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VISION presenting at the Prevention Research 2026 conference

Nine VISION colleagues have had workshop, symposium and individual abstracts accepted at the upcoming Prevention Research 2026 conference in March. The Population Health Improvement UK and the National Institute for Health and Care Research, in partnership with VISION funder, the UK Prevention Research Partnership, organised the event to explore the latest research and collaborative strategies for preventing non-communicable diseases and reducing health inequalities across the UK. This year’s theme is Connecting Research, Policy, and Practice for Health Equity.

VISION research is interdisciplinary and as such, several colleagues collaborated on symposiums and the workshop. We are partnering with Groundswell, Kailo and PHI UK Population Mental Health as well as the Violence, Abuse and Mental Health Network,  and High Trees Community Development Trust amongst others.

 

Individual presentation

Violence across the life course and physical and mental health trajectories in later life

  • Anastasia Fadeeva, VISION Research Fellow, City St George’s University of London

 

Symposiums

Lessons Learned from Lived Experience Engagement in Violence and Trauma Research

  • Sian Oram, Professor at Kings College London and VISION Co-Investigator
  • Kimberly Cullen, VISION Knowledge Exchange Manager, City St George’s UoL
  • Alicia Stillman, Violence, Abuse and Mental Health Network at Kings College London
  • Polina Obolenskaya, VISION Research Fellow, City St George’s UoL
  • Annie Bunce, VISION Research Fellow, City St George’s UoL

Policy insights from a population understanding of mental health inequalities: using England’s mental health survey series, the Adult Psychiatric Morbidity Surveys (APMS)

Presenters include:

  • Sally McManus, Professor at City St George’s UoL and VISION Co-Deputy Director
  • Elizabeth Cook, Senior Lecturer at City St George’s UoL and VISION Co-Investigator

Centring the voices of young people – Learning from four participatory, place-based approaches to violence prevention

Presenters include:

  • Elizabeth Cook, Senior Lecturer at City St George’s UoL and VISION Co-Investigator
  • Ruth Weir, VISION Senior Research Fellow at City St George’s UoL

Understudied Commercial Drivers of Health: Exploring Industry Practices & Developing a Prevention Research Agenda

  • Presenters include Sally McManus, Professor at City St George’s UoL and VISION Co-Deputy Director

 

Workshop

Using Systems Approaches to Connect Communities and Tackle Complexity in Prevention

  • Workshop leads include Olumide Adisa, VISION Co-Investigator at City St George’s UoL

People with mental illness and exposed to assault experience greater mortality

 

Various studies over the years have noted a link between mortality and mental illness, however, the contribution of violence exposure to mortality in people with mental illness remains under-researched. This latest study, The association between violence exposure and general and cause-specific mortality in people using mental health services: cohort study, closes the gap with the finding that people with mental illness, who are exposed to assault, experience greater mortality than those who are not exposed.

The research team led by Dr Nabihah Rafi (Kings College London) included VISION researchers Professor Robert Stewart and Dr Vishal Bhavsar. They examined the association of violence exposure, such as being physically assaulted, with general and cause-specific mortality in a population using mental health services.

Assembling a cohort study using electronic health records from a mental health and substance use treatment provider in south-east London, records were linked to acute medical admission and emergency department presentation data, as well as to a national mortality register with death certificates for deaths registered in England and Wales.

Results indicated that exposure to violence among users of mental health services is associated with increased mortality compared with non-exposed individuals. They may have worse physical health for a range of reasons, such as the metabolic effects of psychiatric treatment, which in turn might influence cause-specific mortality risk (e.g. diabetes-related mortality). Violence exposure, including repeated exposure, might influence mortality risk through a reduced capability to manage existing physical illness, increasing the risk of progression of pre-existing morbidity.

