Violence and abuse are driving mental illness in women and girls, psychiatrists warn

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In a groundbreaking survey of psychiatrists, the three top issues driving poor mental illness in women and girls have been revealed.

The majority of respondents (59%) say violence and abuse are contributing to mental illness in their female patients. This was closely followed by relationship issues (49%), often caused by coercive behaviour, and home and family pressures (48%) which are also causing significant harm.

The Royal College of Psychiatrists (RCPsych) is calling for government, the NHS and the general public to recognise that these factors are leading to women experiencing poor mental health, and to prioritise providing therapeutic support.

Dr Catherine Durkin, Joint Presidential Lead for Women and Mental Health at the Royal College of Psychiatrists, said:

“We have long been aware of the serious harm violence and abuse can do to women and girl’s mental health. Tragically, it is not uncommon for female patients to experience long-term abuse that causes serious symptoms, including suicidal ideation or symptoms of psychosis.

“I regularly see patients who are dependent on an abusive partner or family member due to emotional, family or financial reasons. Victims often feel unable to speak openly about such issues, meaning their problems go unnoticed, sometimes for years.

“Not all abuse is physical - psychological abuse also causes extreme harm and casts a long shadow over victims. We need to identify and respond to trauma if we are to reduce the likelihood of women and girls developing mental illness.”

Isolation or loneliness was also listed as a common challenge facing female patients (24%). Many people experiencing mental illness can struggle with feelings of isolation, but these are made significantly worse if they are experiencing abuse.

In comparison to other challenges, respondents selected funding as the most significant barrier to providing services that are tailored to the needs of women and girls.³

The College is calling for a robust cross-sector strategy to draw together the response to domestic abuse.

RCPsych also wants ring-fenced funding for independent domestic violence advocates to be placed in every mental health trust, in line with best practice. This should sit alongside an expansion of the evidence-based, Identification and Referral to Improve Safety (IRIS) programme, to support the primary care response to domestic violence and abuse.

Dr Philippa Greenfield, Joint Presidential Lead for Women and Mental Health at the Royal College of Psychiatrists, said:

“Clinicians often do not realise that violence, abuse and coercive behaviour can have serious mental health implications. This lack of awareness can leave victims undetected and their mental health needs not appropriately addressed.

“Poor access to practical and psychological support also means that most victims are not receiving the specialist care they deserve and fundamentally, we are missing opportunities to keep them safe.

“As soon as the need arises, victims of domestic abuse should be offered the right support. Access to independent domestic violence advocates is an essential part of this. 

“We need to shift our response to domestic abuse. This requires partnership working between third-sector organisations at a local level, general practices, community health services, in addition to acute and mental health trusts and the wider system. It also needs to include recruiting and training the required healthcare workforce.

“If we carry on waiting until victims reach crisis point, we won’t improve outcomes for women and girls’ mental health. Every victim should know that the NHS is there for them when they need to escape the harm of an abuser.”  

Footnotes 

1. The Royal College of Psychiatrists Women’s survey heard from 515 respondents, of which 82% were female, 17% were male, and 1% preferred not to say. The majority of respondents (76%) said they worked in England.
2. Members of the Royal College of Psychiatrists were asked to choose the top three influences on mental illness in women and girls from the following list: abuse or violence; home and family pressures; relationship issues; bereavement; isolation or loneliness; workplace/study; financial pressure; addiction; hormonal health; physical conditions; caring responsibilities; body image; social media, and other.
3. 25% of survey respondents said that funding is the most significant challenge preventing services from offering good care for women and girls.
4. Psychiatrists and the mental health team are required to assess all patients presenting with mental health needs for signs of abuse, in line with NICE guidelines. See NICE guidelines for domestic violence and abuse