Interpersonal Victimization and Polyvictimization: An Examination of Mental Health Service Complexity

Childhood interpersonal victimization and polyvictimization are associated with negative consequences to mental health. As a result, those exposed to trauma display increased mental health service use. Few studies have examined the impacts of interpersonal victimization and other risk factors on service complexity. This gap in the literature was addressed by analyzing secondary data of 18701 clinically-referred children/youth aged 4–18 who completed the interRAI ChYMH, using a cross-sectional study design. Poisson regression models examined the relationships of interpersonal victimization, polyvictimization, and other relevant factors with service complexity. Children/youth exposed to either sexual abuse, physical abuse or bullying had higher service complexity than their counterparts. Furthermore, in addition to individual-and family-level risk factors, polyvictimization was related to higher service complexity than counterparts. Findings revealed service complexity predictors, including specific interpersonal victimizations, polyvictimization, and other risk factors. Implications for mental health service providers and organizations are discussed.Summary for Lay AudienceWhen children and youth are exposed to interpersonal victimization, several domains of functioning are impacted. One domain in particular that is impacted is mental health. Children and youth who have experienced trauma display greater mental health concerns and increased mental health service use. Unfortunately, Canada's mental health system is overburdened, pointing to a critical need to develop an efficient system equipped to meet the needs of its population. However, the impacts of interpersonal victimization and other relevant risk factors on service complexity are not well understood in the literature. Particularly, little work has examined bullying, sexual abuse, physical abuse, and exposure to multiple interpersonal victimizations, also known as polyvictimization, on service complexity. To address this gap in the literature, the current study examined the relationship between interpersonal victimization, polyvictimization, and other relevant risk factors, with service complexity. It was revealed that children who have been exposed to sexual abuse, physical abuse, and bullying had higher service complexity than their non-traumatized counterparts. In addition, polyvictimization and other risk factors, including older age, inpatient status, having a history of foster placement, greater family dysfunction, and speaking neither French nor English, were related to higher service complexity than counterparts. These results have practical implications for mental health service providers, including considering bullying as a form of interpersonal trauma and understanding its impacts comprehensively. Additionally, this study supports assessing a child's trauma history in the context of other factors, including other individual and family characteristics, to ensure streamlined access to appropriate mental health services.

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