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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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Addressing abuse in teenage relationships

This VISION Policy Brief highlights emerging findings and policy recommendations from ongoing research and stakeholder engagement into abuse in teenage relationships carried out by the UKPRP VISION consortium.

Abuse—whether physical, emotional, or sexual—within young people’s relationships is often overlooked in both research and policy. The Crime Survey for England and Wales (CSEW) finds that young women aged 16 to 19 are more likely to experience domestic abuse than any other age group. Despite this high prevalence, this age group is less likely to be referred to support services. Furthermore, the CSEW does not cover individuals under the age of 16, leaving a major gap in understanding of prevalence.

Key findings:

  • Lack of consistent terminology and recognition – various terms are used to describe abuse in teenage relationships, including ‘teen dating violence’, ‘adolescent domestic abuse’, ‘teenage relationship abuse’ and ‘youth intimate partner violence’. Both the workshop with young people and the roundtables identified that young people generally do not associate the behaviours they experience with any of these terms and are more likely to use language like ‘toxic relationships’.
  • Very limited UK research on risk and protective factors for under 16s – our rapid review found that in the last 10 years there was only one UK academic study that looked into risk and protective factors for abuse in teenage relationships for those aged under 16.
  • Importance of schools and communities – unlike adult domestic abuse, which is largely experienced in private, abuse experienced in teenage relationships is more likely to occur outside of the home, especially within schools.
  • Very difficult to measure extent of issue – due to the current Home Office definition of domestic abuse there is very limited and consistently recorded administrative data collected on those under 16 who are experiencing abuse.
  • Need to take a more radical review of systems – our discussion highlighted the difficulty of addressing abuse in teenage relationships within the current systems.

Recommendations for change:

  • Develop a national strategy – prevention and early intervention
  • Explore support for young people – victims and those carrying out harmful behaviours
  • Commission research into under 16s – including those with lived experience and taking a whole systems approach
  • Improve measurement in under 16s
  • Agree terminology and produce an associated education programme

To download the policy briefing: VISION Policy Brief: Addressing Abuse in Teenage Relationships

To cite: Weir, Ruth; Barrow-Grint, Katy (2025). VISION Policy Brief: Addressing Abuse in Teenage Relationships. City, University of London. Report. https://doi.org/10.25383/city.26539906.v1

For further information, please contact: Ruth at ruth.weir@city.ac.uk

Domestic abuse in cancer care: Improving the identification and support

Although few studies have explored people’s experiences of domestic abuse and cancer, we know the two co-occur. The few studies we do have show that cancer can trigger an escalation of abuse. But there are no published domestic abuse interventions in the cancer setting.

In an attempt to plug that gap, Sandi Dheensa, University of Bristol researcher, and colleagues, including VISION Deputy Director Estela Capelas Barbosa, have conducted a service evaluation on a domestic abuse intervention for hospital-based cancer professionals. Their study, Identifying and responding to domestic abuse in cancer care: a mixed methods service evaluation of a training and support intervention – European Journal of Oncology Nursing, is the first to evaluate a DA training (and support) intervention for cancer professionals in England.

The key findings demonstrate that cancer and DA frequently co-occur, and that training and support intervention of hospital-based cancer staff increased the rate of DA identifications. There is an appetite for DA and cancer training amongst hospital-based cancer staff.

The evaluation contributes further evidence of the benefit of hospital-based domestic abuse coordinator roles and contributes new evidence for the feasibility of adapting the role for a specific context.

To read the article or download the paper free of charge:

Identifying and responding to domestic abuse in cancer care: a mixed methods service evaluation of a training and support intervention – European Journal of Oncology Nursing

To cite:

Identifying and responding to domestic abuse in cancer care: a mixed methods service evaluation of a training and support intervention. Dheensa, Sandi et al. European Journal of Oncology Nursing, Volume 0, Issue 0, 102724

Or for further information, please contact Sandi at sandi.dheensa@bristol.ac.uk

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VAWG data dashboard consultation highlights usefulness of tool

The UK Office for National Statistics (ONS) developed a prototype violence against women and girls (VAWG) data dashboard in 2022. The webpages presented statistics and charts on violence against women and girls in England and Wales, drawing on multiple sources. However, due to reprioritisation at ONS, maintenance of the dashboard stopped and as of April 2024 it was no longer accessible.

VISION developed a consultation to ascertain the usefulness of a VAWG data dashboard as a result. The call was open from March to May 2024, and 102 responses were received. Most participants responded in their capacity as individuals (n=61), although 25 stated that they were responding on behalf of an organisation and four on behalf of a group. Some participants both responded as an individual and on behalf of an organisation or group.

