The temporal relationship between mental health service use and stalking perpetration

Mental disorder is common among people who stalk. However, the nature of this association is unclear and it is not known whether the commencement of stalking is associated with symptoms of disorder. This study used a longitudinal design to examine the association between the onset and cessation of stalking behavior and indicators of mental disorder in the form of mental health service use.

Data linkage was used to explore public mental health service use among 157 people who engaged in stalking in Melbourne, Australia. Mental health service use across the lifetime, 5 months prior to stalking onset, between the onset and cessation of stalking (during stalking) and 5 months post-stalking was identified. Mixed regression models tested temporal associations between types of mental health service use (acute vs continuing care) and onset and cessation of stalking in a subsample of 130 participants where dates of the stalking episode were available.

A total of 105 (67%) participants had lifetime use of public mental health services, while 15% accessed mental health services in the 5 months prior to (N = 19) or during the stalking (N = 20) and 22% (N = 29) used services in the 5 months after the stalking ceased. Odds of using acute mental health services and average monthly rate of use were highest during the stalking. Odds and average monthly rate of using continuing care were highest after the episode ceased.

Most people who stalk have used public mental health services, but a minority access services immediately prior to or during the stalking episode. Acute service use was more common during the stalking, while use of continuing care services was more common after the stalking ceased. These findings provide preliminary support for a temporal relationship between acute mental disorder and stalking behavior.