Khalifeh, H; (2015) Violent and non-violent crime against people with severe mental illness. Doctoral thesis , UCL (University College London).

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Abstract

Introduction: There is emerging evidence that people with severe mental illness (SMI) are at increased risk of being victims of violence and other crimes, but little is known about the extent, impact and reporting of violence against people with SMI compared with the general population. This thesis aimed to address key evidence gaps on victimisation among people with SMI. Methods: Work reported in this thesis includes: (a) A systematic review (on prevalence, relative risks and risk factors for violent victimisation among people with SMI), (b) Analysis of national survey data (from the British Crime Survey and the Adult Psychiatric Morbidity Survey), investigating violence against people with self-reported chronic mental illness (CMI) and (c) A new patient survey, based on modified national crime survey methods, investigating recent crime against patients with SMI compared with the general population. Results: Past-year physical or sexual violence was experienced by around 30% of people with SMI, 12% of those with self-reported CMI and 5-7% of the general population. After adjusting for socio-demographic differences, and compared to the general population, people with CMI had two to three-fold higher odds of being victims of any past-year violence, whilst those with SMI had five to 12-fold higher odds. Victims with pre-existing mental illness were more likely to experience adverse psychosocial effects following violent incidents than general population victims. There is preliminary evidence that risk profiles for community and domestic violence are distinct, and that power imbalance and targeted violence are important interpersonal contexts for violence against people with SMI. Conclusions: Compared to the general population, people with pre-existing mental illness are at increased risk of being victims of all types of violence, and of experiencing adverse psychosocial effects once victimised. Psychiatric services, and public health and criminal justice policies, need to address violence in this at-risk group.

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