Mental Health System
Numerous studies have shown high rates of victimization among those with a variety of psychiatric diagnoses, such as depression, some anxiety disorders, somatic complaints, eating disorders, substance abuse, suicide attempts, sleep disorders, and certain personality disorders. While many biological and psychosocial factors may facilitate the development of any such illnesses, victimization is a strong contributory factor. (37)
There are certain characteristic symptoms seen in many people following highly traumatic life events. Some women experience these symptoms as a result of the trauma associated with adult domestic violence. These symptoms may include hyper-vigilance, re-experiencing aspects of the trauma, and/or emotional numbing. These symptoms are normal psychological responses to stressful life events, much as fever, elevated white blood cell count, and activation of the immune system are normal reactions to infection and are the body's attempts to begin a reparative process.
Many victims experiencing the symptoms mentioned, find that these symptoms spontaneously remit when they become safe from further harm from their abusive partners. In order to appropriately diagnose and treat women presenting with these symptoms, therefore, mental health providers must identify if clients are being abused and develop treatment plans that integrate safety-related concerns.
Men who are abusive use emotional, psychological, economic, sexual, and physical abuse to control their intimate partners. In general, abusers act from a set of attitudes and beliefs about how men and women should relate in intimate relationships. Domestic violence does not result from personal or moral deficits, childhood trauma, diseases, diminished intellect, addiction, mental illness, other persons' behaviors, or external events. Responses to abusers' violent behaviors that focus on these issues, therefore, simply give abusers support for the excuses they offer to explain their abusive behavior and undermine their ability to achieve insight about their capacity to stop their abuse against their partners.
In addition to incorporating the recommendations outlined in the Guiding Principles and the Employers sections into their responses to domestic violence, and being mindful of the potential need for individualized responses based on factors such as socio-economic status, race, ethnicity, sexual orientation, age, religious affiliation, physical and mental disabilities, immigrant status, education, employment status, urban vs. rural residency, and marital status, mental health providers should also integrate the following recommendations specific to the mental health system.
1.VICTIM SAFETY AND SELF-DETERMINATION
a.Private, routine screening for domestic violence should