Hurting the healers: Stalking and stalking-related behavior perpetrated against counselors.

The increased risk of stalking faced by mental health professionals (MHPs) raises many important questions for practitioners. For instance, what factors place MHPs at greater risk of being stalked, and what perceptions do MHPs have about stalking? The present study investigates these and other understudied questions pertaining to stalking and stalking-related behavior perpetrated toward MHPs in the context of their work, by surveying a sample of 346 registered clinical counselors in British Columbia, Canada. Results indicated that many respondents had experienced individual stalking-related behaviors, and 7% (n = 23) had been stalked by a client. Work-related stalking and stalking-related behavior was perpetrated by clients, coworkers, and the acquaintances of clients. Respondents treating clients for forensic, substance abuse, and sexuality issues as well as for sexual abuse were at greater risk of being victimized. However, respondents treating clients out of their residence were not at greater risk. Less than half (47%) of respondents were aware of their heightened risk of being stalked, and many (50%) endorsed the view that poor clinical skill can increase stalking victimization. The majority of respondents reported that they would call police or terminate therapy in the event that they were being stalked by a client and three-quarters wanted to receive training on stalking. Findings suggest the need and desire for training that raises the awareness and abilities of MHPs to manage stalking behavior, but that also challenges unfounded and potentially harmful beliefs that some MHPs hold about their victimized colleagues

Violence risk identification, assessment, and management practices in inpatient psychiatry

Serious mental illness is a major risk factor for violence. Research suggests that many committed psychiatric inpatients have perpetrated violence before, during, and after hospitalization. Despite the prevalence and implications of violence among committed psychiatric patients, the responsibility of health care professionals to identify, assess and manage violence risk, and the development of identification and assessment tools to assist health care professionals in discharging their responsibility, little is actually known about what practices are being used to identify, assess, and manage violence in inpatient psychiatry units. The purpose of this study is to obtain a better understanding of violence risk identification, assessment, and management practices used by inpatient psychiatric units. Specifically, this study involved semistructured interviews with key informants from 13 inpatient psychiatry units in the largest health region in Western Canada. Every inpatient psychiatry unit that was invited to take part in this study agreed to participate. Data were analyzed using frequency and content analysis. The analysis revealed limited use of formal identification and assessment instruments for violence and diversity with respect to strategies used to manage violence. These findings have implications for highlighting promising practices that are currently being used, and identifying potential areas for future improvement

Help-Seeking Behavior in Victims of Elder Abuse: A Systematic Review

Elder abuse has become increasingly relevant for intervention and study in the context of an aging population. One of the major barriers to progress in the field is underreporting of elder abuse by victims. This systematic literature review aimed to synthesize the available findings regarding victims’ help-seeking behavior to inform practice, understand the limits of the evidence, and identify research gaps. A comprehensive search of published and unpublished literature was undertaken, and studies were included if they addressed help-seeking behavior from the perspective of elder abuse victims aged 60 and older. A total of 19 studies met inclusion criteria for review. Findings are presented as a narrative synthesis organized according to help-seeking barriers, facilitators, sources of help, the responses of others, and the characteristics of victims more likely to seek help. Although barriers and sources of help received detailed attention across all studies, findings regarding victim characteristics and facilitators for and responses to help-seeking were limited. The results suggest that there are many barriers to help-seeking and that some victims only seek help when the abuse is perceived as unbearable or they fear for their safety. Results are discussed in relation to implications for intervention, including suggestions to enhance help-seeking behavior. Future research should identify facilitators of help-seeking among victims of elder abuse and victim characteristics associated with early disclosure. Research efforts should frame help-seeking as a continuing process and study ways in which the responses of others may impact future help-seeking or service engagement

Elder homicide: A systematic literature review

This paper presents the findings of the first review of the research-based evidence reporting the phenomenon of elder homicide. A systematic review of peer-reviewed literature published across the world (between 1982 and 2018) was undertaken. A total of 33 articles were identified and appraised using PRISMA including quantitative (n = 30) and mixed methods (n = 3) studies. Four themes were identified in the synthesis of findings: victim characteristics; offender characteristics; victim-offender relationship; and offence characteristics. Through a critical discussion, these themes, and the emerging typology, are contextualised to argue that these findings could influence the improvement of policy and practice, and inform future research, for vulnerable elderly people at risk of violence and homicide. A gap identified in the literature was the lack of identification and analysis of risk factors for elder homicide which provides evidence of the need for further research on elder homicide, risk and risk management

Elder abuse detection and intervention: Challenges for professionals and strategies for engagement from a Canadian specialist service

Elder abuse (EA) is of increasing relevance in the context of an aging society and this has implications for detection and intervention for several types of health care providers, including forensic nurses. Knowledge related to EA is important as victims are likely to interact with providers, either due to existing health problems or the consequences of abuse. This paper provides a brief overview of EA, followed by an outline of current detection and intervention efforts used by health care providers in community and hospital settings. In addition, knowledge about help-seeking and barriers to disclosure are discussed to inform health care provider interactions with older adults where EA is suspected or disclosed. To illustrate challenges faced by health care providers in this area, two cases of EA involving case management by a forensic nurse in a specialist service in Canada are presented

