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The story so far: Co-production in Lambeth

By Elizabeth Cook, Senior Lecturer in Criminology & Sociology at City St George’s, University of London

As the VISION consortium approaches the end of its third year, work continues on consolidating the learning from various large datasets in crime and justice, health, and specialist services.

What we know is that these datasets are structured in different ways, collected by different agencies, and curated for quite different purposes. They represent particular ways of knowing about violence and abuse: they can help to identify patterns (e.g., what determines whether victim-survivors of sexual violence and abuse access support), prevalence (e.g., of workplace bullying and harassment), trends over time, and associations (e.g., between intimate partner violence, suicidality, and self-harm). However, we also know that large datasets struggle to capture the complex, and sometimes messy, realities of violence and abuse experienced by communities, especially those that are marginalised and minoritised.

Peer action research in Lambeth

In Lambeth, working in collaboration with peer researchers has made visible the evidence gaps that emerge at the intersection of multiple systems of inequality, including racism and misogyny.

We are lucky to be partnered with Lambeth Peer Action Collective (LPAC), High Trees and Partisan as part of a peer action research project. The aim of the project is to explore the role that trusted adults and trusted spaces can play in protecting young people from exposure to violence. Currently, there are 11 peer researchers that work as part of the LPAC: a collective of young people and youth organisations campaigning for change in their community. They are supported by High Trees, a Community Development Trust in Tulse Hill, eight partner youth organisations, and Partisan, a Black-led Community Interest Company providing culturally sensitive mental health support.

What has been achieved so far?

The project builds upon research conducted by the previous cohort of LPAC researchers conducted between December 2021 and August 2022. This project identified the impacts of violence on young people in Lambeth and the structural conditions of poverty, housing, education, urban regeneration, and public safety that were experienced unequally across the community.

Developing these findings further, the second cohort of peer researchers have been participating in weekly research training sessions led by High Trees and supported by VISION. The group has been learning everything they need for the next stage: from safeguarding and finances, to developing research questions, critical thinking skills, and how to evaluate research methods. This month, the LPAC researchers are getting ready to put into practice the interview skills that they have been learning each week in preparation for the next stage of the project – recruitment.

There has been amazing progress so far – not only in forming a research question and defining key concepts, but in developing a shared space for researchers to feel like change is possible and to collaborate with others who want the same.

What have we learned?

There are ongoing conversations about how peer action research can work to redress the imbalance between ‘researcher’ and ‘researched.’ These conversations seem even more relevant to research on violence and abuse, where the issue of power is central to both.

So far, the weekly sessions with peer researchers as well as our meetings with High Trees have taught us a lot about how power operates within institutions and the ways that it can be shared if there is a will to share it. This can be reflected in adequate resourcing, decision-making, access, and sharing skills and knowledge. The project has underlined the importance of respect in research: for different forms of expertise, within spaces, and within research relationships. The project has also challenged adult-centric assumptions about what we suppose that young people need to live better lives.

As mentioned previously, this project highlights the evidence gaps that occur at the intersection of multiple inequalities. In doing so, peer action research can also shape how we utilise large datasets, recognising how different social realities are reflected within existing data (or not).

In this sense, this collaboration has also made hyper-visible the question of: what and who is research for? As others have suggested, action research is not so much a methodology, but a way of thinking about research: it is a way of approaching a specific problem through community, participation, and curiosity. It is not necessarily driven by knowing more about something, but by wanting to change something with what you know.

We hope that this research continues in that spirit!

Further information

Do check out the LPAC’s manifesto for change and their previous report!

Photograph is copyrighted to Lambeth Peer Action Collective and not for use.

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.

Illustration at top of page is from licensed Adobe Stock library

Prevalence of sexual violence victimisation amongst mental health service users

Researchers from King’s College London, Anjuli Kaul, Laura Connell-Jones, Sharli Anne Paphitis and Sian Oram (VISION researcher), have published a systematic review and meta-analyses in Social Psychiatry and Psychiatric Epidemiology which provides up-to-date estimates on the prevalence and risk of sexual violence victimisation amongst mental health service users.

This review pooled data from 26 studies encompassing a total of 197,194 participants. Sexual violence included any sexual acts, comments or advances (or attempts at said behaviours) made towards a person without their consent. Mental health service users included any person who had been in contact with a psychiatric inpatient, outpatient, community, perinatal, liaison, addiction, veteran psychiatric inpatient, or forensic mental health service.

The researchers searched 3 electronic databases (Medline, Embase, and PsychINFO) for peer-reviewed publications from their dates of inception until 18^th July 2022. There were no restrictions on the geographic location of the included studies.

