Prevalence of victimisation in a European sample of clients living in mental health care institutions

Background/Objectives: Suffering from severe mental health problems has many direct effects on people's life, on functioning, living situation, work potential and social relationships. Not as overt, but as harmful, can be the extra vulnerability and risk of becoming a victim of acts of aggression. Recent research showed that among psychiatric outpatients, the risk of becoming a victim of a violent crime is 10 times higher than for the general population even when controlling for demographic characteristics such as financial resources and place of residence. Questions can be raised as to whether this high prevalence is maintained among clients in residential care and what influence the shift towards increased community-based housing has on victimisation rates. In this study, we examine the prevalence of victimisation in a large European sample of clients living in residential mental health care facilities with a special focus on the relation between the level of social participation and victimisation.

Methods: This study is part of a larger European study which developed a toolkit to assess the quality of care in longer term hospital and community mental health units. Information on 1,750 clients from 10 European countries was used. Victimisation was assessed with five questions regarding experience of victimisation ranging from less (having been shouted at, frightened or threatened) to more extreme (physical violence, sexual abuse) forms. Clients were also asked whether they themselves had been accused of a crime in the previous year.

Results: Overall, one third of clients (32%) living in longer term mental health units reported minor victimisation and 13% reported more serious violations such as physical violence or sexual abuse. Seven per cent had been accused of a crime in the past year. The level of victimisation of clients in community-based units was not significantly different from those living in hospital-based facilities. Also, no differences were found between males and females. Clients who reported incidents of victimisation were significantly younger (M=44 years; SD=13) than those who did not (M=48; SD=12; t=5.96, p<0.001). Preliminary analyses reveal that significantly different levels of victimisation were found between countries. Further (multilevel) analyses will be done to examine explanatory factors, such as weight of victimisation in each country, social inclusion and other client characteristics.

Discussion/Conclusions: The high prevalence of victimisation amongst people with severe mental health problems is of great concern and mental health professionals should be aware of their clients’ vulnerability to victimisation. Our study found that people living in longer-term facilities are more often victimised than accused of a crime. This supports previous studies and challenges the widespread belief that people with mental health problems are dangerous. A greater awareness of this misconception within the general public may help improve integration and reduce the stigma associated with mental illness.

Funding: Sixth Framework Programme of the European Commission (grant no. SP5A-CT-2007–044088).

Keywords: Recovery-oriented interventions, victimisation, service user evaluation.