Patients with a psychiatric diagnosis, who have experienced homelessness, are at a high risk of being the victim of a violent police-recorded crime, according to findings from a large population-based study published in Lancet Public Health.

Using Danish national registries, Sandra Feodor Nilsson, PhD, from the Copenhagen Research Centre for Mental Health, Copenhagen University Hospital, Hellerup, Denmark, and colleagues collected data between January 2001 and December 2015 from 1,182,749 individuals aged 15 to 35 years.

The researchers analyzed absolute and relative risks of victimization in individuals with experiences of homelessness compared with the general population. Homelessness was defined as at least 1 contact with a homeless shelter, and victimization was measured by the date of the first police-recorded incident. The team calculated incidence rates per 1000 person-years, incidence rate ratios (IRRs), and cumulative probability of any crime and violent crime victimization.


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Overall, 15.6% (n=184,813) of the sample had at least 1 incident of crime victimization, 40% of which were violent victimizations. A total of 4286 individuals had at least 1 experience of homelessness. People with both a psychiatric diagnosis and experience of homelessness had the highest risk of violent victimization (women: IRR, 10.1; 95% CI, 8.6–11.9; men: IRR, 4.3; 95% CI, 3.8–4.9), whereas those with no psychiatric diagnosis or experience of homelessness had the lowest risk.

Compared with the general population, individuals who experienced homelessness had an increased risk of any crime victimization (women: IRR, 2.7; 95% CI, 2.4–3.0; men: IRR, 2.3; 95% CI, 2.1–2.5), which was higher for violent crime victimization (women: IRR, 7.2; 95% CI, 6.3–8.2; men: IRR, 3.6; 95% CI, 3.2–4.0) and remained significant after adjustments for psychiatric diagnoses, parental socioeconomic markers, and past criminal offences. The cumulative probabilities of any crime victimization were substantially higher in the 5 years after first homeless shelter contact (women: 23%; 95% CI, 21–26; men: 16%; 95% CI, 15–18) compared with matched controls from the general population (women: 10%; 95% CI, 10–11; men: 7%; 95% CI, 7–8). The probability of being the victim of a violent crime was 12% (95% CI, 10–14) in women and 11% (95% CI, 10–12) in men who had had contact with a homeless shelter.

The study is limited by a reliance on police records for information on victimization. Whether the results are generalizable to other countries is also difficult to conclude, as crime and homelessness rates vary between high-income countries, especially the United States.

“As victimization leads to health problems and selectively targets marginalized populations, thus exacerbating health inequalities, the high risk of victimization among homeless populations underscores the need to both prevent homelessness and to reduce the numbers of homeless people in high-income countries,” the researchers concluded.

Reference

Nilsson SF, Nordentoft M, Fazel S, Laursen TM. Homelessness and police-recorded crime victimisation: a nationwide, register-based cohort study. Lancet Public Health. 2020;5:e333-341.