Key findings

The review found that studies consistently showed a high prevalence of past year and adult lifetime (since the age of 16) sexual violence victimisation in psychiatric service users, with higher rates found in women than men. Additionally, both male and female psychiatric service users were found to have an increased risk of experiencing sexual violence compared to non-psychiatric service users. This was the case regardless of whether the study measured past year or adult lifetime sexual violence or sampled a population of inpatients, outpatients or both.

The meta-analyses revealed high levels of heterogeneity within the data, which was likely partly due to the varied instruments used across studies to measure mental health and sexual violence. Additionally, there was not enough data available to calculate the pooled odds ratio of sexual violence victimisation for male or female psychiatric service users, nor was it possible to adjust odds ratios for known confounders such as age, ethnicity, income level or substance abuse.

The findings emphasise the need for healthcare practitioners to effectively recognise and respond to sexual violence in mental health services, and the need for a comprehensive and consistent measurement framework for sexual violence to enable reliable and comparable prevalence data to be collected.

For further information please see: Prevalence and risk of sexual violence victimization among mental health service users: a systematic review and meta-analyses | Social Psychiatry and Psychiatric Epidemiology (springer.com)

Or contact Anjuli at anjuli.1.kaul@kcl.ac.uk

Photo by Priscilla Du Preez ?? on Unsplash

A health perspective to the war in Israel and Palestine

Gene Feder, VISION Director and Professor of Primary Care at the University of Bristol, has written an opinion piece with colleagues commenting on events in Israel and Gaza from a public health and primary care perspective. Responding to the war in Israel and Palestine was published in December in the online edition of the British Journal of General Practice.

Gene and his colleagues are GPs working to further the development of family medicine in the occupied Palestinian territory, specifically in the West Bank, but with links to family medicine in Gaza through the United Nations Relief and Works Agency and through Medical Aid for Palestinians. They also have friends and family in Israel and Palestine.

They have three responses to the current crisis as informed by their work as GPs and connection to Palestinian primary care:

A plea for the protection of health care and health professionals amid the war
A plea for the preservation of public health amid war
A recognition that in the aftermath of October 7th and the invasion of Gaza, the widespread direct and vicarious trauma in Israeli and Palestinian populations will result in permanent physical and emotional damage: the former in the shape of orthopaedic, neurological, and gynaecological (as a result of rape) harm, the latter in the form of widespread anxiety, depression, and post-traumatic stress disorder which will also cascade down the generations.

Given VISION’s commitment to developing evidence on violence prevention, we will be organising roundtable meetings bringing together researchers focusing on post-conflict violence reduction. This is an opportunity for dialogue, perhaps leading to new perspectives and research including systematic assessment of sustainable post-conflict interventions as well as further joint activities.

For further information on the opinion piece, please see: Responding to the war in Israel and Palestine

Photograph by Emad El Byed on Unsplash

Mental health in the workplace: how employers should respond to domestic violence

This event is in the past.

VISION member Sally McManus will be talking at a Westminster Insight event on Supporting Women’s Health in the Workplace on 20 March 2024.

Sally will use a life-course approach to understanding women’s mental health and wellbeing at work, including the impact of the psychosocial working environment, bullying and harassment at work, and what support and signposting employers can offer in relation to domestic violence.

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

Photo by Etty Fidele on Unsplash

Dr Annie Bunce receives award at Lancet Public Health Science conference

Dr Annie Bunce, VISION Research Fellow, was awarded Best Oral Presentation at the Lancet Public Health Science conference in London this November. She presented on the Prevalence, nature and associations of workplace bullying and harassment with mental health conditions in England: a cross-sectional probability sample survey.

Annie’s research, conducted with VISION colleagues Ladan Hashemi, Sally McManus, and others, presents the first nationally representative findings on the prevalence of workplace bullying and harassment in England for over a decade. Annie analysed data from the 2 014 Adult Psychiatric Morbidity Survey (APMS) to demonstrate: the prevalence of workplace bullying and harassment (WBH) in the working population in England; the nature of WBH experienced, who it was perpetrated by and the types of behaviour it involved; and associations between the experience of WBH and indicators of adverse mental health.

The study is unique in that the APMS makes robust assessments of mental health – operationalising diagnostic criteria – which provides an accurate assessment of clinical need. Implications for employers, policymakers, health services and researchers are outlined.

For the article, please see: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02066-4/fulltext

Please contact Annie at annie.bunce@city.ac.uk for further information.

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VISION Research Fellow chaired European Public Health Association conference symposium

We’re delighted that one of VISION’s core researchers, Dr Anastasia Fadeeva, chaired a symposium at the upcoming European Public Health Association (EUPHA) conference in November in Dublin.