Further findings about the association between those using mental health services and being exposed to violence also suggest:

  1. Psychological stress that could, over time, cause stress to body systems
  2. An increase in unhealthy behaviours, including alcohol use and smoking, which are important drivers of mortality in people with mental illness
  3. An indication with relationship stress, which some evidence suggests may affect mortality risk
  4. An Influence of mortality risk through a reduced capability to manage existing physical illness, increasing the risk of disease progression.

Recommendations

  1. The association between violence exposure and mortality from natural causes in people with mental illness warrants further research attention to understand the contributory pathways, including through shared causes of both violence exposure and mortality.
  2. Strategies to improve the identification and assessment of violence exposure in people with mental illness could improve the quality of care by reducing health inequalities, as well as by uncovering wider healthcare needs in patients exposed to violence.

To cite: Rafi N, Stewart R, Jewell A, Shetty H, Bhavsar V. The association between violence exposure and general and cause-specific mortality in people using mental health services: cohort study. BJPsych Open. 2026 Jan 12;12(1):e35. doi: 10.1192/bjo.2025.10938. PMID: 41521785.

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Anastasia Fadeeva shares thoughts on Data Impact Fellowship placement studying healthy ageing

 

Dr Anastasia Fadeeva

VISION researcher and Data Impact Fellow, Dr Anastasia Fadeeva, has written a personal blog, Reflections from being a Data Impact Fellow: a placement in Japan, about her time in the country visiting universities and discussing healthy ageing.

In the blog, Anastasia reflects on her short-term placement at Chiba University and Kyoto University, meeting fellow researchers interested in population health and a focus on studying the ageing population and promoting healthy ageing.

As a Data Impact Fellow, Anastasia is researching the issues of violence in older age, the long-term impacts of violence on mental health, and the lack of reliable data. The placement to Japan is one component of the fellowship.

For further information, please see VISION member awarded Data Impact Fellow to study violence and mental health in older age to find out more about her fellowship or contact Anastasia at anastasia.fadeeva@citystgeorges.ac.uk

Top photo supplied through Adobe Stock subscription and bottom photo supplied by Dr Anastasia Fadeeva.

More adults showing signs of drug dependence in England

VISION co-Deputy Director, Professor Sally McManus, has published an article for The Conversation, Drug use is changing in England – with more adults showing signs of dependence. Written with Sarah Morris from the National Centre for Social Research, the article is based on their research using the Adult Psychiatric Morbidity Survey (APMS) 2023-2024 with colleagues.

The APMS is the longest running mental health survey series in the world and provides a picture of how mental health is changing across England. The national study includes people from across English society, not just those that currently use NHS services or have in the past. A random sample of approximately 7,000 adults aged 16 to 100 living in England were asked questions about their mental health, whether they used any of a range of illicit drugs, and if they had experienced signs of dependence, such as symptoms of withdrawal or increased tolerance.

Findings

  • Drug use may be more widespread
  • Non-medical use of prescription opioids may be more widespread
  • In the 16- to 24-year-old age group, the signs of drug dependence were similarly common in men and women which is a noticeable shift from past APMS findings
  • Cannabis dependence is rising
  • There appears to be a lack of specialist support as about one adult in every five who showed signs of drug dependence reported they’d ever received support or treatment for drug use

For further information: Please contact Sally at sally.mcmanus@citystgeorges.ac.uk

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Assisted dying bill: Safeguards against domestic abuse and coercion must be strengthened

One in four women and one in seven men in England and Wales have experienced domestic abuse. Coercive and controlling behaviours are core to domestic abuse. They result in loss of autonomy and independence and are intended to isolate and reduce self-worth. Such behaviours are common but hard for health professionals to detect.

If passed, the Terminally Ill Adults (End of Life) Bill will allow people who are terminally ill and expected to die within six months to request assistance to end their lives. VISION researchers Gene Feder, Elizabeth (Lizzie) Cook and Sally McManus have written an opinion published in The BMJ that calls for safeguards in the bill need to be strengthened to prevent coercion in the context of domestic abuse.

