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

_________

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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How can London’s mothers escape the poverty trap?

Despite its booming jobs market, London’s poverty rate is high. What can be done about it?

Why are mothers in London less likely to work than their counterparts across the country, and how can we ensure that having more parents in jobs brings the capital’s high child poverty rates down?

The answers to these two questions, examined in a new CPAG report on parental employment in the capital, may become increasingly nationally significant as policymakers look to ensure jobs growth doesn’t stall and that a job becomes a more much reliable route out of poverty than it is currently – 64 per cent of poor children live in working families.

The choice any parent makes when balancing work and family life is deeply personal.  It’s a choice driven by a wide range of factors but principally by what parents, with their unique viewpoint, regard as best for their families. The man in Whitehall doesn’t know best.

But the personal is also political. Every one of these personal choices is shaped, limited or encouraged by an external context.   Are there suitable jobs out there? Is there childcare available that is affordable and will work for their child(ren)? And what will be the financial gains from working?

In London, 40 per cent of mothers in couples are not working. In the rest of the country, the figure is much lower – 27 per cent. While employment rates amongst lone parents in London have significantly increased in recent years, the proportion of mothers in couples out of work remains stuck at about 12 percentage points higher than the rest of the UK.

The benefits system has played a part in increasing London’s lone parent employment rate. More and more lone parents are expected to seek work. In 2008, there was no obligation on single parents to start looking for work until their youngest child turned 16. Now they need to start looking when their youngest is five (the Welfare Reform and Work Bill would reduce this down to three). But the more stringent “conditionality” regime, while significant, doesn’t wholly explain the higher employment rate. For example, we know more lone parents with much younger children have also moved into jobs.  It also raises the question of what sacrifices families have had to make to meet the new conditionality.  

Mothers in couples in London, who are not mandated to work, have not entered work to the same level as lone parents. So, what is it about the context in London that makes it less likely for mothers in couples to work? Here are four reasons highlighted in our report for policymakers to consider:

1. The higher cost of working in London is likely to play a significant role in this. London parents are much less likely to be able to call on informal (cheaper or free) childcare from family and friends than other parts in the country: only one in nine children in London receives informal childcare compared to an average of one in three for England. And London childcare costs for under 5s dwarf those in the rest of the country, so for many parents support available through tax credits is inadequate.

2. Add to this high housing and transport costs, and parents are left facing a toxic combination of high costs that can mean they see less financial rewards from their work than parents in other parts of the country.

3. Effective employment support can enable parents to enter work, particularly those who might have taken a break from employment while raising children. But whilst workless lone parents and workless couples are be able to access statutory employment support, if you have a working partner, but don’t work yourself, or if you are working on a low wage and want to progress, there is no statutory support available.

4. The nature of the jobs market in London may also be locking mums out. The number of part time jobs in the capital is increasing, but these jobs don’t attract the same London premium as full time work.  That may be partly why London mums who work are more likely to work full time than working mums in other parts of the country. But this leaves London families facing even higher childcare costs.

Parental employment is a thorny issue. Parenting is a 24-hour job in itself which must be balanced with any additional employment and parents’ individual choices should be at the forefront of this debate. Policy must focus on creating the context that enables parents to make positive choices about employment. That means being able to access the right support to help with looking for work, creating a jobs market that works for families, and childcare options that support child development and enable parents to see financial gains from working.

When it comes to helping parents move into jobs they can raise a family on, getting it right for London, may also go a long way to getting it right for the rest of the country.