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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

            Upcoming event: Weaving Stories of Peer Sexual Abuse 

              Insights from a youth co-created animation project

              Weaving Stories is a pilot animation project developed by County-Durham arts education company, Changing Relations, and funded via the VISION research consortium through the Small Projects Fund.

              The animation was co-produced with Secondary-aged students, survivors of peer sexual abuse, and an artistic team, to amplify young people’s voices on the theme of unwanted sexual behaviour and the culture that enables it. The students and young survivors shaped every aspect of the animation.

              An interdisciplinary Steering Group of academic researchers, creative practitioners, and child protection and sexual violence specialists from a North East school and Rape Crisis centre, were also involved in the project.

              With this animation and associated school based learning programme, Changing Relations seeks to influence knowledge, behaviour, and institutional change using the impactful animation as stimulus for reflection. Following this pilot project, VISION and Changing Relations have organised a one-hour webinar for UK policymakers and practitioners to:

              • Watch the co-created animation (20 minutes)
              • Hear young people’s perspectives on the key themes and co-production approach
              • Explore the animation’s potential impact on school cultures, disclosure, help-seeking, and victim-blaming attitudes
              • Engage in academic-informed analysis of trauma-informed safeguarding and youth-centred approaches to sexual violence prevention
              • Gain practical insights on using creative participatory approaches to engage young people in conversations about violence and abuse
              • Consider actionable recommendations for policy and practice
              • Contribute your reflections

              This webinar will be of interest to a wide range of professionals who work with adolescents and / or in violence-prevention. Educators, social workers, academics, and third sector, central and local government policy analysts and researchers in particular may be interested.

              There are two dates providing the option to choose between a more practice or policy oriented session:

              • Thursday 8th May 1-2pm for policymakers
              • Wednesday 14th May 3-4pm for practitioners

              Speakers and facilitators

              • Lisa Davis, Managing Director, Changing Relations
              • Kate Gorman, Creative Producer and Artistic Director, Changing Relations
              • Kimberly Cullen, Knowledge Exchange Manager, UKPRP VISION research consortium, City St George’s UoL

              Webinar registration

              To register for free for either the 8th or 14th of May, please visit our page on Ticket Tailor.

              The webinar will be on Microsoft Teams and you will receive the link on the day you choose to attend.

              For further information, please contact VISION_Management_Team@citystgeorges.ac.uk

              United to End Violence Against Women and Girls: An Online Animated Campaign  

                Violence against women and girls (VAWG) is a pressing issue in Iran, a Middle Eastern country marked by its patriarchal structure and systematic and pervasive gender discrimination. Educational programmes addressing this issue are scarce, and cultural barriers often hinder open discussion. The United to End Violence Against Women and Girls campaign aims to break this silence through a series of animated videos in Farsi and English and images designed to inform public discourse and to empower victims to seek support.

                 The United to End Violence Against Women and Girls project was led by VISION researchers Ladan Hashemi and Sally McManus, in collaboration with colleagues from other UK universities including the University of Bristol, Goldsmiths University, Animation Research Centre at the University for the Creative Arts, and Leeds Beckett University. 

                They worked with an animation production team in Iran, a social media advisor, and two advisory groups. The advisory groups were Mehre Shams Afarid, an Iran-based non-governmental organisation (NGO), and IKWRO, a London-based charity providing services to women victims of violence from the Middle Eastern and North African (MENA) region—to incorporate culturally specific insights.

                Although the project initially focused on Iran, engaging with the UK-based NGO revealed an interest in extending its reach. As a result, English subtitles were added to make the animations accessible to a wider audience. This collaboration helped the content resonate with audiences both in Iran and within the global diaspora community, particularly those from the MENA region.

                The animations are grounded in evidence from a survey of 453 women in Iran, which explored the manifestation of various forms of VAWG in Iran and women’s perspectives on how to eliminate it. The survey was designed by Fatima Babakhani, CEO of Mehre Shams Afarid.

                Key findings from participants’ open-ended responses to the survey showed that, despite structural inequalities and deeply ingrained societal, cultural, and religious norms that perpetuate VAWG, change is possible through education and legal reforms.

                As one survey participant noted: “Unfortunately, many still don’t understand what violence truly is. Raising awareness is the solution.”

                The first four United to End Violence Against Women and Girls campaign animations focus on coercive control, economic abuse, technology-facilitated abuse, and active bystander interventions, with two more animations in development.

                With guidance from an Iranian social media advisor, a digital strategy was developed to maximise the campaign’s impact. Instagram was chosen as the primary distribution platform, as it is the most widely used social media platform in Iran, with over 47 million users. The animations are also shared on YouTube to further extend the campaign’s reach.

