1
|
Wildman EK, MacManus D, Harvey J, Kuipers E, Onwumere J. Prevalence of violence by people living with severe mental illness against their relatives and its associated impacts: A systematic review. Acta Psychiatr Scand 2023; 147:155-174. [PMID: 36316292 PMCID: PMC10107449 DOI: 10.1111/acps.13516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/21/2022] [Accepted: 10/22/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Violence perpetration by adults with severe mental illness (SMI) specifically towards their relatives is a sensitive topic and a largely neglected area that has consequences and implications for different stakeholders, including healthcare providers. This paper sought to systematically review the relevant literature, to identify the types and rates of violence by people with SMI against their relatives, and to develop a detailed understanding of its reported impacts. METHODS A systematic review, registered with PROSPERO (registration number CRD42019150784), was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The review comprised searches of Medline, Embase, PsycInfo and CINAHL databases, supplemented by manual searches. Data from 38 papers using mixed methodologies were reviewed. RESULTS Key findings highlighted that relatives experienced different types of violence, including physical, verbal, psychological, financial violence, and violence directed towards property. Different types often co-occurred. Mothers were the group most likely to report being victims, compared with other relatives. Reported impacts of violence on relatives included mental ill health (e.g., psychological distress, post-traumatic stress symptoms) and the deterioration, and in some cases the permanent breakdown, of family relationships and the family unit. However, relatives often continued to provide a framework of support for patients, despite risks to their own safety. CONCLUSION Findings speak to the importance of future research extending the focus beyond the identified victimised relative or perpetrator, to also consider the impacts of violence at the family-wide level, and to improve the outcomes of families exposed to and dealing with violence by individuals living with SMI.
Collapse
Affiliation(s)
- Emilie K Wildman
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Deirdre MacManus
- Department of Forensic and Neurodevelopmental Science, King's College London, London, UK
| | - Joel Harvey
- Department of Law and Criminology, Royal Holloway, University of London, Surrey, UK
| | - Elizabeth Kuipers
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, Beckenham, UK
| | - Juliana Onwumere
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, Beckenham, UK
| |
Collapse
|
2
|
Mendes F, Pereira J, Zangão O, Pereira C, Bravo J. The relationship between depression and risk of violence in portuguese community-dwelling older people. BMC Public Health 2022; 21:2335. [PMID: 35668412 PMCID: PMC9171927 DOI: 10.1186/s12889-022-13474-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental disorders are highly prevalent in older people, being depression a predominant disorder. Evidence points to a possible relationship between depression and violence against older people. Nonetheless, the role of the depressive symptomology severity in the risk of violence against older people remains unclear. Thus, this study's main objective was to analyze the relationship between geriatric depressive symptomatology and the risk of violence against older people. METHODS This exploratory study involved 502 community-dwelling older persons aged 65 to 96 years (73.3 ± 6.5). Measures were performed using the Geriatric Depression Scale and the Risk Assessment of Violence against the Non-Institutionalized Elderly scale. RESULTS One hundred nineteen older people (23.7%) had mild/moderate depressive symptomology, and twenty-six (5.2%) had severe depressive symptomology. There were significant relationships between the severity of depressive symptomatology and the risk of violence (p < 0.05). The presence of depressive symptomatology increased the likelihood of being victims of violence, particularly among women (odds ratio: 2-8, p < 0.05). CONCLUSIONS The severity of depressive symptomatology plays an essential role in the risk of violence against community-dwelling older people. Moreover, it was found that older persons with depression symptomatology were at higher risk of being victims of violence. Our study findings support the need for protective measures within mental health national or regional policies to prevent depression and violence against community-dwelling older people.
Collapse
Affiliation(s)
- Felismina Mendes
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza 2B, Évora, Évora, Portugal.
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal.
| | - Joana Pereira
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza 2B, Évora, Évora, Portugal
| | - Otília Zangão
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza 2B, Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
| | - Catarina Pereira
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
| | - Jorge Bravo
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
| |
Collapse
|
3
|
Dash K, Breckman R, Lees-Haggerty K, Elman A, Lachs M, Stoeckle RJ, Fulmer T, Rosen T. Developing a tool to assess and monitor institutional readiness to address elder mistreatment in hospital emergency departments. J Elder Abuse Negl 2021; 33:311-326. [PMID: 34496716 DOI: 10.1080/08946566.2021.1965930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Hospital emergency departments (EDs) lack the tools and processes required to facilitate consistent screening and intervention in cases of elder abuse and neglect. To address this need, the National Collaboratory to Address Elder Mistreatment has developed a clinical care model that ED's can implement to improve screening, referral, and linkage to coordinated care and support services for older adults who are at risk of mistreatment. To gauge ED readiness to change and facilitate adoption of the care model, we developed an organizational assessment tool, the Elder Mistreatment Emergency Department Assessment Profile (EM-EDAP). Development included a phased approach in which we reviewed evidence on best practice; consulted with multidisciplinary experts; and sought input from ED staff. Based on this formative research, we developed a tool that can be used to guide EDs in focusing on practice improvements for addressing elder mistreatment that are most responsive to local needs and opportunities.
