Managing victimization risks attached to societal participation by people with severe mental illness

People with severe mental illness (SMI) in the Netherlands are more often
victims than perpetrators of violence, and are also more often victimized than
other Dutch citizens. This victimization appears to be one of the risks that
these service users of mental health care have to deal with in their efforts to
participate in the community. Other risks in societal participation are
rejection, failure, loss and social stigma with possible adverse consequences.

The main objective of the study is to gain insight in the effectiveness of the
Victoria modules, in terms of acknowledgement for these experiences and risk
awareness. These experiences and insights can be used to take acceptable risks
in rehabilitation process. The focus is on reducing victimization and other
forms of adversity.

Research questions on objective and subjective safety:
- Do the Victoria modules contribute to acknowledgement for victimization
experiences?
- Do the Victoria modules contribute to an increase in perceived safety?
- Do the Victoria modules lead to less forms of adversity in societal
participation?
- Do the Victoria modules lead to less perceived stigmatization and
discrimination?
Research questions on societal participation and rehabilitation
- Do the Victoria modules contribute to more insight in the wishes, needs, and
goals of clients in terms of social participation?
- Do the Victoria modules lead to an increase in social/societal functioning?
- Do the Victoria modules contribute to more self-confidence?
- Do the Victoria modules contribute to a higher quality of life?

The research will be carried out as a multicentre RCT. Randomisation is at a
team level, after which a random subsample is taken at a individual level. A
total of 8 FACT-teams of 2 institutes for mental health care are included (each
institute 4 teams). There are three moments of measurement: at the start (T0),
after 9 months of intervention (T1), and after 18 months of intervention (T2).
In order to monitor the implementation process in the intervention teams,
qualitative interviews will be carried out among clients, mental health
professionals, management staff, and trainers with the focus on the practical
application of the novel intervention. These interviews will take place during
the last measurement period.

The module aims at exploring victimization experiences or other forms of
adversity that service users have experienced in societal participation (in the
field of housing, employment, daily activities, and social relations).

The Victoria modules (the intervention) carefully explore whether there are any
adversities related to participation and rehabilitation. For this study, a
questionnaire will also be administered to the client. Should the client
through conversation about these adversities be thrown off balance, the client
is embedded in a treatment practice and the multidisciplinary FACT team will
act as a safety net. When the client indicates not wanting to talk about victim
experiences, this will be respected.