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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Taggart D (2021) Trauma, mental health and the COVID-19 crisis: are we really all in it together? in Journal of mental health (Abingdon, England)

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Whiting D (2020) Violent outcomes in first-episode psychosis: A clinical cohort study. in Early intervention in psychiatry

 
Description Our meetings and events have been attended by over 380 people, providing opportunities for learning, dissemination, and networking. Twitter coverage has brought information from our events to more than 431,000 people (evidenced through number of impressions). Impact in progress includes our agenda-setting work with The Lancet Psychiatry through our Commission on Intimate Partner Violence and Mental Health and our policy lab on Implementing Trauma-Informed Approaches to Care. Following our policy lab we have been invited to meet with the Department of Health and Social Care in relation to the women's health strategy, and met with Agenda (an NGO) to discuss opportunities for developing multi-sector trauma-informed care standards.
First Year Of Impact 2020
Sector Communities and Social Services/Policy,Government, Democracy and Justice
Impact Types Policy & public services

 
Description Study on the economic, social, and human costs of trafficking in human beings within the EU
Amount € 309,836 (EUR)
Funding ID HOME/2018/ISFP/PR/THB/0000 Lot 2 
Organisation European Commission 
Sector Public
Country European Union (EU)
Start 05/2019 
End 02/2020
 
Description Epidemiology and Psychiatric Sciences Special Issue on Sexual Violence and Mental Health 
Organisation Cambridge University Press
Country United Kingdom 
Sector Private 
PI Contribution The PI was invited to guest edit a special issue of the journal on the topic of sexual violence and mental health. As guest editor she commissioned two 3,000 word commentaries from leading experts working in this field and authored a 1,500 word editorial to introduce them.
Collaborator Contribution Epidemiology and Psychiatric Sciences is an international peer-reviewed journal; each issue has a focus on one topic.
Impact All outputs are listed under publications: (1) Oram et al (DOI: https://doi.org/10.1017/S2045796019000106) (2) Sweeney et al (DOI: https://doi.org/10.1017/S2045796019000131) (3) Hughes et al (DOI: https://doi.org/10.1017/S2045796019000040) Collaboration involves applied health researchers, epidemiologists, and survivor researchers.
Start Year 2018
 
Description Lancet Psychiatry Commission on Intimate Partner Violence and Mental Health 
Organisation The Lancet
Country United Kingdom 
Sector Private 
PI Contribution The research's senior leadership team conceptualized the scope of the commission and identified commissioners in partnership with the editor of The Lancet Psychiatry. The research team provided the secretariat to the commission, including through the organisation of travel and accommodation for commissioners to attend two in-person meetings (June 2019 and February 2020). The PI chaired the in-person meetings with the editor of The Lancet Psychiatry and provided guidance and support to commissioners between meetings.
Collaborator Contribution The Lancet Psychiatry has contributed staff time from the editor and deputy editor, access to facilities and equipment (i.e. catering and room hire), and printing. Future contributions will include printing and dissemination of the commission, podcasts and advertising, and additional staff time including for development of online content.
Impact An editorial announcing the Commission was published in July 2019 (Oram et a doi: 10.1016/S2215-0366(19)30186-5.l, see publications). The collaboration is multidisciplinary: the team of commissioners brings expertise in child and adolescent psychiatry, forensic psychiatry, psychology, primary care, neuroscience, behavioural science, violence against women research, service user-led research, epidemiology, law, sociology, and journalism.
Start Year 2019
 
Description Supporting survivor involvement 
Organisation McPin Foundation
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution The research team provided support to conceptualize, design, and conduct the survivor research consultation; and invited McPin Foundation to be represented at The Lancet Psychiatry Commission on Intimate Partner Violence and Mental Health and to speak at network events.
Collaborator Contribution McPin Foundation led the survivor research consultation (detailed below) including through the design, piloting, and promotion of an online survey; organizing two survivor workshops; analyzing findings; leading write up of findings; and supporting dissemination. McPin Foundation additionally support the network through attendance at and participation in network activities and events and supporting dissemination.
Impact (1) The collaboration has resulted in a consultation exercise to identify priority issues and potential research questions from survivor perspectives, led by the McPin Foundation, a member of the grant-holder team (Dr Angela Sweeney), and an independent researcher affiliated with Survivors Voices, a national peer-led organisation run by and for adult survivors of abuse. The aim of the consultation was to develop a list of priority research topics and potential research questions on the topic of violence, abuse and mental health from the perspective of survivors. The consultation involved collecting information from an open survey and workshops with survivors, followed by the assimilation of findings from both sources into a set of research themes and question. The consultation report was launched and made publicly available in June 2019 (https://www.vamhn.co.uk/uploads/1/2/2/7/122741688/consultation_report_on_website.pdf). It has been disseminated electronically and in hard copy via the research network and its findings used to inform network activities, including its annual grant competitions. (2) McPin Foundation contribute to network activities and events, including through The Lancet Psychiatry Commission on Intimate Partner Violence and Mental Health.
Start Year 2018
 
