Domestic violence among female psychiatric patients: cross-sectional survey

John F Morgan,Sharon Gebhardt,Gabriella Zolese,Jane Mcnulty

doi:10.1192/pb.bp.108.023986

Abstract

Aims and methodTo establish prevalence of domestic violence among female psychiatric patients, including risk factors, health professional attention and acceptability of routine enquiry. Participants were 70 adult women in an inner-city community mental health team who received questionnaire and case-note review. Main outcome measures were: lifetime/point prevalence of domestic violence; attitudes to routine enquiry; past disclosure and recording in psychiatric records; clinical and demographic risk factors.ResultsLifetime prevalence was 60% for physical violence from partners, 27% during pregnancy and 40% receiving injuries. Point prevalence was not reported, as an insufficient number of participants were currently in a relationship. As many as 82% regarded routine enquiry as acceptable, but only 24% had ever been questioned. Logistic regression analysis showed prediction by presence of children, previous overdose, and experience of sexual abuse.Clinical implicationsDomestic violence in female psychiatric patients is common but undetected. Enquiry should be routine, but would require staff training.

Highlights

We aimed to measure prevalence of domestic violence among female psychiatric patients in an urban catchment area, including risk factors, health professional attention and acceptability of questioning, using a structured questionnaire adapted from that applied in a study in primary care in the UK.[2]
Women were asked about the acceptability of being questioned by healthcare workers about domestic violence by a series of questions, for example: ‘In general, would you mind if your psychiatrist asked you whether you were being threatened, hit or hurt by your partner or a previous partner?’ The selfadministered questionnaire was piloted and modified, and thereafter completed in the presence of the researchers
We restricted the study to female patients because of the high prevalence of domestic violence among women in the general population and the gender of the researchers, as suggested by the World Health Organization (WHO) ethics guidelines for research into domestic violence.[9]

Summary

Results

The majority of participants had never been questioned by a psychiatrist or other health professional about experiences of domestic violence, with only 22% (n = 16) having received questions from a psychiatrist or key worker about threatened or actual physical violence and 13% (n = 9) about sexual violence by their partner. Admission to psychiatric hospital or being detained under the Mental Health Act did not put women at more risk of domestic violence About half of those women who had suffered violence (n = 23, 55%) had experienced sexual violence by their partner. The presence of children, a history of overdose, and experience of sexual abuse after the age of 16 years at presentation were the only variables found to have a significant independent effect on experiencing physical violence (Table 2)

Method

Discussion

Disclosure

Study limitations