Domestic violence against women and the COVID-19 pandemic: What is the role of psychiatry?

Gautam Gulati,Brendan D Kelly

doi:10.1016/j.ijlp.2020.101594

Abstract

A heightened risk of domestic violence has been associated with infection-reducing measures undertaken by governments during the COVID-19 pandemic. Psychiatric services can play a key role in addressing this issue by (a) addressing certain risk factors for perpetration of domestic violence through, for example, assertive identification and management of substance misuse; (b) providing support, advocacy and treatment services for victims of domestic violence; and (c) multi-agency working to strengthen medical and social responses to domestic violence. At a time like this, it is important that multi-disciplinary mental health services are strengthened, rather than depleted, in order to address the pressing issues at hand.

Highlights

Addressing domestic violence is a global public health priority in light of both the prevalence of domestic violence and the associated physical morbidity, psychological morbidity and mortality (World Health Organization, 2013)
Using sibling analysis, this study found that men with depressive disorder, anxiety disorder, alcohol use disorder, drug use disorder, attention deficit hyperactivity disorder and personality disorders had a higher risk of domestic violence against women compared to their unaffected siblings
The continued provision and expansion of psychiatric services have a vital role to play in addressing the increased rates of domestic violence associated with the COVID-19 pandemic

Summary

Introduction

Addressing domestic violence is a global public health priority in light of both the prevalence of domestic violence and the associated physical morbidity, psychological morbidity and mortality (World Health Organization, 2013). A legal definition for domestic violence does not exist in every jurisdiction and where present, can vary across jurisdictions, for example in whether it includes perpetrator-victim relationships other than married/heterosexual couples. Increased concerns about domestic violence have been expressed in many countries, including China, France, Spain, Italy and the United Kingdom, since governments restricted travel to prevent the spread of COVID-19 (Taub, 2020). The reasons cited include social isolation, exposure to economic and psychological stressors, increase in negative coping mechanisms (such as alcohol misuse) and an inability to access usual support mechanisms or escape abusive households, owing to quarantine measures or travel restrictions. Disruptions to usual health and social services that have been reconfigured in light of the pandemic, as well as diminished access to supports such as shelters and charity helplines may negatively impact the reporting of domestic violence. The Committee of the Parties to the Council of Europe Convention on Preventing and Combating Violence against Women and Domestic Violence (Istanbul Convention) has issued a declaration alerting member states to the problems of domestic violence during the pandemic and asking them to fortify their responses (Council of Europe, 2020)

Mental health services

People with mental illness as perpetrators of domestic violence

People with mental illness as victims of domestic violence

COVID-19-associated impact and mitigation by psychiatric services

Conclusion