Consultation participants responded as people from across a variety of roles and sectors. The
most commonly cited were working in research or education (n=40) and in policy or planning
(n=28), 27 people responded as someone with lived experience and 13 as members of the
public. The remainder comprised those in service provision (n=17), a campaign role (n=10) or
some other capacity (8).

Consultation results

Many participants had heard of the data dashboard before the VISION consultation (n=51), although 28 reported that they had not. Of those who had heard of the dashboard before, most had made use of it (n=39).

Most participants reported that having a dashboard that brought together data on violence
and abuse would help them either ‘somewhat’ (n=12) or ‘a lot’ (n=39).

Participants were asked what they found to be useful about the data dashboard:

  • Data discovery
  • Finding data and finding it faster
  • Breakdowns and local profiles
  • Comparisons
  • Authoritative context
  • Source material

Participants were asked for their thoughts on the limitations or what was missing from the dashboard:

  • Wider coverage in relation to topics (health, disability, suicide, law, family courts, policy), types of violence and abuse (homicide, forced marriage, sexual violence), and particular groups (men, perpetrators)
  • Deeper context in terms of much more nuanced contextual discussion of what the data means, ‘data without context is misleading’
  • Critical interrogation such as the highlight of methodological limitations
  • Interactive functionality with more scope for further breakdowns by local authority areas and police forces for example
  • Improved search function
  • Positive action such as a ‘section about work being done to support victims/reduce cases’
  • Human stories meaning to go beyond numbers and to tell the human stories that underpin them

Recommendations

Through this consultation, approximately 100 people told VISION that a VAWG data dashboard is
something that they valued having and wish to have again. These included people with lived
experience of violence and abuse, people working in health, justice, specialist and other
services, researchers and academics across disciplines, and members of the wider public.

A violence and abuse data dashboard is needed because it has:

  • Symbolic value: indicating that violence against women and girls matters to the
    Government, and
  • Practical value: as a functional and easy to use tool facilitating access to high
    quality data spanning a range of types of violence, groups, areas and years.

In April 2024, ONS’ prototype VAWG data dashboard was withdrawn due to reprioritisation of
resources within that organisation. Since then, a new Government has come into office with a
stated mission to halve violence against women and girls within the decade. How progress towards this commitment is monitored will be essential to its success. General population health and crime surveys, alongside other data sources, will be key and that includes a revitalised, fit for purpose VAWG data dashboard. To instill trust and collective investment in this goal, a public platform for transparent monitoring is needed and the dashboard could be an effective, useful tool.

Next steps

VISION is a cross-sectoral consortium of academics and government and service partners
working with UK data on violence and abuse. We are aware that further development and relaunching of a data dashboard will require a collaborative effort from relevant departments of
state, data providers (not least ONS) and external funding. Drawing on our work in this area
we aim to coordinate this effort, with three initial objectives:

  • Resource: Identify partners and funding source(s)
  • Define: Agree clear definitions to best capture and monitor subgroup and temporal
    trends in VAWG and violent crime in the population
  • Design and test a revised violence and abuse data dashboard with people from
    across sectors

To download the report:

Consultation: Is there a need for a Violence Against Women and Girls (VAWG) data dashboard

Or for further information, please contact Sally at sally.mcmanus@city.ac.uk

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How much violence is there?

This VISION Policy Brief proposes improvements to the definitions and measurement of violence using the Crime Survey for England and Wales (CSEW), in order to more fully capture different aspects of violent crime, including violence against women and girls (VAWG). The briefing is aimed at researchers, national statistics offices, and others involved in violence research and policy. It draws on a paper recently published in The British Journal of Criminology, Definition and measurement of violence in the Crime Survey for England and Wales.

Key findings:

  • The current definition of violent crime excludes key types: The Office for National Statistics (ONS) headline measure of ‘violent crime’ currently excludes sexual violence, robberies, threats of violence, and many incidents of violence where criminal damage was also involved.
  • A broader definition would better capture scale, harm and inequalities: We use a broader measure of violence that includes these currently excluded forms of violence. This broader measure not only reveals a higher prevalence of victimisation in the population as a whole, it also reveals hidden inequalities. Women are more likely than men to experience sexual violence and threats of violence: excluding these from current estimates leads to rates of violence in women, especially domestic violence, being underestimated. The proportion of people physically and emotionally harmed by violence is also better estimated using this broader definition, particularly affecting estimates for women.

Recommendation for change:

  • National statistics on violence in England and Wales should show violence estimates using a broader definition of violence alongside violent crime statistics to give a more comprehensive overview of violence and its societal impact.

