Prevalence and experience of harassment of people with mental health problems living in the community.
Berzins KM, Petch A and Atkinson JM;
Commented by , 30 Dec 2003
Aims of the study
1) To investigate the prevalence, features and impact of harassment in patients with severe mental health problems in comparison with harassment in people from the general population.
2) To elucidate the reactions of people with mental health problems to harassment.
Method
People with mental problems were approached by their community psychiatric nurse in four areas (cities, towns, peripheral housing estates, and scattered rural settlements) of Scotland and asked if they would accept to be interviewed. Those who agreed (N=165) were then interviewed face-to-face by specifically trained interviewers who asked whether they had experienced harassment, and if so, to describe the harassment, the place where it had occurred, and the author(s) by whom it had been the committed.
Participants were also asked to describe how they had reacted to the harassment, whether they had complained about it, and what happened when they complained. Patients were compared with people from the general population (N=165) matched for gender, age, type of housing and area of living. The interview used in the investigation was developed by the authors of the study. The same interview was administered to the patient group and to the people from the general population.
Results
People with mental health problems reported significantly more harassment than people in the general population. Harassment consisted mainly in verbal abuse and referred mostly to the patients’ mental health problems.
Half of the patients did not report the harassment to anyone and the fact that harassment was reported did not stop the abuse in nearly half of of the cases of people who did complain. Harassment had an adverse impact on mental health in almost all patients who had experienced the abuse.
Discussion
The study has a number of limitations. In particular, the fact that patiens were not selected randomly may have led to a selective sample, with a bias towards towards patients more amenable to take part in the interview or more likely to have experienced harassment. In addition, the study sample included only three people from minority ethnic groups and as such minority groups may have been unterrepresented.
In spite of these limitations, this is an important study with important implications.
The main finding of this study is that a considerable number of patients with mental health problems experience harassment because they have mental health problems and that the harassement has an adverse impact on their mental health.
Mental health professionals need to be aware that a significant number of their patients experience harassment and that they should enquire about whether they are being abused in one way or another because they have mental health problems. They also need to know how best to support their patients when they are being abused, where to refer them to if they experience harassment, and what they can do to stop the abuse.
Finally, the study shows that there is a continued need for education of the general public about mental disorders and for anti-stigma initiatives to fight against the discrimination of people with mental health problems.