Profiling of victimization, perpetration, and participation: A latent class analysis among people with severe mental illness

Abstract

Background: Persons with severe mental illness are more prone to victimization and experience more difficulties regarding societal participation than other community members. These experiences vary greatly among individuals. Community mental health care should offer more individualized support by addressing these differences in experience. Therefore, this study aimed to identify subgroups of outpatients with severe mental illness based on their experiences of social participation and victimization.

Methods: Data from patients with severe mental illness from eight outpatient teams in the Netherlands were used to perform latent class analysis. From the total caseload, 395 patients agreed to participate. Classes were based on: i) criminal victimization incidents, ii) criminal perpetration incidents (Dutch Safety Monitor), iii) experienced discrimination (DISC-12), and iv) social functioning (Social Functioning Scale). Also, to investigate differences between the classes, socio-demographic, clinical, and person-related variables were examined.

Results: Three classes were identified. The Victimized and Perpetrating class (34.4%) had the highest prevalence of discrimination, victimization, and perpetration, and intermediate scores on social functioning subscales. This class also experienced the most problems in other domains, such as psychosocial functioning and quality of life. The Discriminated and Avoiding class (36.4%) had moderate scores for discrimination, victimization and perpetration, and the lowest scores for social functioning and social support. The General Difficulties class (28.8%) had the lowest prevalence of discrimination, victimization, and perpetration, and the highest scores on social functioning.

Discussion: These distinct classes offer new insights to mental health professionals in outpatient teams in in their aim to positively influence the patient's social context during rehabilitation; this includes addressing the role of victimization, and indicates the relevance of distinctive approaches and the support needed for each class. Professionals may need to focus more on the impact of difficulties in their patients' social context to adequately support them in the rehabilitation process.

Fig 1. Profiles of the three classes based on discrimination, victimization, perpetration, and social functioning.

(Standardized scores, N = 395).