respondents were asked questions to gauge knowledge of and familiarity with targeted
violence and countering violent extremism (avenues of targeted violence prevention). Targeted
violence features individuals who espouse ideologies or beliefs that support the use of violence
as a justified means to further political, economic, or social objectives (Figure 8).
Figure 8
Familiarity with Targeted Violence Prevention and Countering Violent Extremism
1%
7%
20%

3%
5%
23%

1%
12%

1%

1%

47%
46%
71%
41%

23%
Have you ever heard of targeted
violence? (n=149)
None at all

Have you ever heard of
countering violent extremism?
(n=148)

A little

A moderate amount

How much have you heard about
countering violent extremism?
(n=148)
A lot

A great deal

Source: ICJIA analysis of survey data.

Most respondents reported they had heard nothing or a little about targeted violence and
countering violent extremism. Further, almost 90 percent had heard nothing or a little about
countering violent extremism programs. After providing survey respondents with the definition
for targeted violence, 19 percent of respondents reported currently working with clients who

 engage(d) in or talk(ed) about engaging in targeted violence and 36 percent of respondents
indicated they had previously worked with a client who talked about or engaged in targeted
violence. Sixty-one percent of those who reported having experience working with clients who
engaged in or talked about engaging in targeted violence had never heard of targeted violence
and 89 percent of them had never heard of countering violent extremism.10
Comfort, Preparedness, and Confidence in Assessing, Preventing, and Intervening
Behavioral and public health practitioners were asked about their comfort and confidence
regarding assessment, prevention, and intervention regarding suicide, violence, and targeted
violence. While most respondents indicated being moderately and very comfortable assessing
individuals for suicide risk and assessing individuals for violence with individuals who had no
history of violence, fewer respondents felt moderately and very comfortable preventing clients
from future violence or intervening with individuals who may espouse beliefs that justify
targeted violence (Figures 9 and 10).
Figure 9
Percentage of Respondents Who Reported Being “Moderately Comfortable” or “Very
Comfortable” Assessing, Preventing, and Intervening with Specific Clients

68%
51%

48%

45%
31%
20%

Assessing for
suicide risk
(n=152)

Assessing for
violence with
individual who
has no violent
history (n=152)

Source: ICJIA analysis of survey data.

Assessing for Intervening with Preventing clients Intervening with
violence with clients who have
from future
individual who
individual who a violent history violence (n=151) may present
has violent
(n=152)
beliefs that justify
history (n=152)
engaging in
targeted violence
(n=136)

 Figure 10
Percentage of Respondents Who Reported Feeling “Not at All” or “Slightly” Prepared to
Assess, Prevent, and Intervene with Individuals Who Espouse Beliefs That Justify Targeted
Violence
Prepared to intervene with someone who
espouses beliefs that justify targeted violence
(n=137)

68%

Prepared to prevent someone who espouses
beliefs that justify targeted violence (n=136)

74%

Prepared to assess someone who espouses
beliefs that justify targeted violence (n=138)

66%

Source: ICJIA analysis of survey data.

Most respondents indicated feeling not at all or slightly prepared to assess, prevent, or intervene
with individuals who may ascribe to certain beliefs that justify or promote violence toward
specific groups of people or entities (i.e. targeted violence) (Figure 10).
There were statistically significant differences in respondents’ reported preparation for
assessment, prevention, and intervention with clients who talk(ed) about or who have engaged in
targeted violence based on the varying levels of experience working with those individuals
(Table 3). Those who reported experience working with clients who espouse beliefs or ideologies
that justify violence reported feeling more prepared to work with them.
Table 3
Test for Differences in Preparedness for Assessment, Prevention, and Intervention for
Respondents Based on Targeted Violence Experience (N=152)
Preparedness for assessment of
someone who may ascribe to beliefs
or ideologies that justify violence.
Preparedness for prevention of
someone who may ascribe to beliefs
or ideologies that justify violence.
Preparedness for intervention of
someone who may ascribe to beliefs
or ideologies that justify violence.
Source: ICJIA analysis of survey data.

t-test

Sig.

