Experiences of violence among people with mental disorders in the context of social, biographical and institutional factors. A mixed-method study

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People with severe mental disorders are at significantly higher risk for being victimised compared to the general population. Experiences of violence not only causes physical injuries but has negative effects on mental health and recovery processes. In mental health settings, services users’ violence experiences (including violent acts) are often not sufficiently addressed by mental health professionals. In Germany, there is a lack of empirical studies on violence among people with severe mental illness. In a mixed-method study including standardised methods and a sequential explanatory design, we will aim at the investigation of prevalences of violent incidents among people with severe mental disorders, a comprehensive understanding of the social, biographical and institutional context factors, and the identification of barriers for addressing experiences of violence within mental health settings. Our study includes the following: (1) In a representative sample (n=500) of people with severe mental disorders, treated in in-patient and out-patient mental health settings, we will investigate the prevalence of victimization and violent behavior, stigmatization and self-stigmatization with regard to violence, and barriers for disclosure of violence experiences within mental health settings. Data will be obtained from samples at 5 psychiatric hospitals with mandatory care on a fixed day. For comparisons with the general population, we use a representative online sample (n=1000). (2) Based on this, we conduct qualitative interviews with a sub-sample of persons with severe mental disorders (n=40) who reported violence experiences beyond a cut-off. Using biographic-narrative interviews we focus on the social, biographical, and normative context. (3) In addition, we use qualitative and quantitative measures to investigate mental health professionals’ experiences and strategies to deal with mental health clients’ experiences of violence. Wordwide, violence against people with severe mental disorders is a pressing problem. With our study, we will significantly contribute to a comprehensive understanding of victimisation and the study findings provide the background for the development of interventions aiming at the prevention and reduction of victimization.Wordwide, violence against people with severe mental disorders is a pressing problem. In order to develop interventions to prevent and reduce victimisation, it is important to systematically assess mental health service users’ experiences of violence, to understand the subjective perspectives on experiences of violence and to include social, biographical and institutional factors.