Assisted dying requires a careful consideration of the risks posed by domestic abuse and coercion. The current bill does not fully tackle specific safeguarding concerns for patients experiencing domestic abuse which can include economic, emotional, physical, and other forms of abuse from a partner or other family member. To safeguard against domestic abuse and associated coercion, Gene, Lizzie and Sally propose a set of principles that should be part of the UK bill.

  1. For doctors responding to any request for assisted dying, training must be extensive, specialist, in person, and backed up by referral pathways.  Independent domestic abuse advocates, with expertise in recognising coercive control, could contribute to assessment of assisted dying requests. 
  2. Commitments to confidentiality and data security must not obscure assisted dying decisions and the contexts in which they occur. The bill must ensure transparency.
  3. The bill must establish accountability. Transparent data about each stage of the approval process would also enable monitoring and regular scrutiny of the processes and outcomes of assisted dying legislation.
  4. Lawmakers must resist expansion. Dementia and mental health conditions are now being considered for eligibility. These are conditions prevalent in survivors of domestic abuse. The UK bill should include clauses that limit any expansion of scope to other conditions and situations.

To read the opinion piece: Safeguards against domestic abuse and coercion in the assisted dying bill must be strengthened

To cite: BMJ 2025;390:r1914

For further information, please contact Gene at gene.feder@bristol.ac.uk

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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Violence in later life: Life course and physical and mental health trajectories

Research has demonstrated that violence is associated with worse health in older age. Most of the evidence, however, comes from cross-sectional studies. Research showing how health changes over time in people who have experienced lifetime violence is very scarce.

To address this gap, VISION researchers, led by Dr Anastasia Fadeeva with colleagues Dr Polina Obolenskaya, Dr Estela Capelas Barbosa, Professor Gene Feder and Professor Sally McManus, used seven waves of data from the English Longitudinal Study of Ageing (ELSA) collected between 2006 and 2019 (waves 3 to 9), to examine the associations between parental physical abuse in childhood and any physical or sexual violence across the life course, with the subsequent changes in depressive symptoms, the likelihood of probable depression, and long-standing limiting illness.

The team used a sample of 6171 participants aged 50 and over who answered all questions about violence exposure in wave 3 of ELSA, while information about their health was collected from wave 3 to 9.

The VISION study provides new evidence that health consequences are sustained throughout later life. Results showed that violence of different kinds predicts poorer physical and mental health in older age. Furthermore, the health disparities between victims and non-victims did not reduce over time. This was evident in both men and women.

The findings highlight the value of implementing violence prevention measures throughout the life course, not only to mitigate immediate consequences of violence and abuse but also to reduce the burden of ill health in older age. The results also underscore the need to identify modifiable risk factors such as violence in order to inform polices aiming to promote healthy ageing. More longitudinal data, including from administrative sources, are needed to further demonstrate the associations between different types of violence and health outcomes as people age.

Recommendation

Healthy aging could be improved by preventing violence across the life course. Reducing and addressing experiences of violence at a younger age could reduce the burden of – and inequalities in – poor health in later life.

To download: Violence across the life course and physical and mental health trajectories in later life: a 13-year population-based cohort study in England

To cite: Anastasia Fadeeva, Polina Obolenskaya, Estela Capelas Barbosa, Gene Feder, Sally McManus, Violence across the life course and physical and mental health trajectories in later life: a 13-year population-based cohort study in England, The Lancet Healthy Longevity, Volume 6, Issue 7, July 2025, 100738 https://doi.org/10.1093/bjc/azaf064

For further information, please contact Anastasia at anastasia.fadeeva@citystgeorges.ac.uk

Photograph from Age Without Limits image library.

Workplace violence and fear of workplace violence: An assessment of prevalence in the UK by industrial sector

Workplace violence is a significant problem with underexamined productivity effects. In a global survey, just under 1 in 5 workers reported exposure to psychological violence and harassment at work, and 1 in 10 reported exposure to physical violence during their working-lives. In the United Kingdom (UK), the Health and Safety Executive (the regulator for workplace health and safety) found 1% of all adults of working age, in the 12 months prior, experienced a physical assault or threat of assault at work.

