title: Institutional abuse - Characteristics of victims, perpetrators and organsations: A systematic review.
abstract: Abuse of vulnerable adults in institutional settings has been reported from various countries; however, there has been no systematic review of the characteristics of the victims and their abusers. Our aim was to identify and synthesise the literature on victims, perpetrators and institutions where abuse occured in order to inform interventions to prevent such abuse.
  
  
  
  Searches of MEDLINE (OVID), CINHAL (EBSCO), EMBASE (OVID) and PsychINFO (OVID) databases identified 4279 references. After screening of titles and abstracts, 123 citations merited closer inspection. After applying inclusion and exclusion criteria, 22 articles were included in the review.
  
  
  
  Our review suggested that the evidence available on risk factors is not extensive but some conclusions can be drawn. Clients, staff, institutional and environmental factors appear to play a role in increasing the risk of abuse.
  
  
  
  Vulnerable clients need closer monitoring. Clients and staff may lack the awareness and knowledge to identify and report abuse. Institutions should take proactive steps to monitor clients, train staff and devise systems that allow for the identification and prevention of incidents of abuse.There is a need for further research into the associations between the individual client, staff, institutional characteristics and abuse.
authors.affiliation: South Oxfordshire Adult Learning Disability Team, Abbey House, Abingdon, UK. Electronic address: Yeshwant.kamavarapu@nhs.net.
authors.forename: Y S
authors.initials: YS
authors.lastname: Kamavarapu
authors.affiliation: Nottinghamshire Healthcare NHS Trust, Rampton Hospital, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Ferriter
authors.affiliation: Nottinghamshire Healthcare NHS Trust, Rampton Hospital, UK.
authors.forename: S
authors.initials: S
authors.lastname: Morton
authors.affiliation: Division of Psychiatry and Applied Psychology, University of Nottingham, UK; Enhanced Service for Personality Disorders, Rampton Hospital, UK.
authors.forename: B
authors.initials: B
authors.lastname: Völlm
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D019548:Crime Victims / Q000706:statistics & numerical data*; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D004552:Elder Abuse / Q000706:statistics & numerical data*; D005260:Female; D006268:Health Facilities; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes
keywords: Abuse; Adults; Caregiver; Characteristics; Institution; Vulnerable