Research, published in the British Journal of Psychiatry, finds women who have been abused by a partner are three times more likely to develop mental health problems
The study is one of the first in the UK to investigate the link between domestic abuse and mental health. Published in the British Journal of Psychiatry, it aimed to “explore the relationship between IPV (intimate partner violence) exposure and mental illness in a UK population”.
Findings revealed that women who have been exposed to domestic abuse are three times more likely to suffer from depression, anxiety or severe conditions, such as schizophrenia or bipolar disorder than other women.
The research also suggests that women do not always report the abuse to their GP. Only 0.25% of women on the primary care lists used in the study had reported domestic abuse to the GP – despite police reporting that one in four women are affected over their lifetime.
In probing the link between domestic abuse and mental health, researchers found that the relationship was two-directional. Women who had previously sought support from their GP for mental health problems were also three times more likely to report domestic abuse at a later date, while nearly half of those who had reported abuse already had mental health problems.
Screening and recording of domestic abuse needs to be a clear priority for public services so that more effective interventions for this group of vulnerable women can urgently be put in place
The academics involved in the study (Joht Singh Chandan, Tom Thomas, Caroline Bradbury-Jones, Rebecca Russell, Siddhartha Bandyopadhyay, Krishnarajah Nirantharakumar and Julie Taylor) conclude that opportunities to spot the signs of domestic abuse and to tackle it, are being missed.
“There does seem to be significant under-recording of domestic abuse within UK primary care. We are not saying that GPs should be asking the question more,” said Dr. Joht Singh Chandan, lead author of the study. However, they do believe there should be better sharing of such information between the public service.
Dr. Beena Rajkumar, the co-chair of the women’s mental health special interest group at the Royal College of Psychiatrists, said: “As a frontline psychiatrist working with women with severe mental illness, I am all too aware of the devastating impact domestic abuse has on mental health, and I work with survivors every day.
“This study highlights the two-way relationship between abuse and mental illness, including serious mental illness, and carries a very important warning that we are missing opportunities to detect abuse that is happening all over the country today.
“Screening and recording of domestic abuse need to be a clear priority for public services so that more effective interventions for this group of vulnerable women can urgently be put in place.”
The study looked at primary care records relating to more than 92,000 women in the UK between 1995 and 2017. They matched 18,547 women who had reported abuse with 74,188 women who had not. Results saw that 49.5% of women in the ‘exposed group’ had some form of mental illness, compared with 24% of women in the ‘unexposed group’.
While they made allowances for other factors that may play a part in mental health, such as deprivation, smoking and drinking habits, it is difficult to understand the exact connection between domestic abuse and mental health.
Speaking about the study on the Victoria Derbyshire show, Dr Chandan said: “Unfortunately we have groups of very vulnerable women who are being subjected to abuse, and the question is, and one of the key highlights of the study, is are there any opportunities for us to help those vulnerable women before they are exposed to domestic abuse.”
Emma Armstrong, a survivor of domestic abuse said that, in hindsight, if she was asked the question, ‘Do you feel safe with your partner?’ by a GP or anyone else, she might have had the opportunity to say no and get out and get the help she needed sooner.
Dr. Rajkumar said: “We as professionals, the onus is on us to make sure we are asking the questions. And not just asking the questions, but knowing how to ask the questions, and we know what to ask.
“If in general practice we ask about smoking and alcohol consumption because of the impact it has on physical health, similarly we should be asking about domestic abuse as a screening question because of the impact it has on mental health.
If in general practice we ask about smoking and alcohol consumption because of the impact it has on physical health, similarly we should be asking about domestic abuse as a screening question because of the impact it has on mental health
“It’s about knowing how to ask and what to ask… instead of asking ‘What’s wrong with you?’, which is filled with judgment and blame, we ask ‘What happened to you?’, which is filled with empathy and validation.”
Louise Howard for the National Institute for Health Research at King’s College London noted that other factors are likely to play a part. “For example, we know that childhood maltreatment and sexual abuse are associated with mental illness, and with being a victim of domestic violence and abuse,” she said.
That’s not to take away the study findings, though. She continued: “The important takeaway message of this study is that domestic violence and abuse is a serious public health and public mental health problem.
“Health practitioners who see women with mental health problems in primary or secondary care, therefore, need to be trained how to ask routinely about domestic violence and abuse, and how to safely respond.”
Read the full study.