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Violent victimization and health service utilization in a forensic psychiatric context: a comparison between offenders with mental disorders and matched controls
Karolinska Institute, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Vadstena Forens Psychiat Hospital, Sweden.
Karolinska Institute, Sweden; National Board Forens Med, Sweden.
2017 (English)In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 17, 91Article in journal (Refereed) Published
Abstract [en]

Background: Offenders with mental disorders constitute a particularly exposed group in society, with high rates of morbidity, mortality, and social deprivation. Often thought of primarily as perpetrators, these individuals may also be subjected to violence. Previous research indicates that violent victimization during lifespan is a risk factor for violent perpetration among psychiatric patients, but victimization studies on the group of offenders with mental disorders are scarce. Health services are pivotal to this group, but although most individuals do utilize these services, their vulnerability seems to remain. This study aimed at exploring the rates of victimization and health service utilization, including perceptions of unmet health care needs, among offenders with mental disorders. Methods: Two hundred detainees undergoing a forensic psychiatric evaluation in Stockholm were asked about violent victimization and health service utilization. Each detainee was compared with three controls from the general population, matched regarding age, sex, and occupation. Results: Victimization during the past year was reported by 52.3% of the detainees and 11.1% of the controls, with a corresponding risk ratio of 8.2. Health service utilization during the past three months was reported by 47.7 and 23.7%, respectively (risk ratio 2.0); and unmet health care needs by 42.2 and 16.7%, respectively (risk ratio 3.4). There was no distinct association between victimization and health service utilization among detainees. Conclusions: Offenders with mental disorders are at great risk of being victimized, and they experience impediments to receiving requisite health care. A possible way to reduce victimization and improve health service utilization may be to establish interdisciplinary yet specialized health centers with outreach teams but without complicated referral procedures.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD , 2017. Vol. 17, 91
Keyword [en]
Victimization; Violence; Forensic psychiatry; Mental disorder
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:liu:diva-136598DOI: 10.1186/s12888-017-1251-0ISI: 000396763900001PubMedID: 28284208OAI: oai:DiVA.org:liu-136598DiVA: diva2:1089970
Available from: 2017-04-21 Created: 2017-04-21 Last updated: 2017-05-08

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