Service users' experience of violence within a mental health system: A study using grounded theory approach

Abstract

Violence in relation to mental illness is largely perceived by professionals and society as one perpetrated by people with mental illness. Mentally ill people do experience violence themselves from a variety of sources that may range from fellow service users to the general public to even the professionals in whom they may invest trust to care for them. However, the impact such violence may have on their lives is rarely subject to the same rigour that has been shown while investigating the factors that may predict violence by people with mental illness. This study attempted to elicit the experiences of six existing service users of mental health services at the Maudsley Hospital by running a focus group. These service users had experienced violence as perpetrators, victims or witnesses within the mental health service. Grounded theory approach was used to analyse the transcript, which identified 21 categories and six themes: (i) 'imbalance of power (exists in the mental health system), (ii) violence has psychological sequelae, (iii) mental Health Services are not geared to help victims of 'institutional violence', (iv) the present mental health system fosters violence, (v) a radical change is needed in the infrastructure of the mental health system and (vi) reinforcement and reforms may come from parallel efforts.' Significant similarities were noted in the recommendations made by the study participants about the factors that may reduce violence within the mental health system. This study demonstrated that people with mental illness do experience violence, which needs to be studied and that they are capable of identifying measures that are known to reduce violence on the basis of their personal experiences.