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.

 

Photo: Getty
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The Prevent strategy needs a rethink, not a rebrand

A bad policy by any other name is still a bad policy.

Yesterday the Home Affairs Select Committee published its report on radicalization in the UK. While the focus of the coverage has been on its claim that social media companies like Facebook, Twitter and YouTube are “consciously failing” to combat the promotion of terrorism and extremism, it also reported on Prevent. The report rightly engages with criticism of Prevent, acknowledging how it has affected the Muslim community and calling for it to become more transparent:

“The concerns about Prevent amongst the communities most affected by it must be addressed. Otherwise it will continue to be viewed with suspicion by many, and by some as “toxic”… The government must be more transparent about what it is doing on the Prevent strategy, including by publicising its engagement activities, and providing updates on outcomes, through an easily accessible online portal.”

While this acknowledgement is good news, it is hard to see how real change will occur. As I have written previously, as Prevent has become more entrenched in British society, it has also become more secretive. For example, in August 2013, I lodged FOI requests to designated Prevent priority areas, asking for the most up-to-date Prevent funding information, including what projects received funding and details of any project engaging specifically with far-right extremism. I lodged almost identical requests between 2008 and 2009, all of which were successful. All but one of the 2013 requests were denied.

This denial is significant. Before the 2011 review, the Prevent strategy distributed money to help local authorities fight violent extremism and in doing so identified priority areas based solely on demographics. Any local authority with a Muslim population of at least five per cent was automatically given Prevent funding. The 2011 review pledged to end this. It further promised to expand Prevent to include far-right extremism and stop its use in community cohesion projects. Through these FOI requests I was trying to find out whether or not the 2011 pledges had been met. But with the blanket denial of information, I was left in the dark.

It is telling that the report’s concerns with Prevent are not new and have in fact been highlighted in several reports by the same Home Affairs Select Committee, as well as numerous reports by NGOs. But nothing has changed. In fact, the only change proposed by the report is to give Prevent a new name: Engage. But the problem was never the name. Prevent relies on the premise that terrorism and extremism are inherently connected with Islam, and until this is changed, it will continue to be at best counter-productive, and at worst, deeply discriminatory.

In his evidence to the committee, David Anderson, the independent ombudsman of terrorism legislation, has called for an independent review of the Prevent strategy. This would be a start. However, more is required. What is needed is a radical new approach to counter-terrorism and counter-extremism, one that targets all forms of extremism and that does not stigmatise or stereotype those affected.

Such an approach has been pioneered in the Danish town of Aarhus. Faced with increased numbers of youngsters leaving Aarhus for Syria, police officers made it clear that those who had travelled to Syria were welcome to come home, where they would receive help with going back to school, finding a place to live and whatever else was necessary for them to find their way back to Danish society.  Known as the ‘Aarhus model’, this approach focuses on inclusion, mentorship and non-criminalisation. It is the opposite of Prevent, which has from its very start framed British Muslims as a particularly deviant suspect community.

We need to change the narrative of counter-terrorism in the UK, but a narrative is not changed by a new title. Just as a rose by any other name would smell as sweet, a bad policy by any other name is still a bad policy. While the Home Affairs Select Committee concern about Prevent is welcomed, real action is needed. This will involve actually engaging with the Muslim community, listening to their concerns and not dismissing them as misunderstandings. It will require serious investigation of the damages caused by new Prevent statutory duty, something which the report does acknowledge as a concern.  Finally, real action on Prevent in particular, but extremism in general, will require developing a wide-ranging counter-extremism strategy that directly engages with far-right extremism. This has been notably absent from today’s report, even though far-right extremism is on the rise. After all, far-right extremists make up half of all counter-radicalization referrals in Yorkshire, and 30 per cent of the caseload in the east Midlands.

It will also require changing the way we think about those who are radicalized. The Aarhus model proves that such a change is possible. Radicalization is indeed a real problem, one imagines it will be even more so considering the country’s flagship counter-radicalization strategy remains problematic and ineffective. In the end, Prevent may be renamed a thousand times, but unless real effort is put in actually changing the strategy, it will remain toxic. 

Dr Maria Norris works at London School of Economics and Political Science. She tweets as @MariaWNorris.