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

与一般人群相比，患有严重精神障碍的人被剥夺自由的风险要高得多。暴力经历不仅造成身体伤害，而且对心理健康和康复进程产生负面影响。在精神卫生环境中，精神卫生专业人员往往没有充分处理服务使用者的暴力经历（包括暴力行为）。在德国，缺乏关于严重精神疾病患者暴力行为的实证研究。在混合方法的研究，包括标准化的方法和顺序的解释性设计，我们的目标是调查暴力事件的患病率严重精神障碍的人，社会，传记和制度背景因素的全面了解，并确定障碍，解决精神卫生环境中的暴力经历。本研究包括以下内容：（1）在一个有代表性的样本（n=500）的严重精神障碍，在住院和门诊的精神卫生机构，我们将调查的受害和暴力行为，污名化和自我污名化的暴力行为，以及在精神卫生机构披露的暴力经历的障碍。数据将从5家精神病医院的样本中获得，这些医院在固定的一天进行强制性护理。为了与一般人群进行比较，我们使用了一个具有代表性的在线样本（n=1000）。(2)在此基础上，我们进行定性访谈的一个子样本的人与严重的精神障碍（n=40）谁报告的暴力经历超过了截止。使用传记叙事访谈，我们专注于社会，传记和规范的背景。(3)此外，我们使用定性和定量的措施来调查心理健康专业人员的经验和策略，以处理心理健康客户的暴力经历。在世界范围内，对严重精神障碍患者的暴力行为是一个紧迫的问题。通过我们的研究，我们将大大有助于全面了解精神障碍，研究结果为制定旨在预防和减少受害的干预措施提供了背景。在世界范围内，对严重精神障碍患者的暴力是一个紧迫的问题。为了制定干预措施，防止和减少暴力行为，必须系统地评估心理健康服务使用者的暴力经历，了解对暴力经历的主观看法，并纳入社会、个人经历和体制因素。

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.