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Impact of verbal abuse as a child just as harmful as physical abuse

Globally, one in six children are estimated to suffer physical abuse within domestic and family relationships. As well as immediate health risks associated with the physical trauma of abuse, physical abuse can have lifelong impacts on mental and physical health and well-being. Thus, even as adults, individuals who have been physically abused as children show higher levels of anxiety and depression as well as more problematic alcohol and drug use.

As a source of toxic stress, verbal abuse, like physical abuse, may affect the neurobiological development of children, leading to immediate and long-term impacts on health and well-being. Like physical abuse, verbal abuse has also been linked with poor mental and physical health outcomes during childhood and across the life course. Increasingly, empirical evidence supports verbal abuse causing damage to child development.

For the study, Comparative relationships between physical and verbal abuse of children, life course mental well-being and trends in exposure: a multi-study secondary analysis of cross-sectional surveys in England and Wales, VISION researcher Professor Mark Bellis and his team, combined data from multiple studies measuring child abuse across England and Wales. They tested the associations with poorer mental well-being across the life course with experiencing physical abuse or verbal abuse as a child individually as well as the impact associated with combined exposure to both abuse types.

Their research showed that exposure to childhood physical or verbal abuse has similar associations with lower mental wellbeing during adulthood. In fact, results identified around a 50% increase in likelihood of low mental wellbeing related to exposure to either form of abuse. With regard to verbal abuse, children who experienced ridicule, threats or humiliation from a parent / guardian have a 64% higher chance of poor mental health as an adult. The researchers also discovered that whilst physical abuse reduces over time, verbal abuse increases.

Verbal abuse may not immediately manifest in ways that catch the attention of bystanders, clinicians, or others in supporting services with a responsibility for safeguarding children. However, as suggested here, some impacts may be no less harmful or protracted. The potential impact of verbal abuse should be better considered in policy, and parenting and child protection interventions. The potential role of childhood verbal abuse in escalating levels of poor mental health among younger age groups needs greater consideration.

Recommendation

Interventions to reduce child abuse, including physical chastisement, should consider both physical and verbal abuse and their individual and combined consequences to life course health.

To download: Comparative relationships between physical and verbal abuse of children, life course mental well-being and trends in exposure: a multi-study secondary analysis of cross-sectional surveys in England and Wales

To cite: Bellis MA, Hughes K, Ford K, et al. Comparative relationships between physical and verbal abuse of children, life course mental well-being and trends in exposure: a multi-study secondary analysis of cross-sectional surveys in England and Wales. BMJ Open 2025;15:e098412. http://doi:10.1136/bmjopen-2024-098412

For further information, please contact Mark at m.a.bellis@ljmu.ac.uk

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A Lived Experience perspective of the 2025 VISION annual conference

by Justin Coleman, Violence, Abuse and Mental Health Network

The UK Prevention Research Partnership VISION consortium’s 4th annual conference on violence prevention was a truly impactful day. As part of the Violence, Abuse and Mental Health Network Lived Experience Advisory Group (VAMHN LEAG), representing a lived experience perspective, I found the discussions both thought-provoking and essential. The event skilfully blended academic rigor, professional expertise, and, crucially, profound lived and learned experience, prompting vital questions about how we truly move forward in creating a more inclusive and effective violence prevention landscape.

The Imperative of Inclusive Practice: Who Are We Really Serving?

A key takeaway was the urgent need for radical inclusivity. While Violence Against Women and Girls (VAWG) was rightly highlighted and the clear and marked volume and % percentage numbers are stark, I question if we’re inadvertently creating gaps for other survivors. As a male survivor of abuse, as a child, I wonder if our messaging and funding focus heavily on one demographic, how do we ensure male survivors, LGBTQ+ individuals, and marginalised communities (young and older) feel seen and supported? True trauma-informed practice, to me, means moving beyond “what’s wrong with you?” to “what happened to you?” for everyone who is impacted by all forms of violence and abuse. No matter who you are, this simply shouldn’t happen to anyone.

Data, lived experience, and investment: Are we looking at the full picture?

