Intimate Partner Violence Presents Special Mental Health Concerns

Research reveals there is a strong relationship between being a victim of intimate partner violence (IPV) – defined as physical, sexual or psychological harm and depressive disorders. This research conducted as part of the Global Burden of Disease Study 2010 showed that experiencing IPV nearly doubled a woman’s risk for subsequently reporting symptoms of depression. More alarming women reporting IPV incident depression were at a higher risk for attempted suicides. In a two-part series, CFYM examines IPV and provides recommendations for self and legislative advocacy.

Robin Axelrod Sabag, LCSW, MFT
Jewish Family & Children’s Service

With one in four women affected by intimate partner violence (IPV), we all know someone who may have been in this situation, whether we realize it or not. IPV occurs in every culture, country, and age sector and does not spare any class of people. It affects all socioeconomic groups and people of all religious backgrounds and occurs in same-sex and heterosexual relationships. It can occur, regardless of how long the couple has been in a relationship or how financially successful one or both partners are. It can happen to partners who are dating, married, living together, or are estranged.  Bottom line—IPV could happen to anyone!

IPV and mental health
Research has established links between IPV and mental health problems. Sixty percent of women using mental health services are survivors of an abusive relationship, and individuals with a pre-existing mental health condition are at an increased risk for becoming victims.

In some cases, the effects of the abuse manifest themselves into harmful coping mechanisms such as substance abuse, eating disorders, and self-injury in order to ease the pain. These additional mental health challenges make it more difficult to leave the relationship and begin the healing process.

Reforms helpful, but more is needed
The Affordable Care Act (ACA) mandates that women have access to free screening and counseling services for IPV. Unfortunately, there is no federal requirement that physicians be trained to conduct the screenings. As a result, physicians and mental health practitioners may not be equipped to assess the occurrence of IPV.

Because medical professionals are frequently not trained to deal with IPV, they often do not ask the right questions, nor do they provide accurate information or offer effective treatments. One inappropriate, but common, treatment approach by medical professionals is to prescribe and rely exclusively on psychotropic medication, thus further stigmatizing the victim. Instead providers, should take into account the experience of the victim, teach her coping mechanisms and offer her resources that will empower her to leave an abusive relationship. Without such care, the victim is left to feel that she is too “sick” to get out of the situation.

Another well-intended, but harmful approach is using couples therapy to “treat” IPV.  However, couples therapy has often been shown to further exacerbate the cycle of violence.

Finally, those with limited resources often rely on community mental health centers. These resources although affordable and confidential, frequently have long wait times and may offer only a limited number of sessions.

CFYM continues the discussion next week on Intimate Partner Violence with recommendations on how you can advocate in support of individuals experiencing a mental health condition as a result of intimate partner violence.

Questions:

  • How would you introduce the link between intimate partner violence and mental health to your medical provider?
  • What policies or actions will improve personal safety assessment skills among healthcare professionals?

Bio

Robin Axelrod Sabag is the Clinical Supervisor and Coordinator of the Domestic Violence Program at Jewish Family and Children’s Service of Greater Philadelphia and an adjunct professor at Temple University. Upon attaining her graduate training in Social Work, she completed a post graduate training program in Marriage and Family Therapy at the Council for Relationships. Her clinical training has prepared her to assist clients with a variety of problems, including domestic abuse, eating disorders, addictions, depression, anxiety, relationships, grief, transition through the life cycle, and self esteem.

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