CI Lower

CI Upper

-3.74

.000

-1.12

-.35

-3.10

.003

-1.07

-.23

-3.58

.001

-1.13

-.32

 Conclusion and Implications for Practice
While targeted violence likely falls into the same area as violence prevention, surveyed
practitioners reported feeling less prepared to deal with individuals who may ascribe to beliefs or
ideologies that justify violence towards specific people(s) or location(s)...
Researchers also found the following:
1. Few practitioners reported receiving referrals from local, state, or federal law
enforcement agencies, nor did they report receiving training on legal liability related to
law enforcement referrals. Most respondents received referrals from physicians,
hospitals, or self-referrals. The vast majority received cultural competency training and
many reported serving individuals from varying backgrounds.
2. Most frequently, participants reported feeling comfortable assessing clients for suicide
risk. They were less comfortable intervening or preventing individuals from committing
future violence. Twenty percent of respondents reported receiving specialized training in
violence prevention and participants infrequently identified violence risk assessments as
part of regular practice.
3. About two-thirds of respondents reported they had no experience working with an
individual who discussed or engaged in targeted violence, with the majority feeling
unprepared to assess, prevent, or intervene with someone who may ascribe to beliefs or
ideologies that justify violence.
4. Approximately half of the respondents were somewhat to extremely concerned about their
legal liability regarding their duty to warn and confidentiality. This suggests that while
respondents may feel they generally have a grasp on duty to warn, training and education
in this area may be needed to address more specifically, how this applies to individuals
who are referred from a law enforcement agency, those who have a history of violence,
and/or those who may ascribe to beliefs or ideologies that justify violence.
Survey findings indicated behavioral and public health professionals may need more
education and training on how to work with populations at risk for violence against themselves
or others, targeted or otherwise. Practitioners may benefit from support and updates—through
continuing education credits and/or from within their own organizations—about legal liability
related to duty to warn, confidentiality, and managing law enforcement referrals. Continuous
refreshers on these topics can maintain practitioner preparation and may create more confidence
in working with individuals at risk for violence, specifically regarding the applicability of the
legal and ethical requirements, especially when situations may pose ethical issues.11
Incorporating additional education and training around these topics may also This assist
practitioners in informing their clients of their own rights to confidentiality, duty to warn, and
what information practitioners can and cannot share with law enforcement. In one study, 43
percent of social workers reported they had informed clients with written descriptions about the
limits of confidentiality.12 This may be one way to maintain consistency across
organizations/providers and set up-front boundaries and expectations with clients.

 It may also be beneficial to provide more specialized training in violence prevention and
intervention incorporating assessment, evaluation, and clinical or practical “tools” that
behavioral and public health practitioners are already using in other situations (e.g. de-escalation,
service linkage, cognitive-behavioral therapy, etc.). This could include training on different types
of violence, such as targeted violence, interpersonal violence, hate crimes/hate-inspired violence,
and gang violence. Specialized training on effective violence prevention strategies would provide
clinicians with the capacity to more broadly impact violence at multiple levels, with the inclusion
of effective violence prevention strategies for their workplace as well as their clients. This
increased capacity, in turn, could help create more healthy and resilient communities.

This project was supported by Grant #EMW-2016-CA-APP-00169, awarded to the
Illinois Criminal Justice Information Authority by the U.S. Department of
Homeland Security. Points of view or opinions contained within this document are
those of the authors and do not necessarily represent the official position or
policies of the U.S. Department of Homeland Security.
Suggested citation: Gleicher, L. (2019). Behavioral and public health perspectives
on violence prevention: A survey of Illinois practitioners. Chicago, IL: Illinois
Criminal Justice Information Authority.
https://doi.org/10.13140/RG.2.2.21462.40007/1

 1

Centers for Disease Control Foundation. (2019). What is public health?. Atlanta, GA: Author. Retrieved
from https://www.cdcfoundation.org/what-public-health; Weine, S., Eisenman, D. P., Kinsler, J., Glik, D.
C., & Polutnik, C. (2017). Addressing violent extremism as public health policy and practice. Behavioral
Sciences of Terrorism and Political Aggression, 9(3), 208–221.
https://doi.org/10.1080/19434472.2016.1198413
2
Centers for Disease Control Foundation. (2019). What is public health?. Atlanta, GA: Author. Retrieved
from https://www.cdcfoundation.org/what-public-health; Weine, S., Eisenman, D. P., Kinsler, J., Glik, D.
C., & Polutnik, C. (2017). Addressing violent extremism as public health policy and practice. Behavioral
Sciences of Terrorism and Political Aggression, 9(3), 208–221.
https://doi.org/10.1080/19434472.2016.1198413
3

National Academies of Sciences, Engineering, and Medicine. (2018). Violence and mental health:
Opportunities for prevention and early detection: Proceedings of a workshop. Washington, DC: The
National Academies Press. https://doi.org/10.17226/24916
4
U.S. Agency for International Development. (2011). The development response to targeted violence.
Retrieved April 12, 2018, from https://www.usaid.gov/news-information/fact-sheets/developmentresponse-violent-extremism
5
American Psychological Association. (2019). Protecting your privacy: Understanding confidentiality.
Washington, DC: Author. Retrieved from https://www.apa.org/helpcenter/confidentiality
6
National Council of State Legislatures. (2018). Mental health professionals’ duty to warn. Washington,
DC: Author. Retrieved by http://www.ncsl.org/research/health/mental-health-professionals-duty-towarn.aspx
7
National Council of State Legislatures. (2018). Mental health professionals’ duty to warn. Washington,
DC: Author. Retrieved by http://www.ncsl.org/research/health/mental-health-professionals-duty-towarn.aspx
Aggregate information gleaned from this survey was used to help provide general insights for ICJIA’s Targeted
Violence Prevention Program
8

9

Division on Mental Health. (n.d.). Mental health. Chicago, IL: Illinois Department of Human Services,
Division Mental Health. Retrieved from http://www.dhs.state.il.us/page.aspx?item=29735
10

Survey respondents were provided with the definition of targeted violence after they were asked about what they
knew about targeted violence and countering violent extremism; therefore, respondents could make a more informed
determination of whether they currently or had ever worked with individuals who have talked about or engaged in
targeted violence.
11

Millstein, K. (2000). Confidentiality in direct social-work practice: Inevitable challenges and ethical
dilemmas. Families in Society, 81(3), 270-282.
12
Millstein, K. (2000). Confidentiality in direct social-work practice: Inevitable challenges and ethical
dilemmas. Families in Society, 81(3), 270-282.