The power of data in policy was clear, but it also raised concerns. Are investment strategies relying on outdated statistics? If resource allocation isn’t based on continuously updated, comprehensive data, are we truly capturing the evolving landscape of violence and the needs of all survivors today? Quantitative data alone can miss nuanced realities that lived experience and ethnographic insights provide. We need a dynamic balance where current lived realities inform and refresh our understanding, ensuring our leadership is deeply connected to ‘our’ diverse lived experiences.

Redefining safety and dignity: Beyond the checklist

The concept of “safety” in support spaces commented on at the conference resonated deeply. Can we ever guarantee “safety,” or should we strive for environments that are continually “safer” and more “supported”? This shift moves us beyond ticking a box to an ongoing commitment. The most impactful word was “dignity.” Shouldn’t ensuring dignity be a fundamental aim at every stage of a survivor’s journey, enabling genuine opportunity for healing and empowerment?

Breaking silos: The path to unified prevention

Effective violence prevention demands a cross-government, cross-sector approach. We need to collaborate beyond our immediate professional bubbles, integrating insights from areas like the criminal justice system to inform victim services. While “whole-family” approaches were discussed, I questioned if we can expand this to truly embrace “whole-community” approaches, ensuring LGBTQ+ individuals, isolated people, and every member of society has an equitable voice and space in prevention, responsibility, and repair.

Moving forward: A collective responsibility

This conference was a crucial step, bringing vital voices to the table. The co-produced animation with VAMHN and SafeLives, available on the City St George’s University of London YouTube channel, https://youtu.be/z6LbYDGfBZw?si=3-tJYXDqLfM16pE-, is an excellent resource for understanding lived experience engagement. To truly mobilise an effective cross-government response, we must continue to ask:

  • Are our investment decisions agile enough to respond to current data and the evolving needs of all survivors?
  • Does promoting the financial cost of crime and low conviction rates discourage reporting?
  • How can we ensure every violence prevention initiative is genuinely trauma-informed and inclusive, making all children, male, LGBTQ+, and all marginalised survivors feel equally seen, heard, and supported? What is the cost of not being inclusive?
  • Are we creating enough opportunities for genuine connection and partnership across diverse stakeholders at events like this, rather than just delivering information?
  • Are we bravely embracing “safer” and “dignity” as guiding principles, continuously improving how we support survivors?
  • Are we actively breaking down silos to build robust and equitable prevention and support systems?

The future of violence prevention depends on challenging existing paradigms, embracing inclusivity, advocating for trauma-informed practice and care, and working together from all perspectives with updated knowledge and a shared commitment to a safer journey towards dignity for all. This VISION conference stimulated valuable questions and directions, strengthening my determination to build connectivity, dignity, and safer spaces for survivors.

To read the latest Violence, Abuse and Mental Health Network newsletter: June VAMHN newsletter

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Perpetrators of domestic abuse against older adults: A rapid evidence assessment

Despite increased research on issues related to aging and older age, abuse of older adults (defined as 60 or over in this study) is a neglected area of academic study. Most of the available evidence is currently found within the elder abuse field; although there is no agreed definition of elder abuse, most incorporate abuse by perpetrators outside of the family (such as carers, people in positions of trust and in some cases strangers) meaning evidence on intimate partner and family member perpetrators is subsumed within these studies. Most studies on domestic abuse have paid limited attention to older age, and in many cases restrict the focus to intimate partner violence among young adults.

PhD student, Merili Pullerits at the Violence and Society Centre at City St George’s University of London, collaborated with colleagues Hannah Bows (Durham University), who led the study, and Natalie Quinn-Walker (University of Wolverhampton), to examine the existing, published research on the demographic and health characteristics, and the offending behaviours and histories of perpetrators of domestic violence and abuse against adults aged 60 and over. 

Using a systematic methodology, searches were conducted in five databases: MEDLINE Complete, APA PsychInfo, CINAHL Complete, SociINDEX with Full Text, Criminal Justice Abstracts with Full Text, and Web of Science (Core Collection), resulting in 75 papers being included in the review.

Their rapid review found that much of the available evidence comes from the elder abuse field, with only a fifth of the included studies taking a specific domestic abuse perspective. Because elder abuse studies often group together all abuse types across varied relationship contexts, such studies make  becomes difficult to extract findings on domestic abuse, potentially hiding important differences. Additionally, the review found that non-intimate partners, that is (adult) children or other family members, tend to be the most frequently reported perpetrator group, although this varied according to the design and methodology of the studies. Most perpetrators tend to be male, and, where information is available, poor health, and drug and alcohol problems are often reported.

