The response of mental health services to domestic violence: a qualitative study of service users' and professionals' experiences.

PURPOSE

Despite numerous policies advocating for routine enquiry of abuse by mental health professionals, it is not known if such enquiry is acceptable to service users and clinicians. Furthermore, limited evidence exists on clinicians' response to domestic violence. This study aims to explore the acceptability of routine enquiry and experiences of responding to domestic violence from service user and professional perspectives.

METHODS

A qualitative study design was used to conduct individual interviews with a purposive sample of community mental health service users (n = 24) and professionals (n = 25). Thematic analysis was employed to establish superordinate and subordinate themes, which were transformed into conceptual maps.

RESULTS

All service users considered routine enquiry about domestic violence in mental health settings to be acceptable but a small minority of professionals did not. Service users described positive experiences of help seeking, including receiving acknowledgement for the abuse and support for their multiple needs, and negative experiences, including nonvalidating responses from clinicians following disclosure, discrimination, and an absence of support from services. Main themes for professionals included difficulties in assessment and management of domestic violence, reporting requirements, and unclear referral pathways.

CONCLUSIONS

To respond to the needs of mental health service users experiencing domestic violence, services need to articulate a clear care and referral pathway.