Violence, Health and Society

Lead Research Organisation: City, University of London
Department Name: Sch of Social Sciences

Abstract

Violence causes harms to health, especially long-lasting harms to mental health. Mental health is significantly impacted by violence. These harms to mental health can be more long-lasting than the immediate harms to physical health. They have consequences that reverberate through a person's life impacting on their functioning in society, with still further consequences. Reducing such 'upstream' determinants of poor mental health would significantly improve the health of the population. Investigating the effectiveness of potential interventions to reduce exposure to violence is central to the proposal.

Within the field of violence, we have special interest in domestic and sexual violence because these are significant causes of inequalities in mental health. We address how to mainstream these issues across multiple sectors rather than seeing them as only of specialised concern. Our Consortium aims to mainstream violence prevention at higher and earlier stages than before.

Multiple institutions are relevant to preventing violence. They include not only health services, but also law enforcement (most violence is a crime), social services (especially important for child protection), specialised services (Third Sector organisations that help victim/survivors of violence), and governmental bodies concerned with law, policy and data quality. The connections between violence and mental ill health are complicated since they are mediated by many social systems (institutions). Identifying these connections (causal pathways) would aid the development of more effective interventions.

The data needed to assess the effectiveness of interventions is currently weak. This is partly because each specialised academic discipline and profession has a different way of measuring violence, which makes cooperation across these differences difficult. Not only do we need harmonised core metrics for cross-sector cost-benefit comparisons, we also need to adapt and extend our metrics to capture the new forms of technology-facilitated abuse. The Consortium aims to improve the measurement framework and data availability to aid the cross-sector evaluation of interventions. It seeks to develop cooperation between academics and professionals as to how this is best done. After reaching agreement on how to proceed, we would develop the data needed to assess interventions. This involves developing cooperation between data providers, agreements on common categories, and making data more available. This involves care and attention to issues of data protection and the development of bespoke agreements on data sharing that respect the communities that generate data.

We would unlock the potential in multiple data sources with increased cooperation over a shared measurement framework. These data sets include major national surveys such as the Adult Psychiatric Morbidity Survey (national survey of mental health that includes information on experience of violence), and the Crime Survey for England and Wales (national survey that includes changes over time in violence and their consequences). They include administrative data sets from professions and practices, including the police, health and social services, specialised services and technology companies. We would locate data analysts of multiple data sets in the same space to facilitate technical cooperation between usually separate disciplines.

With the newly improved data, we would use academic, statistical, and practitioner knowledge and the resources of the Consortium to assess key interventions. These are interventions at the level of institutions and systems. We leave to others the issue of addressing the treatment of trauma in individuals already affected by violence. Our focus is the 'prevention' of violence in the population.

The aim is to reduce the harm to health, especially mental health, by identifying the most effective interventions to reduce violence in the population.

Technical Summary

Violence causes harms to health, especially long-lasting harms to mental health. Preventing 'upstream' determinants of poor mental health would significantly improve the health of the population. We have special interest in domestic and sexual violence because these are significant causes of inequalities in mental health. We intend to investigate the effectiveness of potential interventions to reduce the violence that harms mental health.

The focus is on the prevention of violence rather than the mitigation of its harms by the treatment of individuals. We will use complex systems analysis as part of building a theory of change. Multiple systems are relevant: law enforcement (most violence is a crime), social services (especially for child protection), specialised services (Third Sector organisations that help victim/survivors of violence), and governmental bodies (law, policy and data quality). The interactions between these institutions (systems) is rarely simple and direct; generating perverse outcomes and 'wicked problems'.

The data needed to evaluate interventions is currently weak. This is partly because each specialised academic discipline and profession has a different way of measuring violence. The Consortium aims to improve the measurement framework and data availability and to develop harmonised core metrics for cross-sector cost-benefit comparisons. Data sources include: Adult Psychiatric Morbidity Survey, the Crime Survey for England and Wales, administrative data from police, health, social services, specialised services and technology companies.

With the newly improved data, we would evaluate interventions that are at the level of institutions and systems and have potential for prevention.

This grant is funded by the UK Prevention Research Partnership (UKPRP) which is administered by the Medical Research Council on behalf of the UKPRP's 12 funding partners: British Heart Foundation; Cancer Research UK; Chief Scientist Office of the Scottish Government Health and Social Care Directorates; Engineering and Physical Sciences Research Council; Economic and Social Research Council; Health and Social Care Research and Development Division, Welsh Government; Health and Social Care Public Health Agency, Northern Ireland; Medical Research Council; Natural Environment Research Council; National Institute for Health Research; The Health Foundation; The Wellcome Trust.

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