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When we think about risk issues regarding people with mental health problems, we usually think of particular types of risk. We think about the possibility of the person causing harm to others, harm to themselves, or coming to harm because of self-neglect. There’s another category of risk we should also be alert to, and there’s some research evidence to back this up. That’s the risk of harm being caused by others. In the past this has probably been a risk that services have not been sufficiently alert to. What I’m referring to here is the risk of domestic violence, or verbal and physical abuse by others, financial or sexual exploitation.
Some recent horrific news reports have highlighted this form of harm, notably following the inquiry into the death of Bijan Ebrahimi, a man with a physical disability living in Bristol, and wrongly branded as a paedophile by some people in his neighbourhood. This form of abuse is being increasingly reported, people with mental health or learning disabilities being called ‘paedophile’ by strangers, merely for appearing different, then this becoming a perverse justification for vigilante attacks on the person.
A study has just been reported in the British Journal of Psychiatry showing research evidence that people with severe mental illness are much more likely to experience victimisation than the general population.
What are some of the reasons behind this?
- People with mental health problems may struggle with relationships, and may not have the strategies to deal with an abusive relationship, or feel confident to report it to someone else.
- People with mental health problems may find themselves living in an unsatisfactory environment. Some of the news reports of people being victimised by neighbours were where people had been accommodated on high crime estates.
- People with mental health problems may be seen as the people with the problems, rather than their harassers, and so housing or police agencies do not sufficiently tackle the harassment.
Are there any lessons here for providers of health and social care services? Yes I think there are, and that starts with being aware that risk of harm by others is a category of risk that should be considered when risk assessments are being undertaken. If this is identified as a risk, then interventions need to be developed to manage this risk, and that means working with other agencies, ensuring the person is supported throughout.