The research team concluded that more evidence is required on perpetrators of domestic violence and abuse using a broader range of data sources and research methods.

Recommendation

Evidence on those that use domestic violence and abuse on older people should be situated within the conceptual lens of domestic abuse. Policy and practice should urgently review whether existing risk assessment tools and perpetrator programmes are suitable given that a substantial proportion of domestic abuse against older adults is perpetrated by younger sons, daughters or other family members.

To download: Perpetrators of domestic abuse against older adults – a rapid evidence assessment

To cite: Hannah Bows, Merili Pullerits, Natalie Quinn-Walker, Perpetrators of domestic abuse against older adults – a rapid evidence assessment, Aggression and Violent Behavior, Volume 82, 2025, 102056, ISSN 1359-1789, https://doi.org/10.1016/j.avb.2025.102056.

For further information, please contact Hannah at hannah.bows@durham.ac.uk

Funding: This study was funded by a Home Office (Domestic Abuse Perpetrators) grant.

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VISION/VASC Webinar Series: The intersection of a gendered economy and violence prevention

Mary-Ann Stephenson

This event is in the past.

We are pleased to announce our next webinar for the VISION and Violence & Society Centre (VASC) Webinar Series on Tuesday, 17 June, 11.00 – 11.50.

Mary-Ann Stephenson is the Director of Women’s Budget Group (WBG), a feminist think tank that works in research, advocacy and training to realise a gender equal economy in the UK. As an influential link between academia, the community and voluntary sector, and through their activities of government building and exchanging evidence, data, knowledge, and capacity, WBG’s work often interlinks with violence-prevention research and policy.

Examples include their 2019 report, Benefits or barriers? Making social security work for survivors of violence and abuse across the UK’s four nations, written with Surviving Economic Abuse and End Violence Against Women Coalition. Findings highlighted that the social security systems across the UK failed survivors of violence and abuse when they needed help most.

In 2024, WBG published Funding for violence against women and girls services: Briefing for a new government. Recommendations included:

  • A commitment to long-term grant funding for specialist women’s services, including ringfenced funding for services led ‘by and for’ Black and minoritised women, Deaf and disabled women and LGBT+ survivors.
  • More specialist training for police dealing with VAWG cases.
  • Reform social security (including uprating benefits and scrapping the benefits cap and two-child limit) to ensure women’s economic independence and their ability to leave abusive relationships.

In this webinar, Mary-Ann will highlight WBG’s programme of work demonstrating that a gender equal economy and the embedding of gender equality policymaking are necessary in the reduction of violence against women.

Please join the VISION research consortium and the Violence and Society Centre at City St George’s University of London for what will be a fascinating exploration of economic inequality through a gendered lens.

To register for the event and receive the Teams link, please contact: VISION_Management_Team@city.ac.uk

The purpose of the VISION/VASC webinar series is to provide a platform for academia, government and the voluntary and community sector that work to reduce and prevent violence to present their work / research to a wider audience. This is a multidisciplinary platform and we welcome speakers from across a variety of fields such as health, crime, policing, ethnicity, migration, sociology, social work, primary care, front line services, etc. If interested in presenting at a future Series webinar, please contact: VISION_Management_Team@city.ac.uk

This webinar series is sponsored by the UK Prevention and Research Partnership consortium, Violence, Health and Society (VISION; MR-V049879) and the Violence and Society Centre at City St George’s, University of London.

A Scoping Review: Black and Minoritized Women’s Experiences of Specialist Domestic Violence Services in the UK

Domestic violence and abuse (DVA) harms individuals from all backgrounds, yet the experiences and needs of different communities vary significantly. The Crime Survey for England and Wales (CSEW) estimated that over 1.4 million women and 751,000 men experienced DVA in the year ending March 2023. Black and minoritized women may face heightened vulnerability to DVA due to factors such as socio-economic deprivation, racism, and exposure to specific forms of violence such as so-called honor-based abuse, female genital mutilation or forced marriage.

