The role of mental health in primary prevention of sexual and gender-based violence

Gevers, Aní­k; Dartnall, Elizabeth

doi:10.3402/gha.v7.24741

Cited by 16 publications

(19 citation statements)

References 38 publications

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“…Mental health is more than the absence of symptoms, and positive aspects of mental health may be targeted as protective factors against IPV. For example, positive parenting practices during childhood may be associated with reduced IPV perpetration in adulthood [64]. Inclusion of studies focused on promoting positive aspects of mental health may have resulted in the identification of studies dedicated to the primary prevention of IPV.…”

Section: Discussionmentioning

confidence: 99%

Can mental health treatments help prevent or reduce intimate partner violence in low- and middle-income countries? A systematic review

et al. 2019

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Background Epidemiological research suggests an interrelationship between mental health problems and the (re)occurrence of intimate partner violence (IPV). However, little is known about the impact of mental health treatments on IPV victimization or perpetration, especially in low- and middle-income countries (LMIC). Methods We conducted a systematic review to identify prospective, controlled studies of mental health treatments in LMIC. We defined ‘mental health treatment’ as an intervention for individuals experiencing mental ill health (including substance misuse) including a substantial psychosocial or pharmacological component. Studies had to measure a mental health and IPV outcome. We searched across multi-disciplinary databases using a structured search strategy. Screening of title/abstracts and full-text eligibility assessments were conducted by two researchers independently, data were extracted using a piloted spreadsheet, and a narrative synthesis was generated. Results We identified seven studies reported in 11 papers conducted in five middle-income countries. With the exception of blinding, studies overall showed acceptable levels of risk of bias. Four of the seven studies focused on dedicated mental health treatments in various populations, including: common mental disorders in earthquake survivors; depression in primary care; alcohol misuse in men; and alcohol misuse in female adult sex workers. The dedicated mental health treatments targeting depression or alcohol misuse consistently reduced levels of these outcomes. The two studies targeting depression also reduced short-term IPV, but no IPV benefits were identified in the two alcohol-focused studies. The other three studies evaluated integrated interventions, in which a focus on substance misuse was part of efforts to reduce HIV/AIDS and violence against particularly vulnerable women. In contrast to the dedicated mental health interventions, the integrated interventions did not consistently reduce mental ill health or alcohol misuse compared to control conditions. Conclusions Too few studies have been conducted to judge whether mental health treatments may provide a beneficial strategy to prevent or reduce IPV in LMIC. Key future research questions include: whether promising initial evidence on the effects of depression interventions on reducing IPV hold more broadly, the required intensity of mental health components in integrated interventions, and the identification of mechanisms of IPV that are amenable to mental health intervention. Electronic supplementary material The online version of this article (10.1186/s12905-019-0728-z) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Can mental health treatments help prevent or reduce intimate partner violence in low- and middle-income countries? A systematic review

et al. 2019

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“…This may reduce the psychological impact of past trauma while preventing future violence perpetration among previously victimised boys and men. The collaboration of health practitioners and researchers in the field is critical in the design of future integrated psychosocial treatments that take a holistic approach and emphasize addressing mental health at the individual, family and societal levels [ 59 ]. Another potential entry for prevention are psychosocial interventions in school based programmes with educator and learner participation that include stress modules and coping strategies which have been effective in other settings [ 59 ].…”

Section: Discussionmentioning

confidence: 99%

Structural Pathways between Child Abuse, Poor Mental Health Outcomes and Male-Perpetrated Intimate Partner Violence (IPV)

2016

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BackgroundViolent trauma exposures, including child abuse, are risk factors for PTSD and comorbid mental health disorders. Child abuse experiences of men exacerbate adult male-perpetrated intimate partner violence (IPV). The relationship between child abuse, poor mental health and IPV perpetration is complex but research among the general population is lacking. This study describes the relationship and pathways between history of child abuse exposure and male-perpetrated IPV while exploring the potentially mediating effect of poor mental health.MethodsWe analysed data from a randomly selected, two-stage clustered, cross-sectional household survey conducted with 416 adult men in Gauteng Province of South Africa. We used multinomial regression modelling to identify associated factors and Structural Equation Modelling (SEM) to test the primary hypothesis that poor mental health (defined as abusing alcohol or having PTSD or depressive symptoms) mediates the relationship between child abuse and IPV perpetration.ResultsEighty eight percent of men were physically abused, 55% were neglected, 63% were emotionally abused and 20% were sexually abused at least once in their childhood. Twenty four percent of men had PTSD symptoms, 24% had depressive symptoms and 36% binge drank. Fifty six percent of men physically abused and 31% sexually abused partners at least once in their lifetime. Twenty two percent of men had one episode and 40% had repeat episodes of IPV perpetration. PTSD symptomatology risk increased with severity of child trauma and other trauma. PTSD severity increased the risk for binge drinking. Child trauma, other trauma and PTSD symptomatology increased the severity of depressive symptoms. PTSD symptomatology was comorbid with alcohol abuse and depressive symptoms. Child trauma, having worked in the year before the survey, other trauma and PTSD increased the risk of repeat episodes of IPV perpetration. Highly equitable gender attitudes were protective against single and repeat episodes of IPV perpetration. There was a direct path between the history of child trauma and IPV perpetration and three other indirect paths showing the mediating effects of PTSD, other trauma and gender attitudes.ConclusionsChild trauma is a risk factor for both poor mental health and male-perpetrated IPV among men in Gauteng. Male-perpetrated IPV in these settings should be explained through a combination of the Trauma, Feminist, and Intergenerational Transmission of Family Violence theories. Prevention interventions for male- perpetrated IPV in South Africa need to incorporate strategies and therapies to address poor mental health conditions.

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“…Health providers, on the other hand, felt unprepared to deal with IPV and admitted that they do not encourage clients to disclose violence. In their short communication, Gevers and Dartnall ( 22 ) argue that although it is important to address the mental health needs of survivors of violence, mental health services and principles could also play a crucial role in primary prevention of sexual and gender-based violence. They outline some of the key concepts and competencies from the field of mental health that are essential components of primary prevention and call for greater collaboration between mental health professionals and researchers and practitioners in the field of sexual and gender-based violence.…”

mentioning

confidence: 99%

Intimate Partner Violence and Mental Health

Ellsberg

Emmelin

2014

Global Health Action

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The role of mental health in primary prevention of sexual and gender-based violence

Cited by 16 publications

References 38 publications

Can mental health treatments help prevent or reduce intimate partner violence in low- and middle-income countries? A systematic review

Can mental health treatments help prevent or reduce intimate partner violence in low- and middle-income countries? A systematic review

Structural Pathways between Child Abuse, Poor Mental Health Outcomes and Male-Perpetrated Intimate Partner Violence (IPV)

Intimate Partner Violence and Mental Health

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