Ruth Tsigebrhan1, Teshome Shibre2, Girmay Medhin3, Abebaw Fekadu4, Charlotte Hanlon5. 1. Addis Ababa University, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa, Ethiopia. Electronic address: r_tessera@yahoo.com. 2. Addis Ababa University, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa, Ethiopia. Electronic address: shibreteshome@yahoo.com. 3. Addis Ababa University, Aklilu-Lemma Institute of Pathobiology, Addis Ababa, Ethiopia. Electronic address: gtmedhin@yahoo.com. 4. Addis Ababa University, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa, Ethiopia; King's College London, Institute of Psychiatry, Department of Psychological Medicine, London, UK. Electronic address: abe.wassie@kcl.ac.uk. 5. Addis Ababa University, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa, Ethiopia; King's College London, Institute of Psychiatry, Centre for Global Mental Health, London, UK. Electronic address: charlotte.hanlon@kcl.ac.uk.
Abstract
BACKGROUND: Violence perpetrated by and against people with severe mental illness (SMI) is important but rarely investigated in low- and middle income countries. OBJECTIVE: To compare the prevalence of perpetrated violence and violent victimization, and associated factors, in people with and without SMI in rural Ethiopia. METHOD: A random sub-sample of people with a standardized, clinician diagnosis of SMI (n=201) was recruited from an existing population-based study and compared to a group of unaffected individuals from the same neighborhood (n=200). The lifetime and 12-month prevalence of violence and violent victimization was measured using an adapted version of the McArthur Violence Interview. RESULT: Lifetime and 12-month prevalence of perpetrated violence in people with SMI (28.4% and 17.4%, respectively) was significantly higher than in the non-mentally ill comparison group (15.0% and 8.5%, respectively). Male gender, being literate and violent victimization were associated independently with violence in both groups. In people with SMI, violence was associated additionally with being unmarried, exposure to stressful life events and non-response to medication. The prevalence of violent victimization was also significantly higher in people with SMI than those without SMI (60.7% vs. 41.5%). In people with SMI, violent victimization was associated with unemployment, non-adherence to treatment and being a perpetrator of violence. CONCLUSIONS: Our finding of high levels of violence and violent victimization in people with SMI underscores the need to improve access to mental health services in this setting, as well as the urgent need to raise awareness about victimization of people with SMI.
BACKGROUND: Violence perpetrated by and against people with severe mental illness (SMI) is important but rarely investigated in low- and middle income countries. OBJECTIVE: To compare the prevalence of perpetrated violence and violent victimization, and associated factors, in people with and without SMI in rural Ethiopia. METHOD: A random sub-sample of people with a standardized, clinician diagnosis of SMI (n=201) was recruited from an existing population-based study and compared to a group of unaffected individuals from the same neighborhood (n=200). The lifetime and 12-month prevalence of violence and violent victimization was measured using an adapted version of the McArthur Violence Interview. RESULT: Lifetime and 12-month prevalence of perpetrated violence in people with SMI (28.4% and 17.4%, respectively) was significantly higher than in the non-mentally ill comparison group (15.0% and 8.5%, respectively). Male gender, being literate and violent victimization were associated independently with violence in both groups. In people with SMI, violence was associated additionally with being unmarried, exposure to stressful life events and non-response to medication. The prevalence of violent victimization was also significantly higher in people with SMI than those without SMI (60.7% vs. 41.5%). In people with SMI, violent victimization was associated with unemployment, non-adherence to treatment and being a perpetrator of violence. CONCLUSIONS: Our finding of high levels of violence and violent victimization in people with SMI underscores the need to improve access to mental health services in this setting, as well as the urgent need to raise awareness about victimization of people with SMI.
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