This paper reviews sexual exploitation of women with schizophrenia-related disorders in order to determine prevalence, risk factors, sequelae, and preventive measures.
Abstract:Background: Vulnerable populations are sometimes targets for violence and sexual exploitation; this has been reported with respect to women with serious mental illnesses such as schizophrenia. Aim: The aim of this review is to summarize the recent literature on this topic and to outline promising strategies for prevention. Method: Relevant search terms were used in the Google Scholar database from 2000 to the present, and 50 English language papers were selected for review. Results: Women with schizophrenia are targets for sexual harassment and violence, not only domestically, but also on the street, and in institutions. Perpetrators can be intimate partners, strangers, and hospital or prison staff. Women with schizophrenia are sometimes sextrafficked. They are vulnerable because of isolation, passivity, cognitive defects, psychotic symptoms, substance abuse, homelessness, and poverty, and, as a consequence of exploitation, they suffer shame and guilt, increased severity of psychotic symptoms, and increased risk of sexually transmitted disease, unwanted pregnancy, and abortion. On psychiatric assessment, they are seldom asked about the practice of survival sex or about sexual exploitation, and seldom disclose these aspects of their life. Clinical programs are beginning to become available that address self-stigma, educate about risk factors for sexual exploitation and teach safety and self-defense as well as conflict resolution. Psychiatric services are instituting screening procedures for employees, appropriate staff education, and improvements in surveillance measures and policies. Conclusion: Because of increasing awareness of harassment and exploitation of women in general, there is mounting concern about women made more vulnerable than others as a result of severe mental illness.