Institutions for persons with disabilities four out of ten have been exposed to serious violence. One out of ten persons was a victim of serious physical violence in the past three years whereby persons who require support with basic needs such as personal hygiene are particularly affected. This, according to the analysis, is attributable to care-relevant forms of violence. “Being handled” in an inappropriately rough manner during care activities can be given as an example here. The prevalence is significantly higher for mentally ill offenders in detention both in relation to increased frequency and severity of experiences of physical violence and, in particular, recent experiences of violence (experienced in the past three years). Persons with disabilities are also kicked, pushed or roughly handled more often. The frequency of becoming a victim of this kind of violence is twice as high as for persons without disabilities. The likelihood of being threatened with a weapon (knife or gun) is even three to four times higher for persons with disabilities. The study makes the urgent need for action with regard to sexuality and sexual violence transparent: every second person with disability or mental illness has been affected by sexual harassment or serious sexual violence in their life. Whereas the majority of those in management consider sex education support to be implemented in the institutions, this appears to be the case only half of the time in reality and practice according to the staff. The study identifies a large number of risk and protective factors especially also for girls, women and men. It also demonstrates that the size of an institution is not necessarily an indicator for the institutional culture; smaller institutions are not more likely to provide a violence-free environment. Analyses show that amongst others experience of violence is reported far more frequently in institutions where less caregiving personnel is available. The risk of violence is evidently high if there is little time for person-centred care. In these cases, it is more difficult to react to violence between the residents. Risk and protective factors Structural limitations such as the lack of space to which residents can withdraw, fixed washing times, insufficient autonomy and self-determination increase the risk of violence. Particularly important for violence prevention are social contacts, persons of trust inside and outside of families and institutions, person-centred care concepts and forms of support that enable those in care to participate and lead their lives in a self-determined way. The NPM has regularly addressed these aspects in recent years and will continue to do so. There is a considerable need for action in the reduction of risks to violence. Persons with disabilities and mental impairments must be adequately informed about forms of violence and how to be protected against the same. The promotion of empowerment and self-determination is also deemed an important violence prevention strategy in the study. 94