Mental health therapists’ perceptions of their readiness to address the intersection of intimate partner violence and suicide

Abstract

Our aim is characterize mental health therapists’ self‐efficacy pertaining to working with patients at risk for intimate partner violence (IPV) and suicide at a community mental health center (CMHC), where these issues intersect. Consistent with community‐based participatory research, a multidisciplinary team partnered with an urban CMHC in New York to conduct 3 focus groups comprising 23 therapists. We iteratively coded and mapped prevalent themes according to self‐efficacy theory. Therapists described multiple sources of self‐efficacy: successful achievement of tasks such as demonstrating a mastery of local resources and knowledge of therapeutic strategies for IPV‐involved clients; vicarious experiences including homicide–suicide portrayals in the media; verbally persuading patients regarding treatment engagement; and physiologic reactions, including distress and burnout. Therapists feel equipped to address patients’ needs, but they want more information on IPV and suicide. Perhaps most surprising was the frustration and isolation participants discussed regarding working with physicians and agencies outside their office walls. Interdisciplinary dialogue and case conferencing may enhance patient care and safety.

Mental health therapists’ perceived barriers to addressing intimate partner violence and suicide.

“…The methodology has been previously published as the first analysis of two primary aims of a large umbrella study (see Wilson et al, 2018 and Figure 1); pertinent details for the second (present) analysis are summarized below. We recruited therapists from an urban CMHC providing mental health and substance use treatment to primarily low-income patients from underrepresented racial/ethnic groups in a midsized city in New York to participate in focus groups.…”

“…IPV ϭ intimate partner violence. This table was previously published by Wilson et al, 2018. This document is copyrighted by the American Psychological Association or one of its allied publishers.…”

“…Victims/survivors of IPV and STB face multiple barriers to disclosure and service access, relating to financial, geographic, psychological, sociocultural, and legal factors (Hien & Ruglass, 2009; Ingram, 2007; Peek-Asa et al, 2011; Wilson et al, 2018). Specific patient barriers to counseling include concerns about provider judgment, blame or dismissal of the violence, and whether diagnoses will later be used against them in legal proceedings (i.e., child custody cases; Morse et al, 2012).…”

“…Approximately 20% of IPV victims have co-occurring suicidal thoughts or behaviors (STBs) (Cavanaugh et al, 2011). Previous work has examined the intersectionality of IPV-STB from the perspective of mental health therapists, who described varying levels of self-efficacy while addressing these co-occurring issues (Wilson et al, 2018). Therapists traditionally screen for suicidality when patients present in crisis or with depressive symptoms, but inquiry about suicidality is not always conducted routinely among IPV victims.…”

Hunting to Feel Human, the Process of Women’s Help-Seeking for Suicidality After Intimate Partner Violence: A Feminist Grounded Theory and Photovoice Study

“…Literature on help-seeking for suicidality in women who have experienced IPV is lacking. Services providing care to women are ill-informed on how to help as suicidality and IPV are usually studied separately; therefore, little is known about the unique impact on women’s health when the two intersect (Wilson et al, 2017). Nonetheless, difficulties accessing help for both suicidality and IPV are documented in the literature.…”