Stalking – a significant problem for patients and psychiatrists

Community-based studies on stalking have revealed a high lifetime prevalence of stalking victimisation ranging from 12 to 32% among women and 4 to 17% among men (Dressing et al, 2006). There is also growing evidence that stalking may have deleterious economic, social, medical and psychiatric consequences (Dressing et al, 2006). About 20% of stalking victims consult doctors about mental or somatic symptoms but often fail to inform them about the stalking (Dressing et al, 2005). Doctors receive little or no training in the concept of stalking and its management (McIvor & Petch, 2006), hence the causes of these symptoms remain undetected and treatment is insufficient. Moreover, doctors themselves are much more likely than other professionals to be stalked by their clients, but they are not adequately prepared for the professional handling of this situation (Galeazzi et al, 2005; Purcell et al, 2005; McIvor & Petch, 2006).

In most industrialised countries stalking is considered a form of violent criminal behaviour. It is well known that people with serious mental illness are far more likely to be victims of violence than healthy people and it could be hypothesised that this might also be true for stalking victimisation. To the best of our knowledge this has not been investigated to date. To address this question we performed a cross-sectional study of 300 consecutive in-patients admitted to the psychiatric clinic of the Central Institute of Mental Health, Mannheim (a mediumsized German city). We found a lifetime prevalence for stalking victimisation that was twice as high (21.3%) as that in a community sample from the same region (11.6%; Dressing et al, 2005). In only 4 out of 64 cases (6.2%) was the treating psychiatrist aware of the stalking history. This needs confirmation in further studies.

Current scientific evidence stresses the need to introduce formal educational training on stalking for all doctors. This should include information about the high lifetime prevalence of stalking victimisation in patients as well as the high risk of the doctor becoming a stalking victim. The results of our cross-sectional pilot study underscore the urgent need for advanced educational programmes for psychiatrists. The question ‘Have you ever been stalked?’ should be routinely asked in the psychiatric interview in the same way as questions about past suicide attempts.