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Linking abuse and recovery through advocacy: an observational study

Published online by Cambridge University Press:  30 April 2013

K. Trevillion ,
S. Byford ,
M. Cary ,
D. Rose ,
S. Oram ,
G. Feder ,
R. Agnew-Davies  and
L. M. Howard
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)
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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.

Keywords

Community mental health servicesDomestic violenceintervention studies
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 23 , Issue 1 , March 2014 , pp. 99 - 113
Copyright
Copyright © Cambridge University Press 2013 

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