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Linking abuse and recovery through advocacy: an observational study

Published online by Cambridge University Press:  30 April 2013

K. Trevillion*
Affiliation:
Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King's College, London, UK
S. Byford
Affiliation:
Centre for the Economics of Mental and Physical Health, Health Service and Population Research Department, Institute of Psychiatry, King's College, London, UK
M. Cary
Affiliation:
Centre for the Economics of Mental and Physical Health, Health Service and Population Research Department, Institute of Psychiatry, King's College, London, UK
D. Rose
Affiliation:
Service User Research Enterprise, Health Service and Population Research Department, Institute of Psychiatry, King's College, London, UK
S. Oram
Affiliation:
Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King's College, London, UK
G. Feder
Affiliation:
School of Social and Community Medicine, University of Bristol, Bristol, UK
R. Agnew-Davies
Affiliation:
Domestic Violence Training Ltd, Surbiton, Surrey, UK
L. M. Howard
Affiliation:
Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King's College, London, UK
*
*Address for correspondence: Dr Kylee Trevillion, Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. (Email: kylee.trevillion@kcl.ac.uk)

Abstract

Aims.

High numbers of psychiatric service users experience domestic violence, yet limited interventions exist for these victims. We piloted a domestic violence intervention for community mental health services to explore the feasibility of a future cluster randomized controlled trial.

Methods.

Quasi-experimental controlled design within five Community Mental Health Teams (three intervention and two control teams). The intervention comprised domestic violence training for clinicians' and referral to domestic violence advocacy for service users. Clinicians' (n = 29) domestic violence knowledge, attitudes and behaviours were assessed before and 6 months post-training. Service users' (n = 34) safety behaviours, unmet needs, quality of life and frequency/severity of abuse were examined at baseline and 3 months follow-up. Process evaluation data were also collected.

Results.

Clinicians receiving the intervention reported significant improvements in domestic violence knowledge, attitudes and behaviours at follow-up (p < 0.05). Service users receiving the intervention reported significant reductions in violence (p < 0.001) and unmet needs at follow-up (p < 0.05).

Conclusions.

Interventions comprising domestic violence training for clinicians and referral to domestic violence advocacy may improve responses of psychiatric services. Low rates of identification among teams not receiving training suggest that future trials using service user outcomes are unlikely to be feasible. Therefore, other methods of evaluation are needed.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2013 

