Violent and non-violent crime against people with severe mental illness

Introduction: There is emerging evidence that people with severe mental illness (SMI) are at increased risk of being victims of violence and other crimes, but little is known about the extent, impact and reporting of violence against people with SMI compared with the general population. This thesis aimed to address key evidence gaps on victimisation among people with SMI. Methods: Work reported in this thesis includes: (a) A systematic review (on prevalence, relative risks and risk factors for violent victimisation among people with SMI), (b) Analysis of national survey data (from the British Crime Survey and the Adult Psychiatric Morbidity Survey), investigating violence against people with self-reported chronic mental illness (CMI) and (c) A new patient survey, based on modified national crime survey methods, investigating recent crime against patients with SMI compared with the general population. Results: Past-year physical or sexual violence was experienced by around 30% of people with SMI, 12% of those with self-reported CMI and 5-7% of the general population. After adjusting for socio-demographic differences, and compared to the general population, people with CMI had two to three-fold higher odds of being victims of any past-year violence, whilst those with SMI had five to 12-fold higher odds. Victims with pre-existing mental illness were more likely to experience adverse psychosocial effects following violent incidents than general population victims. There is preliminary evidence that risk profiles for community and domestic violence are distinct, and that power imbalance and targeted violence are important interpersonal contexts for violence against people with SMI. Conclusions: Compared to the general population, people with pre-existing mental illness are at increased risk of being victims of all types of violence, and of experiencing adverse psychosocial effects once victimised. Psychiatric services, and public health and criminal justice policies, need to address violence in this at-risk group

QoS Routing of VoIP using a Modified Widest-Shortest Routing Algorithm

Implementation of current real time services (of which one of the more important is Voice over IP) on the current Internet face many obstacles, among them the issue of routing. Quality of service (QoS) routing, attempts to provide real time services with the required guarantees to achieve acceptable performance. In this paper we study VoIP routing using the Quality of Service (QSR) network simulator utilizing the Widest-Shortest routing algorithm to provide QoS using different metrics. We show that this algorithm using a modified cost metric based on the hop-normalized is able to route real time traffic away from congested links thus providing acceptable jitter, end-to-end delay and throughput to satisfy real time services requirements

Recent physical and sexual violence against adults with severe mental illness: a systematic review and meta-analysis

People with severe mental illness (SMI) have high prevalence of lifetime victimization, but little is known about the extent and risk of recent domestic/sexual violence. The objective was to synthesize evidence on prevalence, odds, and risk factors for recent violence against people with SMI, with a focus on domestic and sexual violence. Relevant studies were identified through literature searches in Medline, Psychinf, Embase (for studies published in 2010–2015), and through existing systematic reviews (for studies published in 2000–2014). The review included 30 studies (with 16 140 SMI participants), including six on domestic violence and 11 on sexual violence. Prevalence of recent domestic violence ranged from 15–22% among women and from 4–10% among men/mixed samples; with little evidence on risk compared with the general population. Median prevalence of sexual violence was 9.9% (IQR = 5.9–18.1%) in women and 3.1% (IQR = 2.5–6.7%) in men; with 6-fold higher odds of victimization compared with the general population. There was little evidence on risk factors for domestic or sexual violence. In conclusion, people with SMI have a high prevalence of recent domestic and sexual violence, but little is known about risk factors for these violence types, or extent of domestic violence victimization compared to the general population