Violence, Abuse and Mental Health: Opportunities for Change

Lead Research Organisation: King's College London
Department Name: Health Service and Population Research

Abstract

Violence and abuse are endemic globally. In the most recent Crime Survey in England and Wales, 2% reported past-year community violence (where most victims were men). Domestic violence or abuse (physical, sexual, psychological, economic and controlling or coercive behaviour) in the last year was reported by 7.5% of women and 4.3% of men, with victims of repeated or severe domestic violence and/or sexual violence more likely to be women. Most previous mental health research has neglected the impact of domestic and sexual violence on mental health and well-being, so our network will prioritise these, and their links with childhood experiences, and mental health in childhood and adulthood. We know that people with mental health problems are more likely to be victims of domestic or sexual violence, or have witnessed parental violence as a child; some mental health problems are also, much less commonly, associated with committing violent acts though there is very little known about this in relation to domestic violence perpetration. The UK government has recognised that preventing and reducing the impact of domestic and sexual violence and abuse is an important way to improve mental health.

This network aims to reduce the prevalence of mental health problems among children, working age adults, and the elderly, by bringing together experts with different ways of thinking about violence, abuse and mental health - some will have personal experience of these issues, others will have expertise from the work that they do, and survivor researchers have expertise born of lived experience and their work. Understanding, preventing and reducing the impact of violence and abuse on mental health requires that we resolve problems that have prevented progress in the past. Firstly, different organisations mean different things when they talk about violence and abuse. This has meant that violence and abuse, and mental health, are measured in different ways by different organisations, and that information collected about violence and abuse does not tell us what we need to know. For example, mental health surveys sometimes ask about violence, but do not ask about the relationship between the victim or perpetrator, what type of violence was experienced, or how it impacted on mental health. Secondly, we have limited knowledge of how and why experiencing different types of violence and abuse increases the risk of developing mental disorders, or how new digital technologies are changing people's experiences of abuse and how this impacts on mental health. Thirdly, we do not have interventions that are effective in preventing or reducing violence experienced by people with mental health problems, or programmes that reduce the risk of mental health problems developing after experiences of violence or abuse.

Network activities will address these challenges through: 1) working with people who have personal experience of violence, abuse, and mental health problems to learn from different perspectives, and generate fresh ideas and research questions, with a focus on the commonest types of violence- domestic and sexual violence and abuse; 2) trying to answer research questions through small grant competitions, workshops, conferences, and other events; some of these will lead to larger grant applications; 3) sharing measurement approaches, including how to ethically and safely research this area, which will help data collection and analysis by health services, the criminal justice system, family courts, social care, charities, and researchers. We will also develop an online resource providing information about datasets that can be used in research in the future. We aim to make our results known by publicising them widely through our network and other organisations, including policy makers within NHS England, Public Health England and the National Institute for Health and Social Care Excellence, technology companies and the general public.

Planned Impact

Key beneficiaries:
1. People with lived experience of interpersonal violence or abuse and mental health problems;
2. The general population including at risk groups such as young people, and people with disabilities;
3. Mental health professionals;
4. Academics - see "Academic beneficiaries";
5. Third sector providers of support for survivors of DV and SV, and programmes for DV perpetrators. The third sector have expressed concern about mental health services failing to address DV and SV, and report mental health problems can be a barrier to effective help for perpetrators and survivors;
6. Self-help groups, peer support providers, and community groups;
7. Policy makers, regulators, commissioners and public health leads;
8. Technologists, including software designers and "Internet of Things" manufacturers;
9. Police, HM prison and probation service.

They will benefit in the following ways:
1. People with mental health problems who are survivors of violence and abuse will be supported more effectively as a result of the development of more appropriate interventions and trauma informed care; they will also be informed about our research through survivor organisations' newsletters and shape the research agenda.
2. The general population will better understand the impact of violence and abuse on mental health through public engagement activities and the media, and through education e.g. on healthy relationships in schools. Publicity and dissemination of the network's activity may also enhance awareness of violence and abuse and help-seeking opportunities.
3. Training of mental health professionals will improve as it will be more informed by a greater understanding of the impact of violence and abuse on mental health. Practitioners will be able to recognise and understand the needs of their clients more effectively; ultimately this will mean their work is more effective and rewarding, and that they understand how their own experiences of abuse may have led them to their work.
4. See earlier for specific benefits to academics.
5. The third sector will benefit through opportunities for collaborations which could result in new ways to analyse their administrative data, in addition to developing new understandings of violence, abuse and mental health which could help multi-agency working.
6. Self-help groups and community groups, working with victims and perpetrators of domestic violence and abuse, will be impacted through similar mechanisms.
7. The policy lab will include members on the DHSC Women's Mental Health Taskforce (Sacks-Jones, CEO AGENDA, named collaborator, is co-Chair with Jackie Doyle-Price MP) e.g. NHSE, which is working on sexual safety and restraint in Mental Health Trusts (relating to Regulation 13 http://www.cqc.org.uk/guidance-providers/regulations-enforcement/regulation-13-safeguarding-service-users-abuse-improper) and PHE. Research of relevance will be fed back to relevant bodies including the Home Office (Violence Against Women and Girls strategy), DHSC, NICE (e.g. NICE PH50), Health Education England, NHS England National Safeguarding Steering Group and Safeguarding Lead Networks, Mental Health Policy Research Unit, and Royal College conferences.
8. Technologists such as software developers, "Internet of Things" manufacturers and engineers will understand how technical systems and platforms can be used in violence and abuse cases and ultimately impact on mental health e.g. cyber-bullying and controlling behaviour in 'smart' and internet-connected homes.
9. The police, HM Prison and Probation service will understand more about the violence and abuse experienced by mentally disordered victims and perpetrators. Furthermore, we will provide opportunities to discuss how criminal justice can better liaise with mental health services, and understand the factors that increase risks of violence, suicide, and re-victimization in those with mental health conditions.

Publications

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