In addition, minoritized “survivor–victims” of DVA may face intersecting challenges within their socio-political and community context that impede their ability to disclose DVA and may experience social stigma and fears of racism from service providers for example.

This scoping review maps the existing available literature on Black and minoritized women’s experiences with specialist DVA services in the UK to summarize current understanding and identify knowledge gaps.

The research team, comprised of Penelope E. Lowe from University of Roehampton, VISION researchers Sally McManus, Ravi K. Thiara, Estela Capelas Barbosa and Ladan Hashemi, and Pardis Asadi Zeidabadi from City St George’s UoL, and Sumanta Roy of Imkaan and a VISION Advisory Board member, conducted a comprehensive search across multiple databases and gray literature sources. 

Thematic analysis of the findings revealed three main themes: additional service needs, barriers to accessing support, and the pivotal role of “by and for” services. The team concluded that “by and for” services—provided by and for minoritized women—which adopt an intersectional approach are crucial in addressing the unique needs of Black and minoritized “survivor–victims”, particularly in terms of language support, practical assistance, and community-related support. There is a need for more peer-reviewed literature to recognize the role of “by and for” services, using diverse methodologies to support Black and minoritized communities better.

To download the article: Black and Minoritized Women’s Experiences of Specialist Domestic Violence Service in the United Kingdom (UK): A Scoping Review

To cite: Lowe, P. E., McManus, S., Asadi Zeidabadi, P., Thiara, R. K., Roy, S., Capelas Barbosa, E., & Hashemi, L. (2025). Black and Minoritized Women’s Experiences of Specialist Domestic Violence Services in the United Kingdom (UK): A Scoping Review. Trauma, Violence, & Abuse, 0(0).  https://doi.org/10.1177/15248380251335038

For further information, please contact Penelope at penelope.lowe@rutgers.edu

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VISION member awarded UKDS Impact Fellow to study violence and mental health impacts in older age

Dr Anastasia Fadeeva

VISION Research Fellow, Dr Anastasia Fadeeva, has been awarded a UK Data Service (UKDS) Fellowship.

Anastasia’s interest and education in medicine increased her awareness of the impact of social determinants on people’s health. This led to an MSc in Public Health at London Metropolitan University followed by a PhD at Northumbria University and a career in health services and public health research.

As a UKDS Fellow, Anastasia will look at the issues of violence in older age, the long-term impacts of violence on mental health, and the lack of reliable data.

For more information about Anastasia and her work, see her blog on the UKDS website or email her at anastasia.fadeeva@citystgeorges.ac.uk.

The UKDS is funded by the UKRI and houses the largest collection of economic, social and population data in the UK. Its Data Impact Fellowship scheme is for early career researchers in the academic or the voluntary, community, and social enterprise (VSCE) sector. The purpose of the programme is to support impact activities stemming from data-enhanced work. For further information on the UK Data Service please see: UK Data Service

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The economic burden of child maltreatment and co-occurring parental domestic violence and abuse in the UK

Child maltreatment (CM) and parental domestic violence and abuse (pDVA) impose considerable lifelong adverse outcomes on those affected. Approximately 8.5 million adults in England and Wales are estimated to have been exposed to CM (physical, sexual or emotional abuse or emotional or physical neglect of a child by a parent or caregiver) before their 16th birthday. Despite sharing multiple family and environmental risk factors, the economic burden of child exposure where they co-occur has not previously been estimated in detail.

VISION researcher Professor Gene Feder estimated average lifetime societal costs resulting from CM or childhood exposure to pDVA, and incremental costs for scenarios where they co-occur with lead researcher Dr Kevin Gilbert at the University of Cambridge and others.

The findings showed that lifetime costs for childhood exposure to CM and/or pDVA, were £71,309 per child (non-fatal exposure), and £1,292,377 per CM fatality, with £27.8 billion projected costs (2013 UK birth cohort).

Total costs for exposure to pDVA alone was £1.0 billion (£16,639 per child exposed), rising to £2.0 billion (£71,037 per exposed child) for children reporting awareness of pDVA. Co-occurring CM and pDVA imposed greater costs than either alone, including costs from child perpetration of intimate partner violence.

