Domestic violence and mental illness: "I have honestly never felt so alone in my life"

Domestic violence, especially related to an intimate partner, is inextricably connected to mental illness. Faridah Newman explains how mental illness can often represent a vulnerability which is exploited by abusive partners.

Though stigmatised as "unstable" and "dangerous", mentally ill people are more likely to be victims than perpetrators of violent crime1, and more likely to have experienced intimate partner violence than the general population2.

Intimate partner violence (physical, emotional, psychological, sexual or economic abuse by a romantic partner or relation) is an issue that rears its head regularly on the mental health blog that I run, Mind Over Matter Zine. With nearly 40,000 subscribers, I've come to receive regular contact from people who may be seeking help but afraid of, frustrated with, or without access to conventional mental health services. Many have survived or are currently in abusive relationships.

The links between mental illness and intimate partner violence are all too well known. It is estimated that at least 60 per cent of female mental health service users are survivors3; 70 per cent in inpatient settings4. Mental health problems are usually seen as an adverse consequence of abuse but while gene-environment interaction studies have revealed that stressful life events like abuse can "unlock" genetic risks to certain mental illnesses5, describing the relationship as one-directional is simplistic and misleading. Mental illness can often represent a vulnerability which is exploited by abusive partners in ways similar to those experienced by people with physical and learning disabilities. (Women with disabilities are twice as likely to experience domestic violence as non-disabled women, and over one in ten young men with a longstanding ilness or disability say they have been assaulted by a partner in the previous year6).

The majority of people I've spoken to through the blog have said they were ill before their abusive relationship began, with some suspecting that their mental health problems may have been a factor that attracted their partner to them. Debbie*, who has multiple diagnoses including Bipolar Disorder and Schizoaffective Disorder, said: "He told me I was beautiful because I was broken. I saw him as a ray of light, at the time."

Jess* has since recognised that her relationship was one of a continuing pattern for her partner: "When we met I was reclusive and hopeless, and he took an intensive caretaker role toward me. Before me, he fostered another young woman in the same way, and as I moved closer to leaving the relationship, he did the same again with another. Both had mental health problems." Her feelings of isolation and loneliness at the time of meeting her partner was shared by others. Forced isolation from support systems is a form of abuse common to many violent relationships; is this why someone with abusive tendencies might seek already isolated romantic interests? David*, who was depressed and suicidal when he met his partner said, "He met me at my lowest and I think this afforded him the power dynamic he was looking for. I don't think he'd be interested in me now that I'm happier, more confident and outgoing."

Having myself witnessed a friend's partner try to dismiss her report of physical violence to the police on the grounds that she was "mental", I am upset but not surprised to find similar experiences shared with me online. Abusers minimise the gravity of the violence, or deny it happened at all using their partner's illness as an excuse. Anna* said, "When I actually sought out some help because I could barely walk from being pushed to the floor multiple times and had marks all over my face from being grabbed by the head, he tried to say that I had scratched myself because I'm "crazy". Luckily, my one confidant knew he was lying, but I could see that kind of thing working, which terrifies me to the core." 

The overwhelming feeling I get when reading back through the blog's inbox is that of people slipping through the cracks of service provision, with mental health services viewing abuse as the remit of survivor's services, and survivor's services reluctant or unsure how to cope with people with pre-existing severe mental illnesses.

Research has shown that many mental health professionals do not view enquiry about domestic violence as part of their role or within their competence7. Indeed, one person who wrote to me said that within therapy this was simply ignored, "I disclosed my situation of current and long-standing abuse only for her to not acknowledge this at all, move on, and never mention it again." When Debbie* was driven to attempt suicide after an evening of particularly acute violence, her husband's claims that she was refusing to take her psychiatric medication were believed and her disclosure again ignored, "I was taken to the ER for observation, where I pleaded with the nurses, and told them the story. They did not make a report. I wasn’t allowed to speak with a counsellor, or a police officer. I was just 'off my meds' in their eyes." When she later managed to get a private interview at a local domestic violence shelter she said of her caseworker, "When she heard of my mental illnesses and how my husband was taking advantage of them, she outright asked me “And have you spoken with your psychiatrist?” I have honestly never felt so alone in my life."

*Some names have been changed to protect identity

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1Teplin, L. (2005) Crime victimization in adults with severe mental illness

2Trevillion, K. et al (2012) Experiences of Domestic Violence and Mental Disorders: A Systematic Review and Meta-Analysis

3Bowstead, J. (2000Mental health and domestic violence: Audit 1999

4Phillips, K. (2000) "Sociogeopolitical issues" in Eriksson, E. et al (ed.) (2000) Mood Disorders in Women

5Caspi, A. et al (2001) Influence of Life Stress on Depression: Moderation by a Polymorphism in the 5-HTT Gene

6Mirlees-Black, C. (1999) Domestic Violence: Findings from a new British Crime Survey self-completion questionnaire> (pdf)

7Trevillion, K. et al (2010) Barriers and facilitators of disclosures of domestic violence by mental health service users: qualitative study

Silhouettes representing French victims of domestic violence. Photograph: Getty Images

Faridah runs the mental health blog Mind Over Matter Zine. She tweets @FaridahNewman.