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References

Agar, K, Read, J (2002). What happens when people disclose sexual or physical abuse to staff at a community mental health centre? International Journal of Mental Health Nursing 11, 7079.CrossRefGoogle ScholarPubMed
Barber, JA, Thompson, SG (1998). Analysis and interpretation of cost data in randomised control trials: review of published studies. British Medical Journal 317, 11952000.CrossRefGoogle Scholar
Barrett, B, Byford, S, Crawford, M, Patton, R, Drummond, C, Henry, J, Touquet, R (2006). Cost-effectiveness of referral to an alcohol health worker in patients attending an accident and emergency department: a decision-making approach. Drug and Alcohol Dependence 81, 4754.CrossRefGoogle Scholar
Boyatzis, RE (1998). Transforming Qualitative Information: Thematic Analysis and Code Development. Thousand Oaks: London, California.Google Scholar
Bramesfeld, A, Ungewitter, C, Böttger, D, El Jurdi, J, Losert, C, Kilian, R (2012). What promotes and inhibits cooperation in mental health care across disciplines, services and service sectors? A qualitative study. Epidemiology and Psychiatric Sciences 21, 6372.CrossRefGoogle ScholarPubMed
Brooks, R (1996). EuroQol: the current state of play. Health Policy 37, 5372.CrossRefGoogle ScholarPubMed
Byford, S, Fiander, M, Torgerson, D, Barber, J, Thompson, S, Burns, T (2000). Cost-effectiveness of intensive v. standard case management for severe psychotic illness: UK700 case management trial. British Journal of Psychiatry 176, 537543.Google Scholar
Campbell, JC (2002). Health consequences of intimate partner violence. Lancet 359, 13311336.Google Scholar
Cavanagh, M-R, Read, J, New, B (2004). Sexual abuse inquiry and response: a New Zealand training programme. New Zealand Journal of Psychology 33, 137144.Google Scholar
Connor, P, Nouer, S, Mackey, S, Tipton, N, Lloyd, A (2010). Psychometric properties of an intimate partner violence tool for health care students. Journal of Interpersonal Violence 26, 124.Google Scholar
Connor, P, Nouer, S, Mackey, S, Banet, M, Tipton, N (2011). Dental students and intimate partner violence: measuring knowledge and experience to institute curricular change. Journal of Dental Education 75, 10101019.Google Scholar
Curtis, L (2010). Unit Costs of Health and Social Care 2010. PSSRU, University of Kent: Canterbury.Google Scholar
Department of Health (2011). National Schedule of Reference Costs 2009–10 for NHS Trusts. HMSO: London.Google Scholar
Dubourg, R, Hamed, J (2005). The Economic and Social Costs of Crime against Individuals and Households 2003/4. Home Office: London.Google Scholar
Duxbury, F (2006). Recognising domestic violence in clinical practice using the diagnoses of posttraumatic stress disorder, depression and low self-esteem. British Journal of General Practice 56, 294300.Google Scholar
Efron, B, Tibshirani, RJ (1993). An Introduction to the Bootstrap. Chapman & Hall: New York.Google Scholar
EuroQol Group (1990). EuroQol – a new facility for the measurement of health-related quality-of-life. Health Policy 16, 199208.CrossRefGoogle Scholar
Feder, G, Ramsay, J, Dunne, D, Rose, M, Arsene, C, Norman, R, Kuntze, S, Spencer, A, Bacchus, L, Hague, G, Warburton, A, Taket, A (2009). How far does screening women for domestic (partner) violence in different health-care settings meet criteria for a screening programme? Systematic reviews of nine UK, National Screening Committee criteria. Health Technology Assessment 13, iii113.Google Scholar
Feder, G, Agnew-Davies, R, Baird, K, Dunne, D, Eldridge, S, Griffiths, C, Gregory, A, Howell, A, Johnson, M, Ramsay, J, Rutterford, C, Sharp, C (2011). Identification and Referral to Improve Safety (IRIS) of women experiencing domestic violence with a primary care training and support programme: a cluster randomised controlled trial. Lancet 11, 18.Google Scholar
Foa, EB (1995). Posttraumatic Stress Diagnostic Scale Manual. National Computer Systems Inc.: Minneapolis, MN.Google Scholar
Foa, EB, Cashman, L, Jaycox, L, Perry, K (1997). The validation of a self-report measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale. Psychological Assessment 9, 445451.Google Scholar
Golding, MJ (1999). Intimate partner violence as a risk factor for mental disorders: a meta-analysis. Journal of Family Violence 14, 99132.CrossRefGoogle Scholar
Hegarty, K (2011). Domestic violence: the hidden epidemic associated with mental illness. British Journal of Psychiatry 198, 169170.CrossRefGoogle ScholarPubMed
Hegarty, K, Sheehan, M, Schonfeld, C (1999). A multidimensional definition of partner abuse: development and preliminary validation of the Composite Abuse Scale. Journal of Family Violence 14, 399415.Google Scholar
Hegarty, K, Bush, R, Sheehan, M (2005). The Composite Abuse Scale: further development and assessment of reliability and validity of a multidimensional partner abuse measure in clinical settings. Violence and Victims 20, 529547.CrossRefGoogle ScholarPubMed
Home Office (2005). Domestic Violence: A National Report. Home Office: London.Google Scholar
Howard, LM, Hunt, K, Slade, M, O'Keane, SV, Leese, M, Thornicroft, G, Wiseman, M (2008). CAN-M: Camberwell Assessment of Need for Mothers. Royal College of Psychiatrists: London.Google Scholar