The workshop, Responding to violence and abuse across the life-course, presented a range of analyses – drawing on data from New Zealand, Germany and the UK – that addressed the ways in which violence and abuse manifest at different life stages, including in childhood, among working-age adults, and in later life.

The presentations highlighted differences across the life course, as well as commonalities. They demonstrated the long-term, even life long, shadow that violence and abuse can cast over people’s health, and provided evidence of the extensive costs for society. Health impacts were shown to be broad, not only anxiety and depression, but substance dependence, chronic physical health conditions, and related health risks such as obesity.

This symposium comprised four presentations that each considered violence and abuse prevalent at a particular stage of life, and provided evidence to inform the sensitive tailoring of responses from and for families, schools, health and social services, workplace human resource employees, and care and residential homes.

For further information on the conference, please see: 16th European Public Health Conference (ephconference.eu)

Or contact Anastasia at anastasia.fadeeva@city.ac.uk

Photo by Priscilla Du Preez ?? on Unsplash

New partnership between VISION and the Violence, Abuse and Mental Health Network

We are pleased to announce a new, one-year partnership with the Violence, Abuse and Mental Health Network (VAMHN).

VAMHN is a network of individuals and organisations aiming to reduce the prevalence of mental health problems by addressing associated violence and abuse, particularly domestic and sexual violence.

The interdisciplinary cross-sector network brings together and supports research by experts from a range of disciplines, sectors, and backgrounds – some with lived experience, others with expertise from the work that they do, and survivor researchers with both.

VAMHN’s work aligns with our own goals of improving measurement of violence and better use of data to prevent and mitigate the harm that violence causes to health and wellbeing.

VAMHN has done sterling work engaging with survivors of violence in co-producing research and creating a Lived Experience (LE) Advisory Group. They will support VISION as we build and expand on LE engagement across our project.

For further information on VAMHN, please see: The Violence, Abuse, and Mental Health Network

Or contact us at VISION_Management_Team@city.ac.uk

Illustration by Elnur/Shutterstock.com

Webinar: Parental and child mental health and intimate partner violence

This webinar is in the past.

27 June 2023, 17:00 – 18:30 BST, Zoom

VISION director, Professor Gene Feder, led the webinar, Interrelationships between parental mental health, intimate partner violence and child mental health – implications for practice, with Dr Shabeer Syed and Dr Claire Powell on behalf of the NIHR Children and Families Policy Research Unit.

They presented findings from a mixed methods study that seeks to improve responses to families affected by intimate partner violence (IPV) and parents and children’s mental health problems.

Then, they presented preliminary findings on the relationship between parental IPV and a range of clinically relevant adversity and mental health-related indicators (www.acesinehrs.com) in anonymised health records from parents and children presenting to GPs, A&E and hospital admissions between one year before and five years after birth.

Their research shows that 1 in 5 (20%) families experienced IPV, although only 1 in 50 (2%) had IPV recorded in the GP record. Recording of other adverse childhood experiences (ACEs) was better, with 1 in 2 (53.4%) families having at least one recorded in the early life course. Compared to families without ACEs, families with ACEs had a higher risk of parental IPV, especially when at least one parent and child had recorded a mental health problem. Gene will discuss the implications of these findings for national guidance on supporting families experiencing IPV and mental health problems, articulating how data already within medical records can help identify those families.

For further information please see: Interrelationships between parental mental health, intimate partner violence and child mental health – implications for practice – ACAMH

Photo by Sebastián León Prado on Unsplash

Mental health service use in perpetrators of partner violence

Perpetration of partner violence is more common in people with recent mental health service use compared to the general household population of England.

Research conducted by Dr Vishal Bhavsar, Kings College London (KCL); VISION Co-Investigator Professor Louise M. Howard, KCL; VISION Deputy Director Sally McManus, City, University of London; and Dr Katherine Saunders, KCL, has demonstrated this correlation is not affected by criminal justice involvement or by social demographics(e.g. class, education), but seems to be explained by greater exposure to childhood adversities and exposure to partner violence.

The researchers think this work highlights an important potential role for health services in responding to perpetrators of domestic abuse, especially services which provide care for people with mental health conditions. Effective strengthening of the healthcare system’s response to perpetrators of domestic abuse has the potential to reduce violence.

For further information please see: Intimate partner violence perpetration and mental health service use in England: analysis of nationally representative survey data | BJPsych Open | Cambridge Core

Or contact Dr Vishal Bhavsar at vishal.2.bhavsar@kcl.ac.uk

Photograph by 88studio / Shutterstock.com