Victimisation in the life of persons with severe mental illness in Uganda: a pluralistic qualitative study.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968559 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-244X (Electronic) Linking ISSN: 1471244X NLM ISO Abbreviation: BMC Psychiatry Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Crime Victims*/psychology ; Qualitative Research* ; Mental Disorders*/psychology; Humans ; Uganda ; Male ; Female ; Adult ; Middle Aged ; Social Stigma

Introduction: Victimisation of persons with severe mental illness is recognised as an urgent global concern, with literature pointing to higher rates of violent victimisation of persons with severe mental illness than those of the general population. Yet, for low income countries, there is a huge gap in the literature on the risk, character and victims' in-depth experiences of victimisation of persons with severe mental illness. We explore the lived experiences and meanings of victimisation of persons with severe mental illness in Uganda, and discuss their implications for care of the mentally ill.
Methods: A pluralistic qualitative study was undertaken to explore victimisation among patients with severe mental illness. Patients who had suffered victimisation were purposively sampled from Butabika National Referral Mental Clinic and Masaka Regional Referral Hospital, following confirmation of symptom remission. In-depth interviews were held with 18 participants, comprising 13 females and 5 males from low to moderate socioeconomic status. Interpretative phenomenological analysis and thematic content analysis were conducted.
Results: Victimisation was exhibited in three main forms: (a) psychological, expressed in attitudes towards mentally ill family members as valueless and dispensable, and stigmatisation, (b) physical, as manifested in beatings, indoor confinement and tethering mostly by family members and (c) sexual victimisation, particularly rape. Also observed were victim's various responses that pointed to the negative impact of victimisation, including a heightened risk of suicide, social withdrawal, a sense of hatefulness and a predisposition to more victimisation.
Conclusion: The family environment plays a predominant role in perpetrating victimisation of the mentally ill in some sub-Saharan African contexts such as Uganda. We propose a holistic framework for mental health interventions, incorporating biomedical but notably also social determinants of mental health, and targeted at improving familial relationships, social support and a sense of belongingness both within the family and the broader community.
(© 2024. The Author(s).)

PLoS One. 2014 Mar 07;9(3):e91029. (PMID: 24609108)
Br J Pain. 2015 Feb;9(1):41-2. (PMID: 26516556)
Schizophr Res. 2014 Jan;152(1):275-82. (PMID: 24275579)
Int J Soc Psychiatry. 2013 Nov;59(7):706-15. (PMID: 22733004)
Front Psychiatry. 2020 Sep 08;11:563860. (PMID: 33033483)
BMC Psychiatry. 2019 Oct 26;19(1):315. (PMID: 31655561)
Br J Psychiatry. 2015 Dec;207(6):515-22. (PMID: 26450584)
PLoS One. 2012;7(1):e29748. (PMID: 22253770)
J Trauma Stress. 2010 Apr;23(2):189-97. (PMID: 20419728)
Eur Arch Psychiatry Clin Neurosci. 2023 Apr;273(3):613-625. (PMID: 36002543)
Psychol Med. 2008 Apr;38(4):591-7. (PMID: 17935638)
Arch Gen Psychiatry. 2005 Aug;62(8):911-21. (PMID: 16061769)
J Health Psychol. 2018 Dec;23(14):1842-1852. (PMID: 28810353)
Clin Psychol Rev. 2011 Aug;31(6):883-99. (PMID: 21596012)
Curr Psychiatry Rep. 2018 Sep 17;20(11):95. (PMID: 30221308)
BMC Public Health. 2017 Feb 2;17(1):153. (PMID: 28152991)
J Elder Abuse Negl. 2011 Apr;23(2):147-68. (PMID: 21462048)
BMC Psychiatry. 2014 Jul 07;14:194. (PMID: 24999041)
Am J Public Health. 2005 Nov;95(11):2015-21. (PMID: 16254233)
Violence Against Women. 2016 Sep;22(10):1211-27. (PMID: 26719079)
Int J Ment Health Syst. 2021 May 20;15(1):48. (PMID: 34016125)
Qual Health Res. 2014 Feb;24(2):254-66. (PMID: 24482422)
World Psychiatry. 2017 Feb;16(1):26-27. (PMID: 28127905)
J Health Soc Behav. 1997 Jun;38(2):177-90. (PMID: 9212538)
Br J Psychiatry. 2003 Dec;183:526-33. (PMID: 14645024)
Issues Ment Health Nurs. 2003 Mar;24(2):175-98. (PMID: 12554427)
Nurs Health Sci. 2015 Sep;17(3):299-306. (PMID: 26086316)
Curationis. 2019 Sep 19;42(1):e1-e9. (PMID: 31588764)
Curationis. 2019 Sep 19;42(1):e1-e7. (PMID: 31588763)
J Am Psychiatr Nurses Assoc. 2009 Jun;15(3):191-9. (PMID: 21665806)
BMC Psychiatry. 2015 Mar 04;15:34. (PMID: 25885525)
Indian J Psychiatry. 2008 Jan;50(1):39-46. (PMID: 19771306)
Neuropsychiatr Dis Treat. 2014 Oct 09;10:1925-39. (PMID: 25336958)
Soc Psychiatry Psychiatr Epidemiol. 2011 Jan;46(1):29-34. (PMID: 19916061)
Acta Psychiatr Scand. 2007 Nov;116(5):345-53. (PMID: 17868429)

This study was funded by MRC core funding to the Mental health project of MRC/UVRI and LSHTM under the headship of Professor Eugene Kinyanda to undertake the 'HIV clinical trials preparedness studies among patients with Severe Mental ILlnEss in HIV endemic Uganda (SMILE Study). MRC (UK)

Keywords: Abuse; Severe mental illness; Sub-saharan Africa; Uganda; Victimisation

Date Created: 20240430 Date Completed: 20240501 Latest Revision: 20240503

20240503

PMC11061965

10.1186/s12888-024-05720-4

38689240