Collapse
Affiliation(s)
- Kim Dash
- Health Promotion, Practice, and Innovation, US Division, Education Development Center, Waltham, MA, USA
| | - Risa Breckman
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine/Ne York Presbyterian Hospital, New York, NY, USA
| | - Kristin Lees-Haggerty
- Health Promotion, Practice, and Innovation, US Division, Education Development Center, Waltham, MA, USA
| | - Alyssa Elman
- Department of Emergency Medicine, Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
| | - Mark Lachs
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine/Ne York Presbyterian Hospital, New York, NY, USA
| | - Rebecca Jackson Stoeckle
- Health Promotion, Practice, and Innovation, US Division, Education Development Center, Waltham, MA, USA
| | - Terry Fulmer
- The John A. Hartford Foundation, New York, NY, USA
| | - Tony Rosen
- Department of Emergency Medicine, Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
| |
Collapse
|
4
|
Labrum T, Solomon PL. Elder Mistreatment Perpetrators with Substance Abuse and/or Mental Health Conditions: Results from the National Elder Mistreatment Study. Psychiatr Q 2018; 89:117-128. [PMID: 28534281 DOI: 10.1007/s11126-017-9513-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A large portion of persons who commit elder mistreatment have long been known to have indicators of substance abuse and/or mental health conditions (SAMHC). However, few studies have specifically examined elder mistreatment by persons with SAMHC, preventing the development of specialized intervention strategies. Using results from the National Elder Mistreatment Study, the current article examines victim, perpetrator, and interaction characteristics between cases of emotional and physical elder mistreatment in which the perpetrator is reported to have vs. not have SAMHC. Chi square tests and Mann-Whitney-Wilcoxon non-parametric tests were performed. 210 perpetrators of emotional elder mistreatment were reported to have SAMHC with 412 perpetrators of emotional mistreatment reported to not have SAMHC. 57 perpetrators of physical elder mistreatment were reported to have SAMHC with 38 perpetrators of physical mistreatment not having SAMHC. Emotional elder mistreatment committed by persons with SAMHC was associated with the following characteristics: perpetrator-unemployment, history of involvement with police, and fewer friendships; victim-female gender, greater emotional problems, and greater occurrences of lifetime emotional mistreatment; interaction-co-residence, and reporting of mistreatment to authorities. Physical elder mistreatment committed by persons with SAMHC was associated with police involvement of the perpetrator and greater occurrences of lifetime physical mistreatment experienced by the victim. These findings indicate that victims of elder mistreatment by persons with SAMHC are in particular need of intervention services as they have greater histories of mistreatment and experience greater emotional problems. Implications for effectively intervening in cases of elder mistreatment by persons with SAMHC are discussed.
Collapse
Affiliation(s)
- Travis Labrum
- Division of Social Work, College of Health Sciences, University of Wyoming, Dept. 3632, 1000 E. University Ave., Laramie, WY, 82071, USA.
| | - Phyllis L Solomon
- School of Social Policy and Practice, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA 19104, USA
| |
Collapse
|
5
|
Dauenhauer J, Heffernan K, Caccamise PL, Granata A, Calamia L, Siebert-Konopko T, Mason A. Preliminary Outcomes From a Community-Based Elder Abuse Risk and Evaluation Tool. J Appl Gerontol 2017; 38:1445-1471. [PMID: 29165020 DOI: 10.1177/0733464817733105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This research addresses the need to develop an assessment tool for case workers working in the aging services field outside of APS. As such, the research discusses the development, implementation, and preliminary outcomes of the Elder Abuse Risk Assessment and Evaluation© tool (EARAE). This instrument was developed and pilot tested by the Elder Abuse Prevention Program (EAPP), a program within Lifespan of Greater Rochester Inc. in Rochester, New York. A total of 189 suspected elder mistreatment cases were investigated using the EARAE instrument to track elements at the start and close of each case. Results indicate the tool represents an effective way to capture abuse indicators, track contributing risk factors, measure multiple case outcomes, and track types of interventions utilized. Opportunities and limitations of the tool are also discussed.
Collapse
|
6
|
Factors related to abuse of older persons by relatives with psychiatric disorders. Arch Gerontol Geriatr 2017; 68:126-134. [DOI: 10.1016/j.archger.2016.09.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 09/23/2016] [Accepted: 09/25/2016] [Indexed: 11/18/2022]
|
7
|
Labrum T, Walk M, Solomon PL. Measuring Limit-Setting Practices Used by Family Members Towards Relatives with Psychiatric Disorders. Psychiatr Q 2016; 87:465-77. [PMID: 26518780 DOI: 10.1007/s11126-015-9400-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Family members often set limits with relatives with psychiatric disorders (PD), however, no scale currently exists measuring the use of such limit-setting practices. The present article describes the development and results of a new measure, the Family Limit-Setting Scale (FLSS). Via a national online survey, the FLSS was completed by 573 adults residing in the U.S. who report having an adult relative with PD. We conducted exploratory and confirmatory factor analyses, examined internal consistencies and other indicators of construct validity, and performed invariance analyses assessing the generality of the optimal factor model to men, women, Caucasian respondents, and non-Caucasian respondents. Results indicate that the FLSS has an acceptable two factor structure (routine limit-setting and crisis prevention limit-setting) with both factors being highly generalizable to all groups of respondents examined. Internal consistencies and other indicators provide additional evidence of the FLSS' construct validity. Use of the FLSS will enable the conduction of quantitative research in this area. In addition, this measure may be employed in education/support organizations for families with a member with mental illness in an effort to identify persons using high levels of limit-setting practices who may benefit from extra support and/or guidance.
Collapse
Affiliation(s)
- Travis Labrum
- School of Social Policy and Practice, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA, 19104, USA.
| | - Marlene Walk
- School of Public and Environmental Affairs, Indiana University, 801 W Michigan Street, Indianapolis, IN, 46202, USA
| | - Phyllis L Solomon
- School of Social Policy and Practice, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA, 19104, USA
| |
Collapse
|