Domestic abuse (DA) is a public health problem with wide-ranging impacts for victim-survivors and services responding to it. The purpose of the current study was to explore relationships between victim-survivors’ experiences of abuse, additional needs/vulnerabilities and sociodemographic characteristics, and physical and mental health outcomes and health care help-seeking behaviours following DA.

In the study, Health outcomes of victim-survivors accessing specialist domestic abuse services: the role of abuse experience, vulnerabilities and sociodemographic characteristics, VISION researchers Annie Bunce, Elouise Davies and Estela Capelas Barbosa, conducted a secondary analysis using Women’s Aid Federation of England’s (Women’s Aid) case management and outcomes measurement system, On Track, the largest national dataset on DA.

The team used a series of logistic regression models to understand the relationship between:

• abuse types (physical, sexual, emotional, financial, coercive control, technology-facilitated abuse (tech abuse) and threats to kill);
• needs/vulnerabilities (disability; offending, drug and alcohol-related support needs; pregnancy, recourse to public funds and accessing by-and-for services);
• health outcomes (perpetrator caused harm to or loss of unborn child;
• attempted strangulation;
• self-harm (disclosed);
• feeling depressed or suicidal;
• injury requiring GP treatment; and
• injury requiring Accident and Emergency (A&E) treatment).

Stakeholders from Women’s Aid and five other third sector organisations input into the study design and interpretation of results.

The study found:

• Ninety-six percent of victim-survivors accessing DA services (n = 77,785) were female
• Almost half (41.24%) had felt depressed/suicidal
• 5.59% disclosed having self-harmed
• Almost one quarter (23.41%) had suffered a strangulation attempt
• 2.54% had suffered harm to or loss of their unborn child caused by the perpetrator
• Just under 10% had an injury requiring A&E treatment
• 7.33% had an injury requiring GP treatment

Associations with the type of abuse varied by health outcome, for example physical abuse followed by threats to kill were most strongly associated with attempted strangulation and injuries requiring GP and A&E treatment, whilst tech abuse was most strongly associated with self-harm and feeling depressed/suicidal. Vulnerabilities/needs were more consistently associated with health outcomes, with those with a disability; drug, alcohol or offending support needs, or living in temporary/unstable accommodation more likely to experience negative outcomes across the board, and almost all needs/vulnerabilities being associated with adverse mental health outcomes (with the exception of pregnancy and accessing specialist by-and-for services, which appeared to have a protective effect).

The results highlight the almost inevitable harms to mental health for victim-survivors of DA, the dangers of non-physical types of abuse such as threats to kill and tech abuse and the heightened risk of attempted strangulation. These findings have particularly important and timely implications for the training of health care professionals. Alongside improvements in health care settings, health care professionals, specialist support workers, researchers and policymakers must continue to explore more integrative and collaborative ways of working to further improve the response to DA and intervene before irreversible damage is done.

To download the article: Health outcomes of victim-survivors accessing specialist domestic abuse services: the role of abuse experience, vulnerabilities and sociodemographic characteristics

To cite: Bunce A, Davies E, Barbosa EC. Health outcomes of victim-survivors accessing specialist domestic abuse services: the role of abuse experience, vulnerabilities and sociodemographic characteristics. BMC Womens Health. 2026 May 23;26(1):363. doi: 10.1186/s12905-026-04518-8. PMID: 42177560; PMCID: PMC13374347.