Police Victimization Exposure Among Adults Diagnosed with Mental Disorders

Background: Victimization is commonly reported among people with mental disorders living in the community. Victimization can exacerbate existing mental health symptoms and increase the likelihood of service use and hospitalization, resulting in psychological and socioeconomic costs. Police victimization, in particular, appears to be common among adults diagnosed with disorders characterized by the presence of psychotic symptoms or pronounced emotional lability, such as schizophrenia and bipolar disorder. There is less evidence regarding police victimization among people with less visible conditions such as major depressive disorder or anxiety disorders. Findings from the first Survey of Police-Public Encounters (SPPE I) showed that police victimization is associated with psychometrically assessed mental health outcomes, but did not examine specific diagnoses. The present study uses data from the second Survey of Police-Public Encounters study (SPPE II) to examine the prevalence of police victimization among adults with mental illness diagnoses.

                                                                                                                         

Methods: SPPE II was a cross-sectional, general population survey study (2017) of adults ages 18 and older in the two Eastern U.S. cities (Baltimore, New York City; N = 1,000). We assessed mental illness diagnoses by asking whether participants had ever been diagnosed with any of 11 common diagnoses, which were recoded into seven categories: 1) severe mental illness (schizophrenia and bipolar), 2) depressive disorder, 3) anxiety disorder, 4) personality disorder, 5) post-traumatic stress disorder (PTSD), 6) obsessive-compulsive disorders (OCD), and 7) other mental health conditions. Past-year police victimization exposure was assessed using the Police Practices Inventory, developed based on the World Health Organization domains of violence (physical, sexual, psychological, neglect). Covariates included sociodemographics and psychosocial factors (crime involvement, adverse childhood experiences, intimate partner violence). Logistic regression analyses estimated associations between each police victimization and each mental illness diagnosis, adjusted for covariates.

Results: After adjusting for sociodemographics, all domains of police victimization were positively associated with severe mental illness. Physical victimization without a weapon had positive relationships with depressive disorder (OR_adj=2.12) and OCD (OR_adj=2.31). Sexual victimization were positively associated with PTSD (OR_adj=2.56) and OCD (OR_adj=3.49). Psychological victimization was associated with all mental illness diagnoses except personality disorder and OCD. However, the relationships between police victimization and mental disorders were attenuated when adding other psychosocial covariates (crime involvement and trauma/victimization exposures) in the model. Specifically, only physical victimization (both without [OR_adj=2.68] ­and with a weapon [OR_adj=2.87]) was associated with an increased risk of severe mental illness diagnoses.

Conclusion: In these data, a range of mental health conditions are broadly associated with elevated risk for exposure to police victimization. However, much of this elevated risk appears to be better explained by co-occurring psychosocial factors including trauma and victimization history, as well as crime involvement. Only severe mental illness remained significantly associated with physical victimization (both with and without a weapon) in the fully adjusted analyses. This implies that community-based mental health social workers should focus on the potential risk for police victimization among adults with severe mental illness. Further research should investigate the causal relations to guide the development of appropriate interventions.