June 7, 2019

expert reaction to domestic abuse in the UK and mental illness

Research published in British Journal of Psychiatry shows that women who suffer domestic abuse are three times more likely to develop a mental illness including severe disorders like schizophrenia and bipolar disorder.

Dr Vishal Bhavsar, BRC Preparatory Fellow and Consultant Psychiatrist, Section of Women’s Mental Health at King’s College, London, said:

“This study of a database of anonymised GP records clearly shows that, in the women who tell their GP about domestic violence, mental illness is much more likely to be recorded over a period of follow up. This suggests some link between experiencing domestic violence and developing mental illness. This is a very large study compared to most previous research, and these are unlikely to be chance findings. It is challenging in data of this type, however, to account for other important influences on mental health, like poverty, or the experience of other forms of abuse and life adversity, so it is not possible to conclusively say that increased risk of mental illness is due to domestic violence. 

“The other important issue here is under-reporting. Only 0.5% of women in this database had domestic violence recorded, which is very low, compared to other UK research. It is impossible to know based on this paper exactly how much domestic violence was under-recorded. This is why we need multiple strategies to study domestic violence to improve services. This includes trying to understand why and how health professionals enquire and record information on domestic violence. “

“I don’t think you can demonstrate the exact extent of under-reporting in this study. It is also important to note that these results do not mean necessarily that signs of domestic violence are being missed by GPs- rather, better awareness of domestic violence and its relationships to mental health, and better information sharing, is likely to support better recording by different health professionals (not just GPs).” 

Prof Louise Howard, NIHR Research Professor in Women’s Mental Health, Institute of Psychiatry Psychology & Neuroscience, King’s College London (IoPPN), said:

“This study confirms other studies reporting a link between domestic violence and abuse and mental health problems. While an both observational study cannot provide conclusive evidence on causality there are a large number of  studies internationally  which confirm this association. However, there are other factors which may also be relevant. 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.

“The important take away 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. It is striking that in this study domestic abuse was recorded in only a very small proportion of women in the GP records and this suggests that despite NICE guidance and the recent DHSC Women’s Mental Health Taskforce, many GPs are not identifying women’s experiences of domestic abuse and therefore women may not get the help they need.”

‘Female survivors of intimate partner violence and risk of depression, anxiety and serious mental illness’ by Joht Singh Chandan et al. was published in British Journal of Psychiatry at 00:01 UK time on Friday 7th June.

Declared interests

Dr Vishal Bhavsar: I am a consultant psychiatrist and mental health researcher with an interest in domestic violence. 

Prof Louise Howard: I receive funding from NIHR and MRC on domestic violence and mental health and lead a UKRI funded cross-disciplinary network on violence, abuse and mental health.