The vulnerability of adults with mental illness to violence has been highlighted by a recent meta-analysis which included 21 studies reporting violence prevalence estimates against adults with disabilities (mainly 18 years and older) from 1990 to 2010 (Hughes et al, 2012). The study showed that the odds of a person with mental illness experiencing physical, sexual or domestic violence was almost four times higher than for adults without any disabilities. In fact, people with mental illness are ten times more likely to be victims than perpetrators of violence. One of the reasons for the particular vulnerability of people with mental illness may be the interpersonal difficulties inherent to those conditions. Other contributing factors seem to be the need for personal assistance in daily living, reduced physical and emotional defences, social stigma, discrimination, communication barriers and exclusion from education and employment.
In the UK, about 17 000 children and young people live with a parent who has a severe and enduring mental illness, and about 175 000 children care for a parent or other family member with a mental disorder (Mental Health Foundation, 2013). Some of these children may experience increased levels of emotional, psychological and behavioural problems. Reasons for this include:
• inherited genes that may make them more vulnerable to mental ill health
• the child's environment (e.g. parents with a severe illness are more likely to live in poverty)
• the child's situation (e.g. feeling insecure/anxious that their parent will become unwell)
• the stigma attached to living with a parent with mental illness (e.g. being bullied at school).
In addition, children may not ask for help because of the fear that they will be taken away from their parent(s).
In light of the increasing evidence base, government policy on the safeguarding of vulnerable adults and children has continued to evolve over the past decade. Services and professionals have a duty to safeguard vulnerable adults who are at risk of violence or of being exposed to violence, and the risk to children must be explicitly considered in all cases.