                Influencers and women’s rights activists with followings from thousands to millions were partnered with to amplify the campaign’s reach. The online campaign officially launched 25th November, on the International Day for the Elimination of Violence Against Women and Girls.

                By leveraging evidence-based content and strategic partnerships, we hope to spark meaningful conversations and drive change across Iran and the diaspora communities from the MENA region.

                Join us in raising awareness and advocating for change. Please follow and share the campaign links on your social media to help spread the message.

                Link to Instagram page

                Link to YouTube channel

                This project was funded by City St George’s, University of London Higher Education Impact Fund (HEIF) Knowledge Exchange and by the UKPRP VISION research consortium.

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

                VISION responds to Parliamentary, government & non-government consultations

                  Consultation, evidence and inquiry submissions are an important part of our work at VISION. Responding to Parliamentary, government and non-government organisation consultations ensures that a wide range of opinions and voices are factored into the policy decision making process. As our interdisciplinary research addresses violence and how it cuts across health, crime and justice and the life course, we think it is important to take the time to answer any relevant call and to share our insight and findings to support improved policy and practice. We respond as VISION, the Violence & Society Centre, and sometimes in collaboration with others. Below are the links to our published responses and evidence from June 2022.

                  1. UK Parliament – Women and Equalities Committee – Inquiry: Community Cohesion. Our submission was published in February 2025.
                  2. UK Parliament – Call for evidence on the Terminally Ill Adults (End of Life) Bill. Our submission was published in February 2025.
                  3. UK Parliament – Public Accounts Committee – Inquiry: Use of Artificial Intelligence in Government. Our submission was published in January 2025.
                  4. UK Parliament – Public Accounts Committee – Inquiry: Tackling Homelessness. Our submission with Dr Natasha Chilman was published in January 2025. See the full report
                  5. Home Office – Legislation consultation: Statutory Guidance for the Conduct of Domestic Homicide Reviews. Our submission was published on the VISION website in July 2024.
                  6. UK Parliament – Women and Equalities Committee – Inquiry: The rights of older people. Our submission was published in November 2023
                  7. UK Parliament  – Women and Equalities Committee – Inquiry: The impact of the rising cost of living on women. Our submission was published in November 2023
                  8. UK Parliament – Women and Equalities Committee – Inquiry: The escalation of violence against women and girls. Our submission published in September 2023
                  9. Home Office – Legislation consultation: Machetes and other bladed articles: proposed legislation (submitted response 06/06/2023). Government response to consultation and summary of public responses was published in August 2023
                  10. Welsh Government – Consultation: National action plan to prevent the abuse of older people. Summary of the responses published in April 2023
                  11. Race Disparity Unit (RDU) – Consultation: Standards for Ethnicity Data (submitted response 30/08/2022). Following the consultation, a revised version of the data standards was published in April 2023
                  12. UK Parliament – The Home Affairs Committee – Call for evidence: Human Trafficking. Our submission was published in March 2023
                  13. UN expert – Call for evidence: Violence, abuse and neglect in older people. Our submission was published in February 2023
                  14. UK Parliament – The Justice and Home Affairs Committee – Inquiry: Family migration. Our submission was published in September 2022 and a report was published following the inquiry in February 2023
                  15. Home Office – Consultation: Controlling or Coercive behaviour Statutory Guidance. Our submission was published in June 2022

                  For further information, please contact us at VISION_Management_Team@city.ac.uk

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                  Reaching a consensus: Technology-facilitated abuse conceptualisation, definition, terminology, and measurement

                    The rapid development of digital systems has benefited modern societies but also created opportunities for the proliferation of harms. Specifically, the term ‘technology-facilitated abuse’ (TFA) describes the misuse or repurposing of digital systems to harass, coerce, or abuse. It is a global problem involving both existing and emerging technologies.

                    TFA is regularly discussed in the context of domestic abuse, where it is perpetrated via a range of systems, including phones, laptops, and tablets, smart home/Internet of things appliances, as well as online accounts, that are either shared or accessed without the partner’s consent. In the United Kingdom, 32% of women and children who sought support for domestic abuse in 2022 to 2023.

                    The research field lacks comprehensive and standardised measurement tools and in 2022, the UN Secretary-General emphasized that the absence of agreed definitions and measures impedes any efforts to understand the true scale of TFA. Despite significant work across research, policy, and practice to understand the issue, the field operates within linguistic, conceptual, and disciplinary silos, inhibiting collaboration.

                    To address this, the present study led by Dr Nikolaos Koukopoulos (University College of London) in collaboration with VISION researchers Dr Madeleine Janickyj and Dr Leonie Tanczer used the Delphi technique to reach a consensus on TFA conceptualization, definition, terminology, and measurement among subject experts.