Howard, LM, Trevillion, K, Agnew-Davies, R (2010 a). Domestic violence and mental health. International Review of Psychiatry 22, 525534.Google Scholar
Howard, LM, Trevillion, K, Khalifeh, H, Woodall, A, Agnew-Davies, R, Feder, G (2010 b). Domestic violence and severe psychiatric disorders: prevalence and interventions. Psychological Medicine 40, 881893.Google Scholar
Krause, DE, Kaltman, S, Goodman, AL, Dutton, AM (2008). Avoidant coping and PTSD symptoms related to domestic violence exposure: a longitudinal study. Journal of Traumatic Stress 21, 8390.Google Scholar
Kuyken, W, Byford, S, Taylor, R, Watkins, E, Holden, E, White, K (2008). Mindfulness-based cognitive therapy to prevent relapse in recurrent depression. Journal of Consulting and Clinical Psychology 76, 966978.CrossRefGoogle ScholarPubMed
McFarlane, J, Malecha, A, Gist, J, Watson, K, Batten, E, Hall, I, Smith, S (2002). An intervention to increase safety behaviors of abused women: results of a randomized clinical trial. Nursing Research 51, 347354.Google Scholar
Morgan, J (2007). ‘Giving up the Culture of Blame’: Risk Assessment and Risk Management in Psychiatric Practice-Briefing Document to Royal College of Psychiatrists. Royal College of Psychiatrists: London.Google Scholar
Mueser, KT, Goodman, BL, Trumbetta, LS, Rosenberg, DS, Osher, CF, Vidaver, R, Auciello, P, Foy, WD (1998). Trauma and posttraumatic stress disorder in severe mental illness. Journal of Consulting and Clinical Psychology 66, 493499.CrossRefGoogle ScholarPubMed
NHS Confederation (2008). Implementing National Policy on Violence and Abuse: A Slow but Essential Journey. pp. 16. Department of Health: London.Google Scholar
Oram, S, Trevillion, K, Feder, G, Howard, LM (2013). Prevalence of experiences of domestic violence among psychiatric patients: systematic review. British Journal of Psychiatry 202, 9499.Google Scholar
Phelan, M, Slade, M, Thornicroft, G, Dunn, G, Holloway, F, Wykes, T, Strathdee, G, Loftus, L, McCrone, P, Hayward, P (1995). The Camberwell Assessment of Need: the validity and reliability of an instrument to assess the needs of people with severe mental illness. British Journal of Psychiatry 167, 589595.Google Scholar
Posner, J, Eilenberg, J, Friedman, JH, Fullilove, MJ (2008). Quality and use of trauma histories obtained from psychiatric outpatients: a ten year follow-up. Psychiatric Services 59, 318321.CrossRefGoogle ScholarPubMed
Priebe, S, Huxley, P, Knight, S, Evans, S (1999). Application and results of the Manchester Short Assessment of Quality of Life (MANSA). International Journal of Social Psychiatry 45, 712.Google Scholar
Read, J, Fraser, A (1998 a). Abuse histories of psychiatric inpatients: to ask or not to ask? Psychiatric Services 49, 355359.Google Scholar
Read, J, Fraser, A (1998 b). Staff response to abuse histories of psychiatric inpatients. Australian and New Zealand Journal of Psychiatry 32, 206213.Google Scholar
Read, J, Hammersley, P, Rudegeair, T (2007). Why, when and how to ask about childhood abuse. Advances in Psychiatric Treatment 13, 101110.Google Scholar
Robinson, AL (2004). Domestic Violence MARACs (Multi-Agency Risk Assessment Conferences) for Very High-Risk Victims in Cardiff, Wales: A Process and Outcome Evaluation. Cardiff University: Cardiff.Google Scholar
Rose, D, Trevillion, K, Woodall, A, Morgan, C, Howard, LM (2011). Barriers and facilitators of disclosures of domestic violence by mental health service users: a qualitative study. British Journal of Psychiatry 198, 189194.CrossRefGoogle Scholar
Royal Pharmaceutical Society (2010). British National Formulary 59. BMJ Group and RPS Publishing: London.Google Scholar
Secker, J, Hacking, S, Kent, L, Shenton, J, Spandler, H (2009). Development of a measure of social inclusion for arts and mental health project participants. Journal of Mental Health 18, 6572.CrossRefGoogle Scholar
Short, ML, Alpert, E, Harris, MJ Jr, Surprenant, JZ (2006). A tool for measuring physician readiness to manage intimate partner violence. American Journal of Preventive Medicine 30, 181185.Google Scholar
Siskind, D, Harris, M, Pirkis, J, Whiteford, H (2012). Personalised support delivered by support workers for people with severe and persistent mental illness: a systematic review of patient outcomes. Epidemiology and Psychiatric Sciences 21, 97110.CrossRefGoogle ScholarPubMed
Trevillion, K, Howard, LM, Morgan, C, Feder, G, Woodall, A, Rose, D (2012 a). The response of mental health services to domestic violence: a qualitative study of service users' and professionals' experiences. Journal of the American Psychiatric Nurses Association 18, 326336.Google Scholar
Trevillion, K, Oram, S, Feder, G, Howard, LM (2012 b). Experiences of domestic violence and mental disorders: a systematic review and meta-analysis. PLoS ONE 7, e51740. doi:i10.1371/journal.pone.0051740.Google Scholar
Young, M, Read, J, Barker-Collo, S, Harrison, R (2001). Evaluating and overcoming barriers to taking abuse histories. Professional Psychology: Research and Practice 32, 407414.Google Scholar
Zimmerman, M, Mattia, J (1999). Is posttraumatic stress disorder underdiagnosed in routine clinical settings? Journal of Nervous and Mental Disease 187, 420428.Google Scholar