Prevalence of sexual violence against mental health patients ‘alarming’

By Mark Cowen, Senior medwireNews Reporter

Around a fifth of patients with mental illnesses report being the victims of sexual violence, results from a Brazilian study show.

The team found that 26.6% of women and 12.5% of men with mental illnesses reported experiencing sexual violence at some point in their lives.

"Our results emphasize the need for mental health services to implement intervention actions for the care and prevention of sexual violence against this population of patients with mental illness in Brazil," say Helian Nunes de Oliveira (Federal University of Minas Gerais, Belo Horizonte) and team.

Such action should include "the training of health-care teams to identify individuals who may have suffered or are at risk of suffering sexual violence in order to provide therapeutic interventions to minimize the consequences to their physical and mental health."

The findings come from a study of 2475 patients, aged at least 18 years, from 11 psychiatric hospitals and 15 psychosocial care outpatient centers in Brazil. The most common diagnosis in the men and women was schizophrenia/other psychoses, at 55.5% and 40.4%, respectively.

All of the participants were interviewed about their experience of sexual violence, defined as ever having been forced to have unwanted sexual relations or having suffered any kind of abuse of a sexual nature against their will.

The most commonly reported perpetrator of sexual violence against women was a partner (31.3%) followed by a stranger (22.1%), while among men, the most the commonly reported perpetrator was an acquaintance (32.7%) followed by a stranger (28.7%).

Among women, factors independently associated with sexual violence included younger age (18-40 years), living alone, a history of homelessness, previous psychiatric hospitalization, a history of lifetime sexual diseases, a diagnosis of depression or schizophrenia/psychosis, a sexual "debut" age of less than 16 years, a lifetime of irregular condom use, and receiving or being offered money for sex.

Among men, younger age (18-40 years), previous psychiatric hospitalization, age at first hospitalization of less than 18 years, lifetime use of marijuana or cocaine, a diagnosis of depression or schizophrenia/other psychosis, and receiving or being offered money for sex were independently associated with sexual violence.

Nunes de Oliveira and team comment in Social Psychiatry and Psychiatric Epidemiology: "The proportion of self-reported sexual violence against individuals with mental illness is alarming."

They conclude: "Immediate and long-term integrated programmatic actions within the public health system may contribute to the prevention of sexual violence, thus improving the quality of life and clinical prognosis of patients with mental illness under treatment in Brazil."

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