                    Following a literature review, a global, cross-disciplinary sample of academics, practitioners, and policymakers (n = 316) reflected on TFA across three survey rounds. The results showed both aligned and opposing perspectives. “Technology” and “facilitated” were the most preferable terms. Still, there was uncertainty regarding the need for additional terminologies to denote the scope of abuse, such as gendered descriptors. Participants had little familiarity with existing TFA measurement tools, with two-thirds unaware of any.

                    Most experts agreed on conceptualising TFA based on the perpetrator’s behaviour, the victim’s harm and impact, and consent. They also supported an expansive TFA definition, beyond intimate relationships, that can involve groups and communities as perpetrators or targets. However, they were more reluctant to perceive TFA as a distinct abuse form, or one guided by social norms, legal thresholds, or involving child perpetrators.

                    Recommendations:

                    • The fragmentation and contrasting conceptualisations of TFA observed in this research underscore the need for greater cross-disciplinary communication among researchers, practitioners, and policymakers to move closer toward a unified understanding of TFA. Some form of standardization is particularly crucial, given the rapidly developing ways existing and emerging technologies are weaponized in the digital realm. Concrete, practical steps could help bridge these divides by consolidating published work into a searchable database. This could include suggestions for conceptually similar terminology across various sectors and subject areas.
                    • Furthermore, an interactive online map of key TFA stakeholders and research groups could facilitate greater collaboration and knowledge-sharing, which the research team is now working on.

                    To download the paper: Defining and Conceptualizing Technology-Facilitated Abuse (“Tech Abuse”): Findings of a Global Delphi Study – Nikolaos Koukopoulos, Madeleine Janickyj, Leonie Maria Tanczer, 2025

                    To cite the paper: Koukopoulos, N., Janickyj, M., & Tanczer, L. M. (2025). Defining and Conceptualizing Technology-Facilitated Abuse (“Tech Abuse”): Findings of a Global Delphi Study. Journal of Interpersonal Violence, 0(0). https://doi.org/10.1177/08862605241310465

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                    Systems analysis of service coordination in domestic abuse, primary care and child mental health services

                      The impact of intimate partner violence (IPV) on parental and child mental health is well documented, as is the associated increased use of healthcare services by survivors of IPV. UK policy emphasises the importance of partnership working between health services and domestic abuse agencies, along with clear referral pathways for victims of violence and abuse and co-ordinated local responses. However, in general, current policy and guidance is focused on the response to adult victims with more limited advice as to how this should be operationalised for working with children.

                      With first author Dr Claire Powell (University College of London), VISION researchers Dr Olumide Adisa and Professor Gene Feder and others explored how services work together to support parents and children experiencing both parental IPV and parental or child mental health problems by drawing on the perspectives of professionals working in primary care, children and young people’s mental health services (CYPMHS), and domestic abuse services.

                      The team conducted a qualitative study, interviewing professionals in geographically contrasting local authority areas in England. They carried out framework analysis using a systems approach and mapping techniques to understand the service interrelationships and boundary judgements of professionals.

                      Results showed that

                      • The relationships between domestic abuse services, CYPMHS, and primary care were complex, involving funders and commissioners, local authority strategic groups, and wider services such as schools and children’s centres.
                      • Participants consistently identified a gap in the relationship between statutory CYPMHS and domestic abuse services.
                      • There were mental health service gaps were for children living with ongoing or intermittent IPV and for children and parents with needs falling below or between service thresholds.
                      • There was a gap in services for users of abusive behaviour to prevent future IPV.
                      • Staff perspectives revealed differing views on treating the effects of trauma, and the co-ordination and sequencing of care.

                      Improving the response to children and adults experiencing mental health problems in the wake of IPV requires a systems perspective to understand the barriers to service co-ordination. The findings indicate a particular need to address the gap between CYPMHS and domestic abuse services.

                      To download the paper: Domestic abuse, primary care and child mental health services: A systems analysis of service coordination from professionals’ perspectives – ScienceDirect

                      To cite the paper:  Claire Powell, Olumide Adisa, Lauren Herlitz, Shivi Bains, Sigrún Eyrúnardóttir Clark, Jessica Deighton, Shabeer Syed, Ruth Gilbert, Gene Feder, Emma Howarth, Domestic abuse, primary care and child mental health services: A systems analysis of service coordination from professionals’ perspectives, Children and Youth Services Review, Volume 169, 2025, 108076, ISSN 0190-7409, https://doi.org/10.1016/j.childyouth.2024.108076

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