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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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    Prior homelessness and associations with health and violent victimisation

      By Dr Natasha Chilman, Research Associate, UKRI Population Health Improvement (PHI-UK), Population Mental Health Consortium, Kings College London

      In the United Kingdom, we have the highest rate of homelessness compared to other high-income countries. For many people homelessness is a temporary, although often very impactful, experience in their lives. However, there is a paucity of research and data looking at people who are formerly homeless and living in private households (i.e., rented or owned accommodation).

      This blog describes a new study which fills this gap, conducted by Dr Natasha Chilman from King’s College London and colleagues, including Professor Sally McManus from VISION.

      The study authors analysed data from the Adult Psychiatric Morbidity Surveys, which is a nationally representative survey of adults living in private households in 2007 and 2014. Out of 13,859 people, 535 people reported previous experience of homelessness.

      Some of the key findings of the study were:

      • A staggering 40% of people who formerly experienced homelessness had experienced violence in their homes at some point in their lives, compared to 7% of people who had never been homeless.
      • A quarter (24%) of people who formerly experienced homelessness reported experience of sexual abuse, compared to less than 5% of people who had never experienced homelessness.
      • Almost half (45%) of the formerly homeless group were currently experiencing depression or anxiety, compared to just 15% of people who had never experienced homelessness. People who formerly experienced homelessness were also experiencing more severe symptoms of these common mental disorders.
      • There were strong associations between former homelessness and health conditions, across common mental disorders, physical health conditions, alcohol/substance dependence, and multimorbidities. These associations persisted even after adjusting for a range of potential confounders, including indicators of socio-economic position and smoking.
      • Adjusting for adverse experiences including violence and abuse attenuated associations between former homelessness and alcohol/substance dependence related health outcomes, but not mental/physical health.

      The findings from this study highlight the urgent need for long-term integrated healthcare support for people who are formerly homeless to continue after they have secured private housing. There were severe inequalities in experiences of violence and sexual abuse for people who have experienced homelessness, underscoring the importance of both violence and homelessness prevention, and of trauma-informed approaches to support.

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

      The public health significance of prior homelessness: findings on multimorbidity and mental health from a nationally representative survey | Epidemiology and Psychiatric Sciences | Cambridge Core

      To cite:

      Chilman N, Schofield P, McManus S, Ronaldson A, Stagg A, Das-Munshi J. The public health significance of prior homelessness: findings on multimorbidity and mental health from a nationally representative survey. Epidemiology and Psychiatric Sciences. 2024;33:e63. doi:10.1017/S2045796024000659

      Or for further information, please contact Natasha at natasha.chilman@kcl.ac.uk

      Workplace bullying and harassment harms health

        Workplace bullying and harassment (WBH) is bad for people’s health, and this negative health impact can manifest in a variety of ways and be long-lasting.

        Over a decade ago the UK government initiated the Fair Treatment at Work survey, aiming to ‘place the issue of bullying at work on employers’ agendas’, yet there has been no major initiative since.

        Using data from the 2014 Adult Psychiatric Morbidity Survey, VISION researchers Annie Bunce, Ladan Hashemi and Sally McManus, along with Carrie Myers and Charlotte Clark from City St George’s, University of London and Stephen Stansfeld from Queen Mary, University of London, examined the prevalence and nature of WBH among workers in England, and associations with mental health.

        A clear picture of the severity of the problem of WBH in England is painted by four key findings.

        1. One in ten people in paid work reported having experienced WBH in the past year. This is likely to be an underestimate due to underreporting for various reasons;
        2. Those who reported bullying were more likely to be in a financially disadvantaged position;
        3. Over half of people who reported having been bullied at work identified the perpetrator as a line manager; and
        4. Clinically diagnosed common mental disorder was more than twice as likely in employees with experience of WBH compared with those without, and those exposed to WBH were also twice as likely as others in paid work to screen positive for PTSD.

        Taken together these findings demonstrate that WBH is common in UK workplaces, it may be driven and exacerbated by issues of inequality, power and hierarchical organisational structures, and it is associated with depressive and anxiety disorders severe enough to warrant health service intervention and treatment.

        This power dynamic should not be forgotten when addressing issues in the workplace, but the complexity of workplace environments creates challenges for identifying, understanding and addressing bullying. Reports of WBH can coincide with performance concerns from managers, and, whilst behaviours intended as legitimate performance management activities might be misinterpreted as bullying by the employee, it is also possible that HR practitioners attribute managerial bullying behaviours to legitimate performance management practice to exonerate mangers and protect the organisation.

        This links to a recently published piece for The Conversation by Sally McManus and Kat Ford (Bangor University), which sets out how companies can influence and perpetuate violence in society, including via employment practices that conceal the extent of bullying, sexual harassment and other forms of workplace violence (for further information see Six ways companies fuel violence (theconversation.com).

        Also, structural issues in the workplace can create pressure for managers which they then take out on those they manage, managers can be victims of WBH themselves, and organisational culture may perpetuate WBH.

        Given such complex power dynamics, it is recommended that organisations involve employees at all levels in the development of policies, and collaboratively review the implementation and performance of policies regularly to ensure they are working for the people they are intended to protect. Rather than prescribed ‘tick box’ policies and responses, creative methods incorporating employees’ perspectives may more likely lead to meaningful change.

        Crucially, managers and HRs might not be the most approachable people for victims of WBH. For example, other VISION research has found this to be the case for victims of intimate partner violence and abuse (see VISION Policy Series: The impact of intimate partner violence on job loss and time off work in the UK – City Vision).  Therefore, alternative sources of support need to be available within organisations, such as unions and counselling services.

        For further information please see the full paper available at: Prevalence and nature of workplace bullying and harassment and associations with mental health conditions in England: a cross-sectional probability sample survey | BMC Public Health (springer.com)

        Or please contact Dr Annie Bunce at annie.bunce@city.ac.uk

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        VISION researchers presenting at UK Data Service Health Studies Conference 2024

          This event is in the past.

          Two researchers of the VISION consortium project presented at the Health Studies Conference in July.

          Dr Elizabeth Cook, Senior Lecturer at City, University of London, presented Indirect victims of violence: mental health and the close relatives of serious assault victims in England.

          Dr Annie Bunce, Research Fellow at City, University of London, presented Prevalence and nature of workplace bullying and harassment and associations with mental health conditions in England: a cross-sectional probability sample survey

          The free event was on 1 July at University College London (UCL) and organised by the UK Data Service in collaboration with UCL and the National Centre for Social Research. The conference provided updates from the data producers of key UK social surveys with health-related content, such as the Health Survey for England, Understanding Society and the English Longitudinal Study of Ageing. There were also presentations by researchers who conducted analyses using health data.

          Register for the event

          Illustration at top of page is from licensed Adobe Stock library