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Barriers and facilitators of disclosures of domestic violence by mental health service users: qualitative study
- Authors:
- ROSE Diana, et al
- Journal article citation:
- British Journal of Psychiatry, 198(3), March 2011, pp.189-194.
- Publisher:
- Cambridge University Press
Mental health service users experience higher rates of domestic violence then the general population but this often goes undetected. This study explored the facilitators and barriers to disclosure of domestic violence from both a service user and professional perspective. Eighteen community mental health service users (16 females, mean age 41 years) and 20 mental health professionals were recruited from a socioeconomically deprived south London borough. Thematic analysis was used to determine dominant and subthemes from individual semi-structured interviews. Service users described barriers to disclosure of domestic violence to professionals including: fear of the consequences (including Social Services involvement and child protection proceedings); fear of not being believed; fear of further violence; the hidden nature of the violence; actions of the perpetrator; and feelings of shame. The main themes for professionals concerned role boundaries, competency and confidence. Enquiry and disclosure were facilitated by a supportive and trusting relationship between the individual and professional. However, both groups suggested that the medical diagnostic and treatment model, with its emphasis on symptoms, could act as a barrier to enquiry and disclosure. The authors conclude that mental health services are not currently conducive to the disclosure of domestic violence. Professional training in how to address domestic violence is recommended in order to increase confidence and expertise.