https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(12)60692-8.pdf

Prevalence and risk of violence against children with disabilities: a systematic review and meta-analysis of observational studies.

Objective: To estimate the prevalence of criminal victimization among people with severe mental illness and to explore risk factors.

Method:  Four databases (MEDLINE, ScienceDirect, ERIC, and AMED) were searched for articles published between January 1966 and August 2007, supplemented with hand-search of reference lists from retrieved papers. The author and a Medical Doctor independently abstracted data and assessed study quality. Disagreements were resolved by consensus after review of the article and the review protocol.

Results:  Nine studies, including 5195 patients, were identified. Prevalence estimates of criminal victimization ranged from 4.3% to 35.04%. Rates of victimization among severely mentally ill persons were 2.3–140.4 times higher than those in the general population. Criminal victimization was most frequently associated with alcohol and/or illicit drug use/abuse, homelessness, more severe symptomatology, and engagement in criminal activity.

Conclusion:  Prevention and intervention programs should target high-risk groups and improve patients’ mental health and quality of life.

Severe mental illness and criminal victimization: a systematic review.

Trauma exposure and posttraumatic stress disorder in adults with severe mental illness: a critical review.

Despite high rates of self-reported crime victimisation, no study to date has compared official victimisation records of people with severe mental illness with a random community sample. Accordingly, this study sought to determine whether persons with schizophrenia-spectrum disorders have higher rates of recorded victimisation than the general population, and to explore whether there have been changes in rates of recorded victimisation over a period of deinstitutionalisation. The schizophrenia-spectrum cases were drawn from a state-wide public mental health register, comprising all persons first diagnosed with a schizophrenic illness in five year cohorts between 1975 – 2005. The criminal histories of 4,168 persons diagnosed with schizophrenic-spectrum disorders were compared to those of a randomly selected community sample of 4,641 individuals. Compared to community controls, patients with schizophrenia-spectrum disorders were significantly more likely to have a record of violent (10.1% vs. 6.6%, odds ratio 1.4) and sexually violent victimisation (1.7% vs. 0.3%, odds ratio 2.77), but less likely to have an official record of victimisation overall (28.7% vs. 39.1%, odds ratio 0.5). Over the approximate period of deinstitutionalisation, the rate of recorded victimisation has more than doubled in schizophrenia-spectrum patients, but stayed relatively constant in the general community. People with schizophrenic-spectrum disorders are particularly vulnerable to violent crime victimisation; although co-morbid substance misuse and criminality both heighten the chances of victimisation, they cannot fully account for the increased rates. Deinstitutionalisation may have, in part, contributed to an unintended consequence of increasing rates of victimisation amongst the seriously mentally ill.

/pdf/a-case-linkage-study-of-crime-victimisation-in-schizophrenia-1lsrbja4uc.pdf

A case-linkage study of crime victimisation in schizophrenia-spectrum disorders over a period of deinstitutionalisation

In public perception, mental illness and violence remain inextricably intertwined, and much of the stigma associated with mental illness may be due to a tendency to conflate mental illness with the concept of dangerousness. This perception is further augmented by the media which sensationalises violent crimes committed by persons with mental illness, particularly mass shootings, and focuses on mental illness in such reports, ignoring the fact that most of the violence in society is caused by people without mental illness. This societal bias contributes to the stigma faced by those with a psychiatric diagnosis, which in turn contributes to non-disclosure of the mental illness and decreased treatment seeking,1 and also leads to discrimination against them. The association of violence and mental illness has received extensive attention and publicity. Public perception of the association between mental illness and violence seems to have fuelled the arguments for coerced treatment of patients with severe mental illness.2 ,3

However, this perception is not borne out by the research literature available on the subject. Those with mental illness make up a small proportion of violent offenders. A recent meta-analysis by Large et al 4 found that in order to prevent one stranger homicide, 35 000 patients with schizophrenia judged to be at high risk of violence would need to be detained. This clearly contradicts the general belief that patients with severe mental illness are a threat.

There are numerous ways of conceptualising the definition of violence, although at present there is no consensus as to which of these is the most appropriate. The WHO has defined violence as ‘the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, …

https://jech.bmj.com/content/jech/70/3/223.full.pdf

Violence and mental illness: what is the true story?

Background While much attention has been given to the prediction of violent offending behaviour amongst people with psychotic disorders, less attention has been given to the fact that these same individuals are often the victims of violence. In this paper, we examine victimisation amongst participants in a prevalence study of psychosis, and describe demographic and clinical correlates of victimisation. Method The study was based on the Australian National Survey of Mental Health and Wellbeing - Low Prevalence (Psychotic) Disorders. The participants were asked if they had been a victim of violence in the previous year. The association between selected demographic and clinical variables and being a victim of violence was examined using logistic regression. Results Of the 962 individuals with psychosis, 172 reported being a victim of violence in the past 12 months (17.9 %). The odds of being a victim were increased in those who: (a) were female, (b) were homeless, (c) had a lifetime history of substance abuse, (d) had been arrested in the previous 12 months, (e) had poorer social and occupational function, and (f) had higher scores on the disorganisation summary score. Conclusions Clinicians should remain mindful that one out of every six individuals with a psychotic disorder reports being a victim of violence in the previous year. Models of care that address issues related to symptom relief, accommodation, and exposure to high-crime areas may reduce the rates of victimisation amongst those with psychotic disorders.

Correlates of victimisation amongst people with psychosis.

We have recently been alerted to errors in Table 1 of this publication. We have re-analysed the primary data and provided a corrected and expanded version of Table 1. We wish to draw attention to the findings that demonstrate a significant association between being a victim of violent crime and the following socio-demographic and clinical variables; (a) younger age, (b) homeless status in the last 12 months, (c) substance abuse or dependence, (d) being arrested in the last 12 months, (e) impaired social and occupational functioning. Neither sex nor chronic course of disorder were significantly associated with victim status. We apologize for errors in the original publication, and request that readers take the corrections into account when reading the original publication.

/pdf/erratum-to-correlates-of-victimisation-amongst-people-with-33yxmh2fyo.pdf

Erratum to: Correlates of victimisation amongst people with psychosis

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Correlates of victimisation amongst people with psychosis.

Erratum to: Correlates of victimisation amongst people with psychosis