To download the policy briefing, please see below. To download the paper upon which the policy recommendation is based, please see: Definition and Measurement of Violence in the Crime Survey for England and Wales: Implications for the Amount and Gendering of Violence | The British Journal of Criminology | Oxford Academic

The citation for the paper: Davies, E., Obolenskaya, P., Francis, B., Blom, N., Phoenix, J., Pullerits, M., and Walby, S. (2024), Definition and Measurement of Violence in the Crime Survey for England and Wales: Implications for the Amount and Gendering of Violence, The British Journal of Criminology. https://doi.org/10.1093/bjc/azae050

VISION Policy Briefing for downloading:

Violence Measurement_VISION Policy BriefingDownload

Violence in the workplace in the United Kingdom

Our latest research examines two nationally representative datasets, The Commercial Victimisation Survey (CVS) and the UK Household Panel Survey (UKHLS), to examine variance in the prevalence of workplace violence by industrial sector and occupational group.

The authors, Dr Vanessa Gash and Dr Niels Blom, found 28% of commercial businesses reported criminal victimisation on their premises in the past year, including 8% reporting violent victimisation (namely assaults, robberies, and threats).

Using individual-level data, the report also found 8% of employees had been threatened, insulted or physically attacked at work in the past year, and a similar percentage have felt unsafe at work, with public sector workers most at risk.

The authors call for enhanced recognition of the problem of workplace violence for a significant proportion of workers in multiple different sectors, alongside improved policies to minimise workplace violence going forward.

Figure 1. Prevalence of Violence and Fear of Violence in the Workplace by Sector, UKHLS data 2020-2021, weighted estimates

The report can be downloaded here: VISION Policy Report – Violence in the workplace in the UK: Business and individual-level exposure

Acknowledgements:

The report benefited from input and insights from the Home Office, who provided us with access to the Commercial Victimisation Survey used here.

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The benefits system: source of support or hindrance to victims of violence?

Previous VISION research showed how 4% of domestic violence victims lose their job as a result of abuse and that half of unemployed women have experienced intimate partner violence in their lives.

A report just published by the Department for Work and Pensions (DWP) further confirms high levels of trauma and mental distress among people not in employment and approaching benefits services for support. The report focuses on those in receipt of Employment and Support Allowance (ESA) aimed at people with an impairment or health condition that affects how much work they do.

VISION researcher Sally McManus, with colleagues Claire Lapham and Ann Conolly from the National Centre for Social Research, analysed the government’s main mental health study. They found that nearly one in three (30%) ESA recipients screened positive for post-traumatic stress disorder. This was more than twice the rate for Jobseeker’s Allowance (JSA) claimants (12%), and ten times that of employed people (3%). The analyses show that the claimant population experienced high levels of stress, in which self-confidence was low and anxiety high. Compared to those in employment, few ESA claimants owned their home and many faced serious debt arrears.

Sally presented findings from this study as oral evidence to the Work and Pensions Committee’s Inquiry into Safeguarding Vulnerable Claimants, including domestic violence victims. She drew attention to calls from Women’s Aid for reform they highlight is needed to make the benefits system the lifeline survivors need, rather than a source of re-traumatisation and further harm.

Women’s Aid recommendations include implementing a named domestic abuse lead in every Jobcentre Plus and ensuring staff receive regular, specialist domestic abuse training, so that work coaches and other frontline staff are better able to recognise claimants experiencing domestic abuse. Specialist domestic abuse services need to be properly funded to support and advocate for survivors in making their claims to DWP. Extending the domestic violence easement to up to a year would also help, alongside exempting those who are moving to or from refuges from repayment of Jobcentre Plus advances.

The report can be downloaded from the DWP website: A health, social and economic profile of ESA recipients: Adult Psychiatric Morbidity Survey 2014 – GOV.UK

To cite:

Claire Lapham, Anne Conolly, Sally McManus (2024): A health, social and economic profile of ESA recipients: Adult Psychiatric Morbidity Survey 2014 DWP ad hoc research report no.79.

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Report launch: A transformative justice framework to address adolescent relationship abuse

This event is in the past.

Despite a general awareness of the prevalence of harm young people are experiencing in their relationships, there is little data and evidence supporting the prevention of and responses to such harm through the adoption of a survivor centred transformative justice approach.

Talia Kensit, founder and former CEO of Youth Realities, explored adolescent domestic abuse as a Fellow with the Churchill Fellowship, a UK charity which supports individual UK citizens to follow their passion for change, through learning from the world and bringing that knowledge back to the UK.

Her travels and research resulted in Prevention, Intervention and Healing: Addressing Adolescent Relationship Abuse, a framework of best practice upheld by the theory of transformative justice. It is Talia’s recommendation that in order to address the epidemic of harm experienced by young people in their intimate relationships, we must implement polices and practice through prevention, intervention and healing.

