The prior conviction for statutory rape was a warning. Nonetheless, he passed a background check and the psychiatric hospital hired him to work with severely ill patients. Before long, he was having sex with multiple women confined to the hospital. In his mind, the women were willing partners, but a sex crimes conviction contradicted this interpretation of events.   

Terrible as it is, sexual abuse of psychiatric patients is far from shocking. What makes this particular victimization so unsurprising? Based on my research, one factor seems to be the common perception that people with mental illness are easily exploitable.

The Nature Of Spotting Victims  

Animals have evolved to exploit victims. Cutthroat as it seems, examples of exploitation should be familiar from a lifetime of nature programs. The lion culls a slow gazelle from the herd. The silverback gorilla pummels a weaker male to maintain troop dominance. The cuckoo lays its eggs in the nest of another bird that fails to jealously guard its territory. 

Humans also exploit. If there is a desirable resource, people have invented a way to take it from others. This includes sex. People use false charm to seduce potential mates. They deceive with lies about personal attributes and intentions. Most troublingly, people pressure others into sex with unrelenting demands, and they coerce with threatened or actual force.  

Exploitation is not random. Lions do not attack the fastest gazelles in the herd. Rather, they spot the slow, weak, or sick prey that can be easily caught. If humans use others for sex, then they too must use cues to spot the easily exploited. Evolutionary theorists have proposed numerous cues that could signal vulnerability to sexual exploitation. They include psychological traits such as low self-esteem, naivete, low intelligence, recklessness, impulsivity, attention-seeking, drug use, and intoxication.

To be frank, the vulnerability cues read to me like a list of symptoms in the Diagnostic and Statistical Manual of Mental Disorders. Across several research studies, I have shown that this similarity is no coincidence.

Mental Illness And Sexual Exploitability

Despite the common myth that people with mental illness are dangerous, they are the ones at increased risk for crime and victimization. Rates of sexual assault are especially high. Why assault them? My research suggests that people view individuals with mental illness as sexually exploitable.   

The task of connecting mental illness with sexual exploitability occurred in several steps. The first step was to determine if people associated cues of exploitability with mental illness. To do this, I asked people to indicate if a long list of previously established cues of exploitability—anxious, reckless, intoxicated, immature, acts unintelligent, etc.—were more typical of individuals with or without mental illness. On average, people associated sexual exploitability cues with mental illness.

The next step was to determine who people think can be exploited. I asked people to compare how easy it would be to pressure, deceive, and coerce a person with or without mental illness into having sex. People indicated that they saw individuals with mental illness as more vulnerable to all three forms of sexual exploitation. They saw women with mental illness as most exploitable, but the trend held for men as well.

A critic might rightly point out that these studies only showed that people with “an illness” are seen as exploitable. It could just as well be a physical illness. So, the final step was to show that perceptions of exploitability are higher for mental illnesses such as bipolar disorder and bulimia than physical illnesses such as asthma and diabetes. The results showed that, at least in terms of perceived exploitability, physical illness was no different from being healthy. People only saw individuals with mental illnesses as relatively easy to deceive, pressure, and coerce into sex.

It’s Not Just Sex

Reconsider the story about psychiatric patients being exploited for sex. Would it be any less believable if the patients had been physically abused? Or if they were bullied into handing over money? I think not.

After looking at perceptions of sexual exploitability, I conducted follow-up studies to show that people also perceive individuals with mental illness as easier to abuse, cheat, cuckold, and kill. It turns out that the perception of people with mental illness as exploitable is broad, not sex-specific. This is consistent with real-world statistics. People with mental illness face an increased risk for a variety of crimes ranging from rape to battery to theft.

Theorists have long considered mental illness a “double problem.” People struggle with the symptoms of mental illness, plus they are stigmatized for having a mental illness. Unfortunately, it may actually be a “triple problem” because people with mental illness are also seen as exploitable, and this could add victimization to lives that are already so often characterized by stress and trauma.  

For Further Reading

Boysen, G. A., Axtell, E. L., Kishimoto, A. G., & Sampo, B. L. (2021). Generalized perceptions of people with mental illness as exploitable. Evolutionary Behavioral Sciences.

Boysen, G. A., & Isaacs, R. (2022). Perceptions of people with mental illness as sexually exploitable. Evolutionary Behavioral Sciences, 16(1), 38–52.

Guy A. Boysen is a Professor of Psychology at McKendree University. His scholarship emphasizes stigma toward mental illness, the teaching of psychology, and the professional development of faculty.