Description 1st Measurement Workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact Workshop hosted by VAMHN co investigator Prof. Sylvia Walby at City University. Approximately 45 invited stakeholders attended in order to facilitate a dialogue between NGOs, researchers, policymakers, funders and publishers regarding the development of a shared measurement framework. The day included presentations, panel discussions and marked the launch of the VAMHN's first small grant competition on the theme of measurement.

Main outcomes/outputs/impact: new connections made, channels of ongoing discussion opened across sectors, small grant competition launched to stimulate new research.
Year(s) Of Engagement Activity 2019
 
Description 1st Network Meeting 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact 1st network meeting attended by approximately 50 network members. The event included talks from Dan Robotham (McPin Foundation), Suzanne Jacob, Emma Vallis and Shanti Rao (SafeLives), Sarah Hughes (StandingTogether) and Khatidja Chantler, Solveig Vatnar and Nicky Stanley (Domestic Homicide International Research Group). The event also included roundtable discussion sessions and opportunities for networking.

Main outcomes/outputs/impact: new cross-sector connections made, new research shared, Mental Elf live tweeting and podcasts shared online, results of roundtable discussion used to influence network's aims and activities.
Year(s) Of Engagement Activity 2019
URL https://www.vamhn.co.uk/news/first-network-meeting-podcasts
 
Description 2nd Measurement Workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact Measurement workshop hosted by VAMHN co investigator Dr Emma Howarth. The event involved preliminary work to support the development of a core outcome set to assist in the monitoring and evaluation of family and child focused targeted interventions. Key stakeholders were invited included healthcare practitioners, academics, members of the third sector and people with lived experience of violence, abuse and mental health problems.

Main outcomes/outputs/impact: new connections made, contribution to core outcome set publication - expected in 2020/21.
Year(s) Of Engagement Activity 2019
 
Description 2nd Network Meeting 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact 2nd Network Meeting hosted at the Institute of Mental Health in Nottingham. The day included presentations from Concetta Perot, Prof. Vanessa Munro, Dr Parveen Ali and Dr Julie McGarry. The event also included roundtable discussions and opportunities for networking.

Main outcomes/outputs/impact: new connections made, Theory of Change output for the network planned as a result of roundtable discussions - impact on research an policy, podcasts and live tweeting.
Year(s) Of Engagement Activity 2019
URL https://www.vamhn.co.uk/news/second-network-meeting-071019
 
Description ESRC Festival of Social Sciences: Resilience to Transformation 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact Workshop on "Resilience to transformation: improving the response to violence against women and its impact on mental health" hosted by Dr Helen Adams. The event looked at concepts of resilience and transformation from a geographical and psychological perspective. The event was held as part of the ESRC Festival of Social Sciences.

Main outcomes/outputs/impact: Podcasts and live tweeting from the mental elf, new connections made, collaborative publication planned from Helen Adams, Nadia Mantovani and Collette Hirsch who met at the workshop - impact on research.
Year(s) Of Engagement Activity 2018
 
Description International Violence, Abuse and Mental Health Network Meeting 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Inaugural meeting of the International Violence, Abuse and Mental Health Network created by network member Dr Roxanne Keynejad (King's College London) who obtained seed funding to bring international early career researchers together to present their work. Research was presented from India, Ethiopia, Somaliland and Uganda.

Main outcomes/outputs/impact: new international connections made
Year(s) Of Engagement Activity 2019
 
Description Lancet Psychiatry Commission Preliminary Meetings: Intimate Partner Violence and Mental Health 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Two meetings which bought together approximately 25 international experts for preliminary work on a planned publication with the Lancet Psychiatry on 'Intimate Partner Violence and Mental Health'. The publication aims to establish a roadmap for future work across mental health research, services, and policy. The publication is expected by November 2020.

