Victimization

Preventable Tragedies: Victimization

Victimization can include violent acts like assault and non-violent acts like theft or property crimes. People with severe mental illness (SMI) are more likely to experience violent victimization than the general population.

Between 7% and 56% of people with SMI experienced violent victimization in the past year. Sexual violence, including both sexual assault and rape, have been estimated to impact 10% of women and 3% of men with severe mental illness, with people with SMI overall being 5-17 times more likely to experience sexual violence than the general population.

People with SMI also experience high rates of domestic violence, with 15-22% of women and 4-10% of men with severe mental illness experiencing domestic violence annually. Nonviolent victimization has been estimated to impact 19% of people with psychotic disorders, with 70% of participants experiencing financial victimization in the past month in one study. Characteristics that may increase risk of victimization among people with SMI include homelessness, substance abuse, medication non-adherence, not living with family, and symptom severity, among others.

Consequences of victimization for people with SMI

Following violent victimization, a victim may be left with bruises, broken teeth or bones, and may contract a sexually transmitted disease or become pregnant. They may require medical attention, which can be difficult to seek if someone is already suffering from disorganized thinking or psychotic symptoms due to SMI. Non-violent victimization can similarly have intense consequences for a victim’s well-being. In one study, 35% of people with SMI completely ran out of money because of financial victimization.

In addition to these serious physical consequences, there are lasting psychological consequences to experiencing victimization including an increase in symptom severity, increased substance abuse, and lower community functioning. The psychological impacts of victimization can in some cases be deadly. For example, one article reported that among women with SMI, being a victim of a serious sexual assault led 53% of women to attempt suicide. This is a rate 15 times higher than women without SMI who were victims of comparable sexual assaults. These traumatic experiences can impair sleep and cognition, increase substance use, feelings of shame and self-loathing, chronic health conditions, pain, and experiences with flashbacks of the traumatic event.

Why do people with SMI experience victimization at such high rates?

The elevated risk of victimization among people with SMI may be caused by a variety of factors. For example, experiencing delusions of invulnerability or unrealistic power may lead people with SMI to encounter dangerous situations at a higher rate than the general population. SMI can also cause people to engage in odd, unexpected, or aggressive behaviors, which may attract unwanted attention or elicit aggressive reactions from others. People with SMI may also be more likely than the general population to live in neighborhoods with higher crime rates, which may also increase the likelihood of experiencing victimization.

Treatment may help people with SMI to manage delusions, decrease incidences of violence, and improve interpersonal and community functioning, all of which may help to decrease risk of victimization.