Victimization in patients with severe mental illness, a nationwide multi-site study

Up to now, psychiatric patients are more often examined as perpetrators
probably caused by the perception that psychiatric patients are dangerous and
unpredictable and pose a threat to their surrounding caregivers (Thornicroft,
2006). International research, morstly conducted in the US, showed that the
percentage of psychiatric patient that are victim to violence is higher than
the percentage of patients that are perpetrator of violence (Choe e.a., 2008).
Moreover, it was shown that the risk to become victim is higher in psychiatric
patients than in the general population (Teplin e.a., 2005). In Holland, the
topic of victimization of psychiatric patients has been ignored. Apart from a
literature review, no research have been conducted in The Netherlands (Naudts
e.a., 2004). As a result, no information is available on size, nature, context
and consequences of violence against this population.

The project proposes to study 12-month victimization rates and risk factors
among persons with severe mental illness (SMI). The results will be compared
with a matched sample from the general population. Additionally, we will
develop a preliminary conceptual model, in which the associations between
different types of victimization, risk factors and consequences in this
population can be described.

We will conduct a nationwide multi-site cross-sectional survey among 940 SMI
patients. At each site a random sample, stratified on sex and age, will be
selected. In a structured interview, we will assess experiences and
consequences of victimisation, discrimination and self stigmatization,
perpetration of violence, childhood trauma, symptom severity and co-morbid
psychopathology (e.g. anger, PTSD). Research findings will be compared with a
matched sample from the Dutch general population. These data have been
collected as part of the National Victimization and Safety Monitor.

The study population consist of vulnerable patients, who might experience the
questions on victimization experiences as threatening. This might lead to
psychological decompensation. The length of the interview (70 minutes) kan be
taxing for the respondent. The population of psychiatric patients will benefit
from the results of this study, since the results will help diminish the social
stigma of violence attached to this group. We expect the social impact to be
large, partly as a result of the explicite efforts put in by NWO to promote the
topic.