The Violence & Society Centre at City St George’s, UoL, and the UK Prevention Research Partnership VISION consortium are pleased to host Talia’s Churchill report launch on Wednesday 6 November from 4 – 6 pm at City St George’s, UoL, Clerkenwell campus.

Talia will also be joined by:

  •  Ruth Weir, City St George’s, UoL, Taking a collaborative approach to understanding more about abuse in teenage relationships
  • Christine Barter, University of Central Lancashire, Qualitative findings looking at the nature and impact of IPVA in young people’s relationships
  • Jeff Temple, University of Texas, Dating violence prevention program: implementation and effectiveness

Seating, drinks and nibbles will be provided.

To register for the event: Select tickets – Report launch: A transformative justice framework to address adolescent relationship abuse – City St George’s , University of London, Clerkenwell campus (tickettailor.com)

For questions about the event: violenceandsociety@city.ac.uk

All those registering will receive an email by 30 October from the Violence and Society Centre with the room and building number where the launch will be held on our Clerkenwell campus.

New book & upcoming launch- Tackling Domestic Abuse & Sexual Violence: A Systems Approach

This event is in the past.

Tackling Domestic Abuse and Sexual Violence: A Systems Approach is a newly edited collection, curated by University of Suffolk colleagues, Dr Olumide Adisa (and Co-Investigator at VISION, and Honorary Senior Research Fellow at the Violence & Society Centre, City St George’s) and Professor Emma Bond, Pro Vice-Chancellor, Research and Knowledge Exchange.

The book’s chapters use retrospective case studies to engage with a systems approach to discover new thinking and applications that may best suit the area of domestic abuse and sexual violence (DASV). All the chapters showcase systems approaches in varying ways to ignite new inquiries and conversations about grappling with the greater complexity of problems.

Dr Adisa and Professor Bond, together with their collaborators, will launch the book at a special event at City St. George’s University of London on Tuesday, 26 November at 5.30 pm. They will explain the book and share their inspiration for the themes covered. A panel of speakers will share their collective vision for systems change in tackling DASV in different systems. The event will also feature poetry (spoken word) performances based on lived/living experiences of domestic abuse and as a survivor-centred response to the book’s themes.  

Dr Adisa said:

“I am incredibly excited about the launch event. I have been overwhelmed by the positive and heartwarming reaction to the book from those committed to tackling the problem of DASV and those sadly affected by DASV. I have been impressed with the brilliant contributions made by all the authors who are deeply committed to bringing about change. This event is an opportunity to hear from some amazing speakers and forge new encounters and connections, united in our quest to reduce DASV and mitigate its devastating impact on children, families, and communities.”

Professor Sally McManus, Director of the Violence and Society Centre, and Co-Deputy Director, VISION, said:

“Dr Adisa works at the forefront of systems thinking. This new collection – co-curated with Prof Bond – brings a radical new approach to addressing violence and abuse, rooted in diverse real-world examples of challenge and change. The book houses many rich voices, distinct yet drawn together through common themes of complexity and hope.”

Please join Dr Adisa, Professor Bond, and their fellow collaborators at their 26 November book launch at The Pavilion, University Building, City St George’s, from 5:30 – 7 pm. Drinks and nibbles will be provided.

Registration is required for this free event: Select tickets – Book launch: Tackling Domestic Abuse & Sexual Violence – A Systems Approach – The Pavilion, University Building, City, University of London (tickettailor.com).

This book launch is hosted by the UK Prevention and Research Partnership consortium, Violence, Health and Society (VISION) (MR-V049879) and the Violence and Society Centre at City, University of London (VASC).

VISION/VASC Webinar Series: Measuring the global burden of morbidity associated with violence against women and children

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, 1 October 2024, 1300 – 1350.

Joht Chandan, Clinical Professor of Public Health at the University of Birmingham, will present his research on measuring the global burden of morbidity associated with violence against women and children.

Joht has spent considerable time working on designing and delivering a public health approach to abuse and violence. This includes research into finding what works to support survivors of violence, abuse and maltreatment as well as methods to improve surveillance in the context of violence against women and children. For example, his research has shown that survivors of domestic abuse are nearly three times more likely to suffer from mental ill health during their lifetime and have above-average rates of diabetes, heart disease and death.    

To register for the event in order to receive the Teams invitation, please contact: VISION_Management_Team@city.ac.uk

The purpose of the 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

The VISION/VASC Webinar Series is sponsored by the UK Prevention and Research Partnership consortium, Violence, Health and Society (MR-V049879) and the Violence and Society Centre at City, University of London.