As a result of the research the team concluded that CM and/or pDVA exposure incurs large personal and societal economic burdens. Costs from both pDVA exposure and intergenerational transmission of IPV perpetration highlight the importance for policies to address both CM and domestic violence and abuse in affected households.

Given the scale of burden accrued over the life course after CM and/or pDVA exposure, this model can provide a framework upon which policy makers can identify the best use of resources to maximise the societal benefits from the effective interventions needed to tackle a complex social issue.

To download the article: The economic burden of child maltreatment and co-occurring parental domestic violence and abuse in the UK

To cite: Herbert K, Feder G, Gilbert R, Powell C, Howarth E, Morris S. The economic burden of child maltreatment and co-occurring parental domestic violence and abuse in the UK. Child Abuse Negl. 2025 Mar 31;163:107435. doi: 10.1016/j.chiabu.2025.107435. Epub ahead of print. PMID: 40168916.

For further information, please contact Kevin at kch28@medschl.cam.ac.uk

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Systematic review: Effectiveness of UK-based adult domestic and sexual violence support interventions and services

Recommendations

  • Further high-quality research into the effectiveness of domestic and sexual violence and abuse (DVSA) interventions and evaluations of perpetrator programmes are required, including randomised controlled studies where appropriate and ethical, to improve certainty regarding the effect estimates generated from evidence syntheses. Published protocols, adherence to reporting guidelines, such as CONSORT, STROBE and SQUIRE 2.0, and considering and accounting for confounding factors where randomisation is not feasible, will strengthen the research.
  • Developing a core outcome set via co-production with survivors, practitioners and service providers, commissioners, policy makers and researchers will increase consistency in reported outcomes and create the cohesion necessary to develop a robust evidence base to aid understanding of how effective various support services are.

In the United Kingdom, there are a range of support services and interventions for people who have experienced domestic and sexual violence and abuse (DSVA), including refuges, advocacy such as Independent Domestic Violence Advisors (IDVAs), referral, outreach, and helplines. These are often provided by the Voluntary and Community Sector (VCS), although may also be located in the public or private sector. Due to the lack of consensus on outcomes used to assess effectiveness, evidence syntheses in this field have been limited.

Dr Sophie Carlisle led a team of VISION researchers, Dr Annie Bunce, Prof Sally McManus, Dr Estela Capelas Barbosa, Prof Gene Feder, and Dr Natalia V Lewis, and Prof Matthew Prina from Kings College London. They used findings from their scoping review to identify the common reported outcomes, to direct and inform an evidence synthesis on the effectiveness of UK-based interventions and services for DSVA.

The team conducted a systematic review and, where possible, meta-analysis. They searched relevant peer reviewed and grey literature sources. The following were included: randomised controlled trials, non-randomised comparative studies, pre-post studies, and service evaluations of support interventions or services for adults who had experienced or perpetrated DSVA. The intervention typology and selection of outcomes was determined based on co-production with stakeholders from specialist DSVA organisations. The quality of the studies was assessed independently by two reviewers. Where meta-analysis was not possible, the researchers synthesized studies with vote counting based on the direction of effect.

The review demonstrates that there appear to be benefits of UK-based advocacy and outreach services, psychological support interventions, and perpetrator programmes. However, risk of bias and methodological heterogeneity means that there is uncertainty regarding the estimated effects.

A co-produced core-outcome set is needed to develop a more robust evidence base and facilitate future research in this field. Research practices such as publishing of study protocols, following reporting guidelines and, for research where randomisation is not feasible, considering and accounting for potential confounding factors, would greatly improve the quality of research.

To download the paper: Effectiveness of UK-based support interventions and services aimed at adults who have experienced or used domestic and sexual violence and abuse: a systematic review and meta-analysis – PMC

To cite: Carlisle S, Bunce A, Prina M, McManus S, Barbosa E, Feder G, Lewis NV. Effectiveness of UK-based support interventions and services aimed at adults who have experienced or used domestic and sexual violence and abuse: a systematic review and meta-analysis. BMC Public Health. 2025 Mar 14;25(1):1003. doi: 10.1186/s12889-025-21891-5. PMID: 40087589; PMCID: PMC11908015.

