Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.
Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Can J Psychiatry. 2020 Jul;65(7):492-501. doi: 10.1177/0706743720919660. Epub 2020 May 4.
Understand the relationship between criminal accusations, victimization, and mental disorders at a population level using administrative data from Manitoba, Canada.
Residents aged 18 to 64 between April 1, 2007, and March 31, 2012 ( = 793,024) with hospital- and physician-diagnosed mental disorders were compared to those without. Overall and per-person rates of criminal accusations and reported victimization in the 2011/2012 fiscal year were examined. Relative risks were calculated, adjusting for age, sex, income, and presence of a substance use disorder. The overlap between diagnosed mental disorders, accusations, and victimization with a χ test of independence was studied.
Twenty-four percent ( = 188,693) of the population had a mental disorder over the 5-year time frame. Four to fifteen percent of those with a mental disorder had a criminal accusation, compared to 2.4% of the referent group. Individuals with mental disorders, especially psychotic or personality disorders, were often living in low-income, urban neighborhoods. The adjusted relative risk of accusations and victimization remained 2 to 5 times higher in those with mental disorders compared to the referent group. Criminal accusations and victimization were most prevalent among individuals with a history of attempted suicide (15.2% had an accusation and 8.1% were victims). The risk of victimization in the same year as a criminal accusation was significantly increased among those with mental disorders compared to those without (χ = 211.8, < 0.001).
Individuals with mental disorders are at elevated risk of both criminal involvement and victimization. The identification of these multiply-stigmatized individuals may lead to better intervention and support.
利用加拿大马尼托巴省的行政数据，在人群水平上了解刑事指控、受害与精神障碍之间的关系。
比较了在 2007 年 4 月 1 日至 2012 年 3 月 31 日期间年龄在 18 至 64 岁之间、有医院和医生诊断的精神障碍的居民（n=793,024）与无精神障碍的居民。在 2011/2012 财政年度，检查了刑事指控和报告受害的总体和人均率。使用独立性 χ 检验研究了诊断性精神障碍、指控和受害之间的重叠情况。
在 5 年时间内，人群中有 24%（n=188,693）患有精神障碍。与对照组的 2.4%相比，有精神障碍的人群中，有 4%至 15%的人受到刑事指控。患有精神障碍的人，尤其是患有精神病或人格障碍的人，通常居住在低收入、城市社区。与对照组相比，调整后的精神障碍患者的指控和受害的相对风险仍高达 2 至 5 倍。有自杀未遂史的个体（15.2%的人被指控，8.1%的人是受害者）的指控和受害情况最为常见。与无精神障碍的个体相比，在同一年遭受受害的风险在有精神障碍的个体中显著增加（χ=211.8， < 0.001）。
患有精神障碍的个体面临更高的犯罪参与和受害风险。识别这些受到多重污名化的个体可能会导致更好的干预和支持。
