Women who have been abused by a partner are three times more likely to suffer depression, anxiety or severe conditions such as schizophrenia or bipolar disorder than other women, according to research.
The study is one of the first in the UK to probe the relationship between domestic abuse and mental health. It found that it was two-directional: women who had been to their GP about mental health problems were also three times more likely to report domestic abuse at a later date – nearly half of those who were abused already had mental health problems.
The research also suggests that women do not always tell their GP of abuse. Only 0.25% of women on the primary care lists used in the study had reported domestic abuse to the GP – while police report that one in four women are affected over their lifetime.
The researchers from Birmingham University say that opportunities to spot the signs of domestic abuse, and to tackle it, are being missed. “There does seem to be significant under-recording of domestic abuse within UK primary care. We are not saying that GPs should be asking the question more,” said Dr Joht Singh Chandan, academic clinical fellow in public health and lead author. But they do believe there should be better sharing of such information between the public services.
The study, published in the British Journal of Psychiatry, looked at primary care records relating to 92,735 women in the UK between 1995 and 2017. It matched 18,547 women who had reported abuse with 74,188 women who had not. They made allowances for other factors that can play a part in mental health such as deprivation, smoking and drinking habits and body mass index, a measure of obesity.
Dr Beena Rajkumar, co-chair of the women’s mental health special interest group at the Royal College of Psychiatrists, said: “As a frontline psychiatrist working with women with severe mental illness, I am all too aware of the devastating impact domestic abuse has on mental health, and I work with survivors every day.
“This study highlights the two-way relationship between abuse and mental illness, including serious mental illness, and carries a very important warning that we are missing opportunities to detect abuse that is happening all over the country today.
“Screening and recording of domestic abuse needs to be a clear priority for public services so that more effective interventions for this group of vulnerable women can urgently be put in place.”
It is not easy to work out the exact connection between domestic abuse and mental illness. Louise Howard, of the National Institute for Health Research at King’s College London, said other factors were likely to play a part. “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.”
But, she said, “the important takeaway 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.”
Mind’s head of policy and campaigns, Vicki Nash, said that “the journey to good mental health can be difficult, particularly for women who have faced traumatic life events”.
The new prime minister must pass the domestic abuse bill to ensure women get the mental health support they need, she said.
“Whoever becomes prime minister must commit to improving women’s experiences of mental health services, as well as working on a joined-up approach which tackles problems with social care, justice, housing, health and benefits. Only then will women with mental health problems get the support they deserve.”