Victimisation of individuals with serious mental illness living in sheltered housing: differential impact of risk factors related to clinical and demographic characteristics

Abstract

Background: Sheltered housing is associated with quality-of-life improvements for individuals with serious mental illness (SMI). However, there are equivocal findings around safety outcomes related to this type of living condition.

Aims: We aimed to investigate raw differences in prevalence and incidence of crime victimisation in sheltered housing compared with living alone or with family; and to identify groups at high risk for victimisation, using demographic and clinical factors. We do so by reporting estimated victimisation incidents for each risk group.

Method: A large, community-based, cross-sectional survey of 956 people with SMI completed the Dutch Crime and Victimisation Survey. Data was collected on victimisation prevalence and number of incidents in the past year.

Results: Victimisation prevalence was highest among residents in sheltered housing (50.8%) compared with persons living alone (43%) or with family (37.8%). We found that sheltered housing was associated with increased raw victimisation incidence (incidence rate ratio: 2.80, 95% CI 2.36-3.34 compared with living with family; 1.87, 95% CI 1.59-2.20 compared with living alone). Incidence was especially high for some high-risk groups, including men, people with comorbid post-traumatic stress disorder and those with high levels of education. However, women reported less victimisation in sheltered housing than living alone or with family, if they also reported drug or alcohol use.

Conclusions: The high prevalence and incidence of victimisation among residents in sheltered housing highlights the need for more awareness and surveillance of victimisation in this population group, to better facilitate a recovery-enabling environment for residents with SMI.

Keywords: Victimisation; living conditions; serious mental illness; sheltered housing; supported housing.

Fig. 1

Estimated number of victimisation incidents in the past year, from multivariable Poisson regression for each person within a clinical or demographic risk group. The reference consists of individuals with no drug or alcohol misuse, no comorbid PTSD, no perpetration of assault and low education background. Each panel shows predicted victimisation after changing a single predictor (e.g. adding drug misuse to reference in the top left panel). PTSD, post-traumatic stress disorder.