Detection of domestic violence by community mental health teams: a multi-center, cluster randomized controlled trial

Abstract

BackgroundDomestic Violence and Abuse (DVA) is associated with a range of psychosocial and mental health problems. Having a psychiatric illness increases likelihood of being a victim of DVA. Despite the evidence of a high risk for DVA and the serious effects of violent victimization in psychiatric patients, detection rates are low and responses are inadequate. The aim of the BRAVE (Better Reduction trough Assessment of Violence and Evaluation) study is to improve detection of and response to DVA in psychiatric patients. In this article, we present the protocol of the BRAVE study which follows the SPIRIT guidelines.MethodsThe BRAVE study is a cluster randomized controlled trial. We will include 24 community mental health teams from Rotterdam and The Hague. Twelve teams will provide care as usual and 12 teams will receive the intervention. The intervention consists of 1) a knowledge and skills training for mental health professionals about DVA, 2) a knowledge and skills training of DVA professionals about mental illness, 3) provision and implementation of a referral pathway between community mental health and DVA services. The follow up period is 12 months. Our primary outcome is the rate of detected cases of recent or any history of DVA in patients per team in 12 months. Detection rates are obtained through a systematic search in electronic patient files. Our secondary aims are to obtain information about the gain and sustainability of knowledge on DVA in mental health professionals, and to obtain insight into the feasibility, sustainability and acceptability of the intervention. Data on our secondary aims will be obtained through structured in depth interviews and a questionnaire on knowledge and attitudes on DVA.DiscussionThis study is the first cluster randomized controlled trial to target both male and female psychiatric patients that experience DVA, using an intervention that involves training of professionals. We expect the rate of detected cases of DVA to increase in the intervention teams. With early detection of victimization of DVA in psychiatric patients we hope to improve the mental health of psychiatric patients in the short and long term.Trial registration ISRCTN:14115257. Date of registration: 15th January 2015.

Is intimate partner violence more common in pregnant women with severe mental illness? A retrospective study

“…This was confirmed in a study of professionals specifically in relation to SMI, family and domestic violence (FDV) and pregnancy (Van Deinse et al, 2019). This study found women with SMI in pregnancy were also likely to face greater hurdles in accessing support from relevant service providers (Trevillion et al, 2016;Forsdike et al, 2019;Ruijne et al, 2019). Australian research on screening for IPV confirms the importance of screening within the health systems if there is to be the identification, response and then ultimately a reduction in harm to women and children from IPV (J.…”

“…The rate of screening for IPV within antenatal and mental health care is often reported as low despite an increasing focus on policy that would support this practice. Indeed, a survey of mental health professionals' knowledge and skills in IPV in the Netherlands found low levels of both knowledge and confidence supporting the need for more education and focus on IPV within mental health (Ruijne et al, 2019) with similar findings in other jurisdictions (Trevillion et al, 2016). Furthermore, a survey of mental health clinicians training found few had adequate training in assessment and identification of IPV (Forsdike et al, 2019).…”

Mental health professionals' knowledge, skills and attitudes on domestic violence and abuse in the Netherlands: cross-sectional study

“…However, since this study is part of a longitudinal trial on DVA management by MHC professionals, we hope future analysis will provide better insight. 22 …”

“…The current study is embedded in a cluster randomised controlled trial on DVA detection in MHC: Better Reduction through Assessment of Violence and Evaluation (the BRAVE study, registration: ISRCTN14115257). 22 The protocol and addendum were approved by the Medical Ethics Committee of the Erasmus Medical Centre (MEC 2015-409). Participation in the survey was voluntary, and consent was assumed from participation.…”

Exploring Australian psychiatrists’ and psychiatric trainees’ knowledge, attitudes and preparedness in responding to adults experiencing domestic violence

“…9,10 There is no published study in Australia that provides details of the current levels of Australian mental health professionals' knowledge and preparedness to work with patients who are experiencing DV. 11 O'Connor and colleagues argue that education and training is needed but to what extent is unclear. 12 This paper aims to explore the current knowledge, opinions (attitudes Exploring Australian psychiatrists' and psychiatric trainees' knowledge, attitudes and preparedness in responding to adults experiencing domestic violence and beliefs) and practices of Australian psychiatrists in relation to DV.…”