Main outcomes/outputs/impact: Influence on Policy, Practice, Patients & the Public, new international connections made.
Year(s) Of Engagement Activity 2019,2020
URL https://www.sciencedirect.com/science/article/pii/S2215036619301865?via%3Dihub
 
Description Launch Event 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact <100 people attended from different areas including third sector, policy and academia to celebrate the launch of the UKRI Violence, Abuse and Mental Health Network. The day included presentations from 5 key network partners; Kate Lovett, Wendy Burn, Felicity Callard, Donna Covey and Louise Arseneault. The event also included opportunities for networking.

Main outcomes/outputs/impact: influence research and policy through subsequent activities of the network
Year(s) Of Engagement Activity 2018
 
Description McPin Survivor Research Priorities Consultation Workshops 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact Two workshops conducted with people with lived experience of violence, abuse and/or mental health problems in order to gain insight into what their research priorities are as survivors. One workshop was held in London and the other in Birmingham, and both were hosted by Dan Robotham (McPin), Concetta Perot (Survivors' Voices, King's College London, Independent Researcher) and Angela Sweeney (St George's University of London). The workshops acted as preliminary work to create the 'VAMHN Survivors' priority themes and questions for research consultation report' which aims to inform the activities of the network.

Main outcomes/outputs/impact: to influence research in the area of violence, abuse and mental health in a way that reflects the views and needs of survivors, to create the VAMHN consultation report to guide the activities of the network in a way that reflects the views and needs of survivors.
Year(s) Of Engagement Activity 2019
URL https://www.vamhn.co.uk/uploads/1/2/2/7/122741688/consultation_report_on_website.pdf
 
Description Mental Elf Blog: 'Mental disorders and intimate partner violence perpetrated by men towards women' by Anna Sri 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Mental Elf blog written by network member Anna Sri evaluating the paper 'Mental disorders and intimate partner violence perpetrated by men towards women: A Swedish population-based longitudinal study' by Yu et al (2019). The publication of the Yu et al (2019) paper was facilitated by the VAMHN and includes L. Howard (VAMHN co-lead) and S. Fazel (VAMHN grantholder) as co authors. Mental Elf blogs reach hundreds of researchers and practitioners and have significant impact on the uptake and readership of a scientific paper.
Year(s) Of Engagement Activity 2020
URL https://www.nationalelfservice.net/mental-health/substance-misuse/mental-disorders-and-intimate-part...
 
Description Mental Elf Blog: 'Mental health policy: are the "facts" based on "evidence"?' by Anjuli Kaul 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Mental Elf blog written by network coordinator Anjuli Kaul evaluating the paper ' The accuracy and accessibility of cited evidence: a study examining mental health policy documents.' by Hui et al (2019). Mental Elf blogs reach hundreds of researchers and practitioners and have significant impact on the uptake and readership of a scientific paper.
Year(s) Of Engagement Activity 2020
URL https://www.nationalelfservice.net/publication-types/policy/mental-health-policy-are-the-facts-based...
 
Description Newsletters 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact Monthly newsletters disseminated to VAMHN mailing list since December 2018. The newsletters contain relevant information about resources, events and collaboration opportunities facilitated by the network and externally. As of Jan 2020 the newsletter has directly been mailed to 562 people.

Main outcomes/outputs/impact: new connections made, new collaborations for grant applications made, research publications and organisations spotlighted.
Year(s) Of Engagement Activity 2018,2019,2020
URL https://www.vamhn.co.uk/newsletter.html
 
Description Policy Lab Workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Policy lab workshop on the subject of "what is needed for a Trauma Informed Approach to be effectively implemented across all relevant public service settings?" The workshop synthesised the perspectives of key stakeholders on the implementation of Trauma Informed Approaches in policy. The main aim of the workshop was to identify key recommendations for policymakers and collate in the form of a briefing note to be disseminated widely. A briefing pack on trauma informed approaches was provided to attendees in advance of the workshop and published on the VAMHN website.

Main outcomes/outputs/impact: impact on policy through the subsequent development of a policy briefing note, new connections made, increased profile of the network in policy, increased awareness of trauma informed approaches through online distribution of the briefing pack
Year(s) Of Engagement Activity 2019
URL https://www.vamhn.co.uk/uploads/1/2/2/7/122741688/vamhn_policy_lab_briefing_pack_website.pdf