How Does Crime Affect the Mental Health of Older Victims?

What you need to know

• Older crime victims often experience significant psychological distress, including symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD).
• Around 28% of older crime victims may continue to experience depression and/or anxiety 3 months after the crime.
• Limited research has been done on interventions for older crime victims, but cognitive-behavioral therapy shows some promise for treating anxiety and depression.
• More high-quality research is needed to understand the full impact of crime on older adults and develop effective support strategies.

Psychological Impact of Crime on Older Adults

The review found that crime can have a significant negative impact on the mental health and wellbeing of older adults. Some of the key psychological effects identified include:

Emotional Responses

Older crime victims often experience intense emotional reactions such as:

• Distress and upset
• Fear and feeling frightened
• Anxiety
• Sadness and depression
• Anger
• Embarrassment and shame
• Feeling vulnerable and insecure

For example, one case study of an older rape victim described acute reactions of disbelief, crying, embarrassment, and intense anger in the immediate aftermath. The victim continued to experience fear, difficulty concentrating, and ongoing anger months later.

Mental Health Symptoms

Studies found older crime victims were at risk of developing clinical mental health issues, including:

• Depression - One study found 17.7% of older violent crime victims met criteria for major depression, compared to 8.5% of non-victims.

• Anxiety - Rates of anxiety disorders were elevated in several studies of older crime victims.

• Post-traumatic stress disorder (PTSD) - One study found older assault victims had significantly higher PTSD symptoms than older victims of motor vehicle accidents.

• Sleep disturbances - Difficulty sleeping was commonly reported.

For instance, a survey of older burglary victims in Ireland found 50% reported anxiety or depression symptoms, 44% had sleep disturbances, and 44% developed agoraphobia (fear of leaving home).

Behavioral Changes

Many older victims altered their behavior after experiencing crime, such as:

• Avoiding going out, especially at night
• Increasing home security measures
• Being more cautious and wary of strangers
• Avoiding online activities like banking

These behavioral changes were often driven by fear and could lead to social isolation and reduced quality of life.

Risk Factors for Psychological Distress

The review identified several factors that may increase an older crime victim’s risk of experiencing severe or prolonged psychological distress:

Type of Crime

Violent crimes like physical and sexual assault appear to have a greater psychological impact than non-violent crimes. However, even non-violent crimes like fraud and burglary can cause significant distress in older adults.

Social Isolation

Older victims with limited social support seem to be at higher risk of depression and other negative outcomes after experiencing crime. Strong relationships with family members may help buffer the psychological impact.

Individual Characteristics

Some studies found certain groups of older adults may be more vulnerable, including:

• Women
• Those living in rural areas
• Transgender older adults
• Victims of hate crimes targeting their identity

However, more research is needed to fully understand how individual factors influence outcomes.

Behavior Changes

While many older victims alter their behavior to feel safer after a crime, extreme avoidance behaviors may actually increase psychological distress over time. Finding a balance between reasonable precautions and maintaining normal activities appears to be important.

Interventions for Older Crime Victims

The review found very limited research on interventions specifically designed to help older crime victims cope with psychological distress. Only four small feasibility studies were identified:

Nursing Interventions

Two studies looked at nursing-based support:

1. A case study of crisis counseling for an older rape victim, which included emotional support, psychoeducation, and help accessing other services. This appeared to help the victim maintain independent living despite ongoing trauma symptoms.

2. A “nurse-link” program in the UK where district nurses visited older burglary victims to assess health needs and coordinate care. This identified high rates of depression and anxiety among victims.

Psychoeducation Video

One small randomized trial tested a psychoeducation video on coping strategies for older violent crime victims. While it increased knowledge, it did not reduce depression or anxiety symptoms compared to usual care.

Cognitive-Behavioral Therapy (CBT)

A pilot study adapted CBT for older crime victims experiencing continued distress 3 months after the crime. Early results suggested it may help reduce anxiety and depression, but not PTSD symptoms. A larger trial is now underway to further evaluate this approach.

Overall, while these initial intervention studies show some promise, much more research is needed to develop and test effective support strategies for older crime victims.

Conclusions

• Crime can have a severe and lasting psychological impact on older adults, including symptoms of anxiety, depression, and PTSD.
• More high-quality research is urgently needed to understand the full scope of this issue and identify those most at risk.
• Developing and testing targeted interventions to support older crime victims should be a priority for researchers and policymakers.
• The impact of crime on older adults should be viewed as an important public health concern requiring greater attention and resources.