Domestic and sexual violence against patients with severe mental

illness

H. Khalifeh, P.Moran, R. Borschmann, K. Dean, C. Hart, J. Hogg, D. Osborn, S. Johnson and L.M. Howard

Published in: Psychological Medicine, August 2014

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The introduction

• Domestic and sexual violence are significant public health problems but the extent to which women and men with a severe mental illness (SMI) are at risk of abuse in comparison to the general public is unknown.

• This article aimed to compare the prevalence and impact of violence against people with a severe mental illness and the general public.

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The methodology

• 303 patients that had had contact with a community services at Camden and Islington NHS Foundation Trust or South London and Maudsley NHS Foundation Trust in the last year were randomly chosen to participate in the research.

• The participants were diagnosed with a range of mental health problems, mainly affective and non-affective psychosis, but also severe non-psychotic illnesses.

• All participants were interviewed using the Crime Survey for England and Wales (CSEW), which includes an optional self-completion module on domestic and sexual violence. The data collected was compared with that collected from 22,606 private individuals using the CSEW as part of the British Crime Survey which took place at the same time.

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The key findings

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Women’s lifetime experiences of domestic violence

0

10

20

30

40

50

60

7069.2

63.259.4

27.8

62.1

42.1

32.626.8

23.1

7.2

29.7

10.3

%

Women with SMI

General femalepopulation

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Men’s lifetime experiences of domestic violence

05

101520253035404550

48.8

42.9

31.8

4.1

38.3

31.8

17.112.6

1.6 0.6

14.1

7

% Men with SMI

General population

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Women’s and men’s past year experience of domestic violence

6.5

9.4

15.8

16.9

1.7

3.8

2.7

7.3

0 5 10 15 20

Men - from family member

Men - from partner

Women - from familymember

Women - from partner

%

General population

People with SMI

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Women’s and men’s experiences of sexual violence

0

20

40

60

80

100

120

%

General malepopulation

Men with SMI

General femalepopulation

Women with SMI

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Impact of serious sexual assaults on women*

53.1

91.8

49

95.9

3.4

64.2

40.4

78.4

0 20 40 60 80 100 120

Suicide attempt

Psychological/social

Physical injury/disease

Any adverse impact

%

Women with SMI

General femalepopulation

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*These outcomes were estimated for women only as the total number of male victims was too low for stable estimates.

*These outcomes were estimated for women only as the total number of male victims was too low for stable estimates.

Points of disclosure for female survivors of serious sexual assault*

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0

20

40

60

80

100

120

140

75.5

51

42.936.7

22.4

58.2

46.8

15.415.6

19.8

%

General femalepopulation

A summary

• Women and men who have a severe mental illness are likely than someone in the general population to experience:

– domestic violence (69.2% v 32.6% for women; 48.8% v 17.1% for men)

– sexual violence (61.2% v 21.1% for women; 22.9% v 3.1% for men)

• Women who have a severe mental illness are more likely than someone in the the general population to:

– experience an adverse effect of serious sexual assault (95.9% v 78.4%)

– attempt suicide (53.1% v 3.4%)

• Women who have a severe mental illness are more likely than someone in the the general population to:

– disclose serious sexual assault to someone else (75.5% v 58.2%)

– disclose serious sexual assault to a health professional (42.9% v 15.4%), although this may be attributed to people with an SMI having more regular contact with health professionals

– report serious sexual assault to the police (36.7% v 15.6%)

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