Violence against adults with severe mental illness compared with the UK general population
Lead Research Organisation:
University College London
Department Name: Division of Psychiatry
Abstract
Past research on violence and mental illness focussed on crimes committed by psychiatric patients. However, recent evidence suggests that, compared with the general population, people with severe mental illness (such as schizophrenia or bipolar disorder) are significantly more likely to be victims of violence than to carry out violent acts. This can lead to physical ill health, a worsening of their pre-existing mental illness, and poorer quality of life. In order to protect them, we need to understand why they are vulnerable to abuse, and what helps them avoid repeated violence.
There are no detailed UK studies on violence against people with mental illness, so it difficult to develop effective interventions. I plan to study the extent, nature and causes of being a victim of violence in this group. I will interview patients under the care of mental health services in North London using the Home Office British Crime Survey questionnaire, and compare my findings to the general population. I will also carry out in-depth interviews with some patients who experienced repeated violence to explore their coping strategies. This will increase our scientific understanding of violence against people with mental illness, with the aim of helping them to avoid abuse.
There are no detailed UK studies on violence against people with mental illness, so it difficult to develop effective interventions. I plan to study the extent, nature and causes of being a victim of violence in this group. I will interview patients under the care of mental health services in North London using the Home Office British Crime Survey questionnaire, and compare my findings to the general population. I will also carry out in-depth interviews with some patients who experienced repeated violence to explore their coping strategies. This will increase our scientific understanding of violence against people with mental illness, with the aim of helping them to avoid abuse.
Technical Summary
Aims To investigate the extent, correlates and impact of violence against adults with severe mental illness (SMI), and to compare findings with the UK general population
Objectives
To determine the prevalence of interpersonal violence against adults with SMI
To test the hypothesis that victimisation prevalence is higher in SMI patients compared with the general population, after controlling for gender, age and residential area
To identify demographic, socio-economic and behavioural factors associated with victimisation, and to test the hypothesis that SMI modifies the effect of significant correlates including substance misuse and social deprivation
To test the hypothesis that service contact and associated cost are greater in victimised SMI patients compared with non-victimised SMI patients
To qualitatively explore the strategies used by SMI patients to cope with repeated violence
Design
A cross-sectional survey of violence against SMI patients using the British Crime Survey (BCS) questionnaire (the same instrument used by the Home Office in its annual survey of violence against the general population of England and Wales).
A qualitative study of the experiences of SMI patients in coping with repeated victimisation.
Methodology
Setting and participants
The patient study population will be a random sample of adults with schizophrenia or bipolar disorder who are under the care of mental health services in one of five North London boroughs. The general population comparison sample will be drawn from the Home Office BCS database.
Measurements
The BCS questionnaire will be used to measure the following dimensions of self-reported experiences of victimisation: frequency, nature, correlates, physical and psychological impact, and contacts with health services or police. Additional measures (instrument) used among SMI patients will include diagnosis (OPCRIT), symptoms severity (BPRS), disability (DASII), social support (MOS-SSS), childhood abuse (CTQ) and service contacts (CSRI).
Qualitative study
I will conduct semi-structured interviews with a purposive sample of patients who experienced repeated violence, and compare the coping strategies of patients where the abuse was on-going with those where the abuse had stopped, using thematic analysis to extract relevant themes.
Scientific and medical opportunities
A recent government initiative to tackle the impact of violence is currently being piloted in the health sector, but has limitations among people with SMI because the extent, correlates and impact of abuse in this population are not known. The proposed study will directly address these unknowns and provide essential, timely information for prevention policy in this vulnerable group.
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Objectives
To determine the prevalence of interpersonal violence against adults with SMI
To test the hypothesis that victimisation prevalence is higher in SMI patients compared with the general population, after controlling for gender, age and residential area
To identify demographic, socio-economic and behavioural factors associated with victimisation, and to test the hypothesis that SMI modifies the effect of significant correlates including substance misuse and social deprivation
To test the hypothesis that service contact and associated cost are greater in victimised SMI patients compared with non-victimised SMI patients
To qualitatively explore the strategies used by SMI patients to cope with repeated violence
Design
A cross-sectional survey of violence against SMI patients using the British Crime Survey (BCS) questionnaire (the same instrument used by the Home Office in its annual survey of violence against the general population of England and Wales).
A qualitative study of the experiences of SMI patients in coping with repeated victimisation.
Methodology
Setting and participants
The patient study population will be a random sample of adults with schizophrenia or bipolar disorder who are under the care of mental health services in one of five North London boroughs. The general population comparison sample will be drawn from the Home Office BCS database.
Measurements
The BCS questionnaire will be used to measure the following dimensions of self-reported experiences of victimisation: frequency, nature, correlates, physical and psychological impact, and contacts with health services or police. Additional measures (instrument) used among SMI patients will include diagnosis (OPCRIT), symptoms severity (BPRS), disability (DASII), social support (MOS-SSS), childhood abuse (CTQ) and service contacts (CSRI).
Qualitative study
I will conduct semi-structured interviews with a purposive sample of patients who experienced repeated violence, and compare the coping strategies of patients where the abuse was on-going with those where the abuse had stopped, using thematic analysis to extract relevant themes.
Scientific and medical opportunities
A recent government initiative to tackle the impact of violence is currently being piloted in the health sector, but has limitations among people with SMI because the extent, correlates and impact of abuse in this population are not known. The proposed study will directly address these unknowns and provide essential, timely information for prevention policy in this vulnerable group.
Word count:399