The Mental Health Impact of Domestic Violence
Sally McManus, Health and Wellbeing Team Research Director at NatCen Research, explains the clear relationship between violence, including domestic violence, and mental health disorders. Transcript: I'm going to talk about why violence and abuse are core business for mental health services, and about the survey data that shows that people with extensive experience of physical and sexual violence are five times more likely to have a clinical mental disorder.
Britain has many of the best social research studies in the world, including a remarkable programme of surveys, funded by the Department of Health, that has been tracking the mental health of the nation since the early 1990s.
Large, random samples of people from across the country have answered detailed survey questions about their life circumstances and about their mental health. Analysis of data from this series has shown that there is a social gradient in mental health. For example, people experiencing financial strain or who are living in a cold home, are more likely to have poor mental health than those who do not.
But when analysing this data one aspect of people's lives stood out for us as having a much stronger association with mental health than any of the other factors we examined - that is, participants' experiences of abuse and violence.
At least one person in four across the English population has had experience of violence and abuse in their lives. For some of these people, this was an isolated incident. But for many it was part of a much wider, more pervasive pattern.
About one person in twenty five in the English population has had extensive experience of both physical and sexual violence in adulthood, with a history of violence extending back into childhood.
The types of experiences reported to us by people in this group included: - being kicked, hit or bit, - being choked or strangled by a partner, - sexual abuse as both an adult and a child, - and extensive cohesive control from a partner, such as being prevented from seeing family and friends, and not having fair access to household finances.
The people with this most extensive experience of physical and sexual violence - who make up about 4% of the English population - were: - five times more likely to have clinical anxiety or depression, than those without such experiences, - half of the people in this group reported having self-harmed, and they were - 15 times more likely to have had made a suicide attempt.
People with histories of violence of abuse tended to have worse general health - and were more likely to be disabled - than the rest of the population.
They were also more likely to be women and many likely to live in deprived neighbourhoods. However, the survey data showed that there were many men with such experiences, and we found cases of violence and abuse in every socio-economic group.
Our research has had a very wide range of implications:
In terms of setting priorities for the National Suicide Prevention strategy - it has shown that people with such experiences are a crucial group for the strategy to address.
For service providers - our research supports the need for what is known as 'routine enquiry' - that is, service providers need to routinely ask the clients that they come into contact with whether or not they have experienced violence and whether or not they are safe now. Training needs to be available to service providers to help them feel able to ask these questions. Service providers also need to feel confident that if they identify someone at risk of violence, there is the support available to which they can refer that person.
And as Local authorities and Health and Wellbeing Boards take on responsibility for public health. Our research has shown that violence and abuse are clearly public health issues, and that they should be a part of the wider public health agenda. Violence and abuse are not only linked with poor mental health, but also with poor phy...