Women with severe mental illness are up to five times more likely to be victims of sexual assault and two to three times more likely to suffer domestic violence compared to the general population.

“This study highlights that patients with severe mental illness are at substantially increased risk of being a victim of domestic and sexual violence.

“Despite the public’s concern about violence being perpetrated by patients with severe mental illness, the reality for patients is that they are at increased risk of being victims of some of the most damaging types of violence,” said study author Professor Louise Howard, Head of the Section on Women’s Mental Health at the Institute of Psychiatry, Psychology and Neuroscience (IoPPN) at King’s College London.

Specifically, 40 percent of women surveyed with severe mental illness had suffered rape or attempted rape as adults, of whom 53 percent had attempted suicide as a result. In the general population, 7 percent of women had been victims of rape or attempted rape, of whom 3 percent had attempted suicide.

Twelve percent of men with severe mental illness had been seriously sexually assaulted, compared with 0.5 percent of the general population.

The study involved a survey of 303 randomly-recruited psychiatric outpatients who had been in contact with community services for a year or more, 60 percent of whom had a diagnosis of schizophrenia. The participants were interviewed with a questionnaire about domestic and sexual violence, and their responses were compared to those from 22,606 respondents from the 2011/12 national crime survey. The results were adjusted for a wide range of socio-economic factors including age, ethnicity and marital status.

“The number of rape victims among women with mental illness is staggering. At the time of the survey, 10 percent had experienced sexual assault in the past year, showing that the problems continue throughout adulthood,” said Dr. Hind Khalifeh of UCL’s Division of Psychiatry, and now at the IoPPN at King’s.

“Considering the high rate of suicide attempts among rape victims in this group, clinicians assessing people after a suicide attempt should consider asking them if they have been sexually assaulted. Currently this is not done and so patients may miss opportunities to receive specialist support.”

Men and women with mental illness were also more likely to be victims of domestic violence than the general population. Domestic violence includes emotional, physical and sexual abuse. Sixty-nine percent of women and 49 percent of men with severe mental illness reported adulthood domestic violence.

Domestic violence from family members (other than partners) made up 63 percent of total domestic violence cases against mentally ill patients compared with 35 percent of the general population.

“Most domestic violence prevention policies for adults focus on partner violence, but this study shows that interventions for psychiatric patients also need to target family violence,” said Khalifeh.

The findings show a strong relationship between mental illness and sexual and domestic violence, but the direction of causality was not determined. In some cases, experiences of violence may have contributed to the onset of mental illness.

However, violence that took place within the past year would have been after diagnosis of severe mental illness since all the patients had been under the care of mental health services for at least one year.

The study, published in Psychological Medicine, was conducted by researchers at King’s College London and University College London (UCL).

Source: King’s College London