 

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Air pollution: 5 steps to vanquishing an invisible killer

A new report looks at the economics of air pollution. 

110, 150, 520... These chilling statistics are the number of deaths attributable to particulate air pollution for the cities of Southampton, Nottingham and Birmingham in 2010 respectively. Or how about 40,000 - that is the total number of UK deaths per year that are attributable the combined effects of particulate matter (PM2.5) and Nitrogen Oxides (NOx).

This situation sucks, to say the very least. But while there are no dramatic images to stir up action, these deaths are preventable and we know their cause. Road traffic is the worst culprit. Traffic is responsible for 80 per cent of NOx on high pollution roads, with diesel engines contributing the bulk of the problem.

Now a new report by ResPublica has compiled a list of ways that city councils around the UK can help. The report argues that: “The onus is on cities to create plans that can meet the health and economic challenge within a short time-frame, and identify what they need from national government to do so.”

This is a diplomatic way of saying that current government action on the subject does not go far enough – and that cities must help prod them into gear. That includes poking holes in the government’s proposed plans for new “Clean Air Zones”.

Here are just five of the ways the report suggests letting the light in and the pollution out:

1. Clean up the draft Clean Air Zones framework

Last October, the government set out its draft plans for new Clean Air Zones in the UK’s five most polluted cities, Birmingham, Derby, Leeds, Nottingham and Southampton (excluding London - where other plans are afoot). These zones will charge “polluting” vehicles to enter and can be implemented with varying levels of intensity, with three options that include cars and one that does not.

But the report argues that there is still too much potential for polluters to play dirty with the rules. Car-charging zones must be mandatory for all cities that breach the current EU standards, the report argues (not just the suggested five). Otherwise national operators who own fleets of vehicles could simply relocate outdated buses or taxis to places where they don’t have to pay.  

Different vehicles should fall under the same rules, the report added. Otherwise, taking your car rather than the bus could suddenly seem like the cost-saving option.

2. Vouchers to vouch-safe the project’s success

The government is exploring a scrappage scheme for diesel cars, to help get the worst and oldest polluting vehicles off the road. But as the report points out, blanket scrappage could simply put a whole load of new fossil-fuel cars on the road.

Instead, ResPublica suggests using the revenue from the Clean Air Zone charges, plus hiked vehicle registration fees, to create “Pollution Reduction Vouchers”.

Low-income households with older cars, that would be liable to charging, could then use the vouchers to help secure alternative transport, buy a new and compliant car, or retrofit their existing vehicle with new technology.

3. Extend Vehicle Excise Duty

Vehicle Excise Duty is currently only tiered by how much CO2 pollution a car creates for the first year. After that it becomes a flat rate for all cars under £40,000. The report suggests changing this so that the most polluting vehicles for CO2, NOx and PM2.5 continue to pay higher rates throughout their life span.

For ClientEarth CEO James Thornton, changes to vehicle excise duty are key to moving people onto cleaner modes of transport: “We need a network of clean air zones to keep the most polluting diesel vehicles from the most polluted parts of our towns and cities and incentives such as a targeted scrappage scheme and changes to vehicle excise duty to move people onto cleaner modes of transport.”

4. Repurposed car parks

You would think city bosses would want less cars in the centre of town. But while less cars is good news for oxygen-breathers, it is bad news for city budgets reliant on parking charges. But using car parks to tap into new revenue from property development and joint ventures could help cities reverse this thinking.

5. Prioritise public awareness

Charge zones can be understandably unpopular. In 2008, a referendum in Manchester defeated the idea of congestion charging. So a big effort is needed to raise public awareness of the health crisis our roads have caused. Metro mayors should outline pollution plans in their manifestos, the report suggests. And cities can take advantage of their existing assets. For example in London there are plans to use electronics in the Underground to update travellers on the air pollution levels.

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Change is already in the air. Southampton has used money from the Local Sustainable Travel Fund to run a successful messaging campaign. And in 2011 Nottingham City Council became the first city to implement a Workplace Parking levy – a scheme which has raised £35.3m to help extend its tram system, upgrade the station and purchase electric buses.

But many more “air necessities” are needed before we can forget about pollution’s worry and its strife.  

 

India Bourke is an environment writer and editorial assistant at the New Statesman.