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October is Domestic Abuse Awareness Month! Mental health is a part of that too.

It seems no time at all since this time last year when the supporters for domestic abuse got great national coverage of the plight of people experiencing domestic abuse. There were story-lines to help people recognise the signs/symptoms of domestic abuse and lots of signposting to get people the help they needed. With this media attention people have become more aware of the different types of abuse, emotional, psychological, sexual, economic and physical abuse. When I asked what people knew about domestic abuse in training sessions 10 years ago, the answers were much shorter than they are today!

However, when we talk about the mental health consequences of domestic abuse, things get a little more vague. Whilst people are aware of things like depression and complex trauma, that is pretty much it. In fact, people who have experienced domestic abuse are more than twice as likely to experience depression and more than three times as likely to experience complex trauma as the general population. Our recently published study at the University of Salford showed that those people attending DACS at the University were, on average, presenting with moderately severe anxiety and depression, ranging from sub-clinical to severe. You can see from the average that very few of our clients’ were sub-clinical when they arrived. It is also interesting to note that all were recounting previous experiences of domestic abuse i.e. they were not in an abusive relationship at that time. I think this clearly shows that the mental health consequences of domestic abuse can be still apparent long after the relationship has ended. Regrettably, this often results in a life half-lived, when processing the abusive memories can result in a life fully lived.

Another aspect of mental health and domestic abuse that is not often reported is that men and women are more likely to die from suicide than at the hands of their abusive partner. The most recent data suggests that hundreds of people experiencing domestic abuse will complete suicide each year. Suicidal ideation is often linked with hopelessness, that feeling that nothing can be done and that there are no other options. We know that being in a hugely controlling and abusive relationship can lead to people feeling that they cannot do anything right and as their self-esteem and self-worth reduces, so their ability to take action and change their life diminishes. It is not unusual for people who have experienced domestic abuse to have suicidal thoughts, around 25-50% of clients depending on their experience of abuse will report this. Often, this is not part of an active plan, it is more an expression of how they feel and their lack of efficacy. Helping someone to see a way forward is key part of therapy with this client group for this reason and holding the hopelessness that they can feel whilst we support their move towards hopefulness is a key part of the work.

Because of the intertwining of abusive experiences with the main mental health symptoms of depression, anxiety, complex trauma and suicidal ideation, mental health treatment needs to focus on processing the client experience, not the presenting symptoms, other than providing tools to manage symptoms whilst the experiences are processed. This is why clients tend to do much better in specialist domestic abuse clinics than in general mental health services. Unfortunately, when people have tried counselling and it hasn’t worked out due to the lack of understanding of abusive relationships, people can take many years to re-access mental health support. If you know someone like that, please consider forwarding on this blog to them, so that they can, with the right support, recover their mental health and experience life to the full again.

Let’s help to make people more aware of domestic abuse and the possible impact on mental health together with the possibilities for recovery and living life to the full!

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