People are frightened of being assaulted by someone who is mentally ill, although this risk is exaggerated. In many ways, however, people with mental disorders are the population at risk. In JAMA Psychiatry, Kimberlie Dean and her colleagues show that becoming mentally ill increases your risk of being a crime victim.
OBJECTIVES To establish the incidence of being subjected to all types of criminal offenses, and by violent crimes separately, after onset of mental illness across the full diagnostic spectrum compared with those in the population without mental illness.
DESIGN, SETTING,AND PARTICIPANTS This investigation was a longitudinal national cohort study using register data in Denmark. Participants were a cohort of more than 2 million persons born between 1965 and 1998 and followed up from 2001 or from their 15th birthday until December 31, 2013.
MAIN OUTCOMES AND MEASURES Incidence rate ratios (IRRs) were estimated for first subjection to crime event (any crime and violent crime) reported to police after onset of mental illness. The IRRs were adjusted for cohort member’s own criminal offending, in addition to several sociodemographic factors.
RESULTS In a total cohort of 2,058,063 (51% female), the adjusted IRRs for being subjected to crime associated with any mental disorder were 1.49 (95% CI, 1.46-1.51) for men and 1.64 (95% CI, 1.61-1.66) for women. The IRRs were higher for being subjected to violent crime at 1.76 (95% CI, 1.72-1.80) for men and 2.72 (95% CI, 2.65-2.79) for women. The strongest associations were for persons diagnosed as having substance use disorders and personality disorders, but significant risk elevations were found across almost all diagnostic groups examined.
CONCLUSIONS AND RELEVANCE Onset of mental illness is associated with increased risk of exposure to crime, and violent crime in particular. Elevated risk is not confined to specific diagnostic groups. Women with mental illness are especially vulnerable to being subjected to crime. Individual’s own offending accounts for some but not all of the increased vulnerability to being subjected to crime.
Why does the onset of mental illness increase your risk of being a crime victim? Jeff Swanson and Charles Belden argue that a principal reason is that becoming ill increases the likelihood that you will become poor. Poverty, in turn, increases your exposure to crime.
The connection between poverty and crime points to the importance of effective and humane policing of poor neighbourhoods. But why should mental illness devastate the rest of your life? One reason to have a strong social safety net, including universal health insurance with parity for mental health care, is to buffer the life consequences of illness. The safety net is therapeutic; because it’s hard to recover from mental illness if you are evicted from your house or assaulted on the street.