Workplace violence covers a broad range of adverse social interactions and behaviours committed by or towards employees. It includes encounters between colleagues and between workers and service users. It can also include incidents of domestic abuse experienced at work, with abusers known to pursue victims in the workplace.

Direct and indirect exposure to violent acts or threats of violence at work can be anticipated to lead to anxiety and fear of further victimization. Workplace violence, especially when persistent, may cause psychological disorders including common mental disorders (CMD) of generalized anxiety and depression.

VISION researchers Dr Vanessa Gash (City St George’s University of London) and Dr Niels Blom (University of Manchester) used the United Kingdom Household Panel Study, a nationally representative survey with mental health indicators to examine the prevalence of violence and fear of violence by sector and the effect of violence on common mental disorders (CMD) risk. They also supplemented the analyses with the views of those with lived experience.

Their study, Workplace violence and fear of violence: an assessment of prevalence across industrial sectors and its mental health effects, examined variance in the prevalence of workplace violence and fear of violence in the UK by industrial sector and determined the mental health effects thereof using longitudinal data.

Results showed that a high prevalence of workplace violence and fear of workplace violence was found in multiple different UK industrial sectors – >1 in 10 workers were exposed to violence in the last 12 months in 30% of sectors and >1 in 20 workers were exposed in 70% of sectors. Workers employed in public administration and facilities had the highest risks of workplace violence. The second highest sector was health, residential care, and social work. Workplace violence increased CMD risk as did fear of violence at work. Also, the effect of violence and fear of violence on CMD remained when the researchers investigated CMD one year later. 

Recommendation

The researchers recommend better recognition of the extent to which workplace violence is experienced across multiple sectors and call for better systems wide interventions to mitigate the associated harms.

To download: Workplace violence and fear of violence: an assessment of prevalence across industrial sectors and its mental health effects

To cite: Gash, V, Blom, N. ‘Workplace violence and fear of violence: an assessment of prevalence across industrial sectors and its mental health effects’. Scandinavian Journal of Work, Environment & Health. https://doi.org/10.5271/sjweh.4230

For further information, please contact Vanessa at vanessa.gash.1@citystgeorges.ac.uk

Illustrations from Geisa D’Avo and copyright owned by UKPRP VISION research consortium

Multiple adverse childhood experiences and mental and physical health outcomes in adulthood: New systematic review protocol assessing causality

Research suggests that adverse childhood experiences can have a lasting influence on children’s development that result in poorer health outcomes in adulthood. Like other exposure-outcome relationships, however, there is uncertainty about the extent to which the relationship between adverse childhood experiences and health is causal or attributable to other factors.

The aim of this systematic review is to better understand the nature and extent of the evidence available to infer a causal relationship between adverse childhood experiences and health outcomes in adulthood.

A comprehensive search for articles will be conducted in four databases (Medline, CINAHL, PsycInfo and Web of Science) and Google Scholar. The team, led by Dr Lisa Jones of Liverpool John Moores University, and includes VISION researchers Professor Mark Bellis and Professor Sally McManus, will review studies published since 2014:

  • of adults aged 16 years or over with exposure to adverse childhood experiences before age 16 years from general population samples;
  • that report measures across multiple categories of childhood adversity, including both direct and indirect types; and
  • report outcomes related to disease morbidity and mortality.

To download the protocol: Interpreting evidence on the association between multiple adverse childhood experiences and mental and physical health outcomes in adulthood: protocol for a systematic review assessing causality

To cite: Jones L, Bellis MA, Butler N, et al. Interpreting evidence on the association between multiple adverse childhood experiences and mental and physical health outcomes in adulthood: protocol for a systematic review assessing causality. BMJ Open 2025;15:e091865.  doi: 10.1136/bmjopen-2024-091865

For further information, please contact Lisa at l.jones1@ljmu.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