Older Adult Homicide: Investigating Case, Victim and Perpetrator Characteristics in a National Sample from England and Wales

Older adult homicide (OAH) is the most severe, yet understudied, form of older adult abuse. This study examined the case, victim and perpetrator characteristics of OAH. A secondary analysis of national data from England and Wales (2008–2019) was conducted where cases of non-stranger OAH (victims aged sixty years and over) were compared to adult homicide (victims aged eighteen to fifty-nine years) at the case, victim (n ¼ 3,274) and perpetrator (n ¼ 2,763) levels. Logistic regression models used to identify characteristics that were OAH risk factors, showed only a slight increase in predictive power but high accuracy in classifying adult homicide cases. Nevertheless, some risk factors known to be predictors of older adult abuse were significant predictors of OAH (e.g. living with the perpetrator, the perpetrator’s mental state). Implications for research, policy and practice are discussed

Judicial Decisions Regarding Expert Evidence on Violence Risk Assessment

In Canada, there are legal provisions called Dangerous Offender and Long-Term Offender designations available to apply severe restrictions on individual liberties for persons who engage in serious offences (often repetitive) and who pose a substantial risk for violence. Since establishing the presence of a risk for violence is central to decision making in these cases, an evaluator’s violence risk assessment (VRA) and expert witness testimony play a vital role in hearings for these offenders. The present study examined judicial decisions regarding expert evidence on VRAs submitted to the court in 214 Dangerous Offender/Long-Term Offender hearings identified through the Canadian Legal Information Institute database. Written judicial decisions were analysed for any comments regarding factors related to expert evidence on VRA. The commonalities that were identified, including qualities of: (1) the evaluators, (2) the VRAs completed, and (3) the evaluators’ expert testimony about VRA, offer key considerations for professionals working in the mental health and criminal justice fields. They may also contribute to the development of guidelines for professionals conducting VRA used by courts

The impact of stalking and its predictors: Characterising the needs of stalking victims

Objective. Victims of stalking suffer severe and varied impacts requiring assessment and treatment. Research to inform support is limited. The present study examines a national sample of stalking victims to identify the types and prevalence of impact reported and the predictors of impact. Method. A secondary analysis of 258 stalking cases reported to a stalking charity was conducted. Four categories of victim reported impact were coded; psychological and substance abuse, physical health, practical impact on life and impact on others. Stalking duration, severity, the diversity of stalking behaviors and the relationship between the victim and perpetrator were investigated as predictors of impact. Results. 48 types of impact were identified with victims experiencing an average of four types. Psychological impact was the most prevalent (91.5%). Several new forms of impact were identified including a variety of impacts on persons known to the victim (e.g., children, friends) in 35.3% of the sample. Increased diversity of stalking behavior was predictive of impact in all models (explaining 11% of the variance in total impact scores), except for physical impact which was not analysed due to low prevalence. Conclusions. Stalking impact was prevalent and varied, suggesting that victims (and potentially those close to them) require trauma informed support from clinicians. Future research should include the development of a stalking impact index to improve the consistency of research and clinical assessment of need

Technology-Facilitated Intimate Partner Violence: A multidisciplinary examination of prevalence, methods used by perpetrators and the impact of COVID-19.

A multidisciplinary team of academics from the University of Kent’s Institute for Cyber Security in Society (iCSS) received funding from the Home Office Domestic Abuse Perpetrators Fund to conduct research into the perpetration of Technology Facilitated Intimate Partner Violence (TFIPV). The project comprised of 4 workstreams: 1) A Rapid Evidence Assessment (REA) of the evidence base around TFIVP, 2) A thorough analysis of a representative sample of cases of TFIPV as reported to The Cyber Helpline, 3) interviews and surveys with Helpline Responders around their experiences responding to TFIPV and 4) a synthesis of the findings and a visual presentation

Elder Abuse Vulnerability and Risk Factors: Is Financial Abuse Different from other Subtypes?

Elder abuse (EA) affects one in six older adults, and financial EA, a common subtype, severely impacts victims and society. Understanding victim vulnerability and perpetrator risk factors is essential to EA prevention and management. The limited existing evidence about these factors in relation to EA types suggests that financial EA is different. In a cross-sectional quantitative analysis of secondary data (N = 1,238) we investigated EA vulnerability and risk factors, and victim-perpetrator family relationship, with respect to different EA types (financial only, financial co-occurring with other types, and non-financial abuse). Financial abuse-only cases had the lowest prevalence of vulnerability and risk factors. Most of these factors, and a familial relationship, were significantly more common in cases involving other EA types. Findings indicate that financial abuse, occurring in isolation, is distinct from other EA types. Risk assessment and future research should consider financial abuse separately to other EA forms