For further information, please contact Sophie at sophie.carlisle4@nhs.net

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Physical health conditions and intimate partner violence: A gendered issue

Intimate partner violence (IPV) is a widespread global public health issue with serious and long-lasting consequences. While much research has focused on the mental health consequences of IPV, such as depression and PTSD, there is limited evidence on its association with physical health.

This study explored how different types and number of types of IPV are linked to specific physical health conditions, and whether these associations differ between men and women. VISION researchers Dr Ladan Hashemi, Dr Anastasia Fadeeva and Professor Sally McManus, with Nadia Khan, City St George’s UoL, examined this using data from the 2014 Adult Psychiatric Morbidity Survey.

Key findings include:

  • Women were more likely to experience IPV and a higher number of IPV types than men.
  • Women’s experience of lifetime and 12-month IPV were significantly associated with 12 and 11 different physical health conditions, respectively, while men’s experience of lifetime and 12-month IPV were significantly associated with 4 and 1 conditions, respectively.
  • Different types of IPV types were associated with different types of physical health condition, particularly among women.
  • A cumulative association between experiencing a greater number of IPV types and an increased risk of physical health conditions was evident for women but not for men.

The research concludes that IPV is a gendered issue, with stronger associations between IPV and physical health evident in this data for women than for men. This may be because women are more likely to experience more and multiple types of IPV, more frequently, and more often with injury. Healthcare systems must recognise IPV as a priority issue, ensuring support is tailored to those affected.

Recommendation

  • Healthcare systems need to address IPV as a priority health issue for the female population. Gender-informed approaches in IPV intervention strategies and healthcare provision are required. This means emphasising the development of IPV-responsive healthcare systems and comprehensive IPV curricula in medical and health training.

To download the paper: Intimate partner violence and physical health in England: Gender stratified analyses of a probability sample survey – Ladan Hashemi, Anastasia Fadeeva, Nadia Khan, Sally McManus, 2025

To cite: Hashemi L, Fadeeva A, Khan N, McManus S. Intimate partner violence and physical health in England: Gender stratified analyses of a probability sample survey. Women’s Health. 2025;21. doi:10.1177/17455057251326419

For further information, please contact Ladan at ladan.hashemi@citystgeorges.ac.uk

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VISION Policy Briefing: Domestic violence and abuse and mental and physical health

Domestic violence and abuse (DVA) is prevalent within the United Kingdom (UK) and has severe and long-lasting physical and mental health consequences. An estimated 2.3 million adults in England and Wales (4.8%) experienced domestic abuse in the past 12 months. More women than men experience DVA, and women experience more repeated abuse, more physical, sexual, and emotional violence and coercive control, more injuries, and greater fear.

We, in the VISION research consortium, investigate how DVA is related to health. This policy briefing summarises evidence from five of our recent publications. We highlight the key recommendation resulting from across the research and discuss the key findings and evidence demonstrating the prevalence of DVA and the need for a cross-government approach to violence prevention.

Key Recommendation

A cross-government approach to preventing violence needs to include health services, alongside justice, welfare, education and other sectors. An effective and safe NHS response to survivors of domestic violence needs to be implemented. That response, embedded in training for healthcare professionals and referral to appropriate services, stretches from identification of survivors to initial support, to addressing the mental health and other sequelae of violence. Currently, the response is sporadic and patchy, with many Integrated Care Boards (ICBs) not commissioning necessary services. Integrated commissioning, as recommended in the NICE guidelines, could help bridge silos and sectors. 

Key findings

  • Domestic violence and abuse (DVA) affects the physical and mental health of victim-survivors.
  • About half of people who attempted suicide in the past year had experienced violence from a partner at some point in their life, and one in four experienced violence from a partner in the preceding year 
  • The type of intimate partner relationship and the type of violence and abuse affects the nature and level of physical and mental health consequences. 
  • People who use violence against their partners also tend to have worse mental health, and mental health services present an opportunity for intervention with this group. 

To download the paper: VISION Policy Briefing: Domestic violence and abuse and mental and physical health

To cite: Blom, N., Davies, E., Hashemi, L., Obolenskaya, P., Bhavsar, V., & McManus, S. (2025). VISION Policy Briefing: Domestic violence and abuse and mental and physical health. City St George’s, University of London. https://doi.org/10.25383/city.28653212.v3

For further information, please contact Niels at niels.blom@manchester.ac.uk