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Service duration, determinants of case closure and case completion for victim-survivors accessing domestic abuse support services

Demand for specialist domestic abuse (DA) support services is high, in the United Kingdom (UK) and worldwide, and resource is scarce. The length of time victim-survivors spend in service depends on multiple factors, but what determines whether they successfully complete support, or their case is closed for another reason, is less well understood.

The purpose of the current study, Service duration and determinants of case closure and case completion for victim-survivors accessing specialist domestic abuse support services, was to improve understanding of the relationship between length in service, case completion and possible needs and vulnerabilities of specialist service users.

VISION researchers Dr Annie Bunce, Dr Elouise Davies and Dr Estela Capelas Barbosa analysed Women’s Aid Federation of England’s (WAFE) case management and outcomes management system, On Track, the largest national dataset on domestic abuse. 

To further examine the influence of reason for case closure, which the team explored as determinants of case completion, a series of multinomial logistic regressions were conducted, controlling for potentially confounding variables. Stakeholders from Women’s Aid and five other third sector organisations provided input into the study design and interpretation of results.

Most survivors accessing DA services needed community-based services (n = 210,599) and spent an average of just under three months in service. Those who needed more intensive support (e.g. accommodation, refuge) stayed in service for longer on average- 130 days and 115 days, respectively. The survival analysis revealed that cases were less likely to close for people with additional vulnerabilities. Results from the multinomial logistic regressions demonstrated that, for those whose case had been closed, additional vulnerabilities meant they were more likely to have disengaged, had a service-related closure or an unknown reason for case closure.

The limited supply of services impacts on the level of unmet needs for victim-survivors of domestic abuse. If services continue having to do more and more with less, they will be forced into a position of having to trade-off between spending time supporting people to cater to multiple needs and vulnerabilities, and getting people in and out of the door to ensure the slot is available for the next victim-survivor who needs it. 

Recommendation

  1. It is critical that DA services are resourced adequately to support those with multiple needs and additional vulnerabilities to complete a period of time in service. This is something that should be considered by commissioners of DA services.

To download the publication: Service duration and determinants of case closure and case completion for victim-survivors accessing specialist domestic abuse support services

To cite: Bunce, A., Davies, E. & Barbosa, E.C. Service Duration and Determinants of Case Closure and Case Completion for Victim-Survivors Accessing Specialist Domestic Abuse Support Services. J Fam Viol (2026). https://doi.org/10.1007/s10896-026-01052-x

For further information: Please contact Annie at annie.bunce@citystgeorges.ac.uk

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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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Definitions of non-intimate partner and family-related femicide/feminicide

Significant public and media attention often follow the killing of women and girls outside of intimate or domestic relationships – or non-intimate partner and family-related (non-IPF) femicide/feminicide. However, less attention is paid to non-IPF femicide/feminicide in research and policy including an agreed definition. 

What is currently known about these cases falls into a range of overlapping structural contexts, circumstances, and relationships, creating challenges for measurement. Non-IPF femicide/feminicide could include ‘stranger’ femicides or the killing of women and girls by acquaintances, employees, employers and clients. There is also the context of misogynist extremism, trafficking and organised crime, so-called ‘honour’ killings and more. Thus, a diverse range of relationships, contexts and circumstances emerge across non-IPF femicide/feminicides that require definition and synthesis.

A scoping review, Definitions of non-intimate partner and family-related femicide/feminicide: A scoping review, conducted by VISION researcher Dr Elizabeth Cook with colleagues Dr Caroline Miles and Merili Pullerits, identifies current definitions of non-IPF femicide/feminicide and the types of evidence that exist in relation to these killings.

The primary research question for the scoping review was: What definitions of non-intimate femicide exist and what types of evidence are available in relation to this type of femicide? The search strategy included electronic database searches (MEDLINE Complete, Social Policy and Practice, APA PsychInfo, Criminal Justice Abstracts with Full Text; Sociology Source Ultimate; Web of Science), citation-tracking, and hand searching non-governmental organisation websites (e.g., EIGE, UNODC, Femicide Watch). Sources were eligible for inclusion if they reported on women or girls aged 10 or above killed by non-intimate or non-domestic relations. Restrictions were not placed on study context, design or publication language. In total, 126 studies (140 reports) met the inclusion criteria.

The research shows that non-IPF femicide/feminicide encompasses a wide range of types (e.g., sexual femicides, work-related homicides) as well as relationships (e.g., strangers, acquaintances, clients, and employers). However, the team also found that a large proportion of studies did not substantively engage with the gendered contexts and motivations of killings.

Key findings

  • Few reports define non-intimate partner or family-related femicide/feminicide
  • Legal frameworks in Latin America and the Caribbean are key sources of definitions
  • Reports noted specific risks for minoritised women (e.g., Black or migrant groups)
  • Reports identified specific age groups at risk: adolescents and older age victims
  • Definitions operate over three axes: space/location, intimacy, and circumstance

Recommendations

  1. Future research should provide clearly reported and explicit definitions of non-IPF femicide/feminicide including how ‘non-intimacy’ is qualified (e.g., emotional, physical, sexual, or other notions of trust, dependency, or care).
  2. Further research is required to unpack previously described ‘grey areas’ of intimate and non-intimate relationships (e.g., casual sexual partners, adolescent relationships, and dating relationships). This type of research would also provide opportunity to identified potential misclassification of femicide/feminicide.
  3. A significant number of quantitative reports were based on studies of sexual homicide which were focused on forensic characteristics of homicides and perpetrators behaviours and traits, rather than the structural circumstances in which these killings were committed. Future analysis should seek to foreground and interrogate the gendered social structures and relations that surround these femicides/feminicides.
  4. Further research is required that compares intimate and non-IPF-femicide/feminicide cases including victim, perpetrator, and incident characteristics, risk factors, and motives
  5. The availability of data on non-IPF femicide/feminicide is arguably lacking in comparison to data on intimate femicide/feminicide. The publication of various statistical classification frameworks is a promising development but requires application and testing in different jurisdictions.
  6. There is a specific need for intersectional analyses of non-IPF femicide/feminicide to understand how structures and histories of oppression create the conditions in which the killing of women is committed and rationalised (e.g., policing killings of Black women, or sexual femicides of migrant women).

To cite: Elizabeth A. Cook, Caroline Miles, Merili Pullerits, Definitions of non-intimate partner and family-related femicide/feminicide: A scoping review, Social Science & Medicine, 2026, 118917, ISSN 0277-9536, https://doi.org/10.1016/j.socscimed.2025.118917

For further information: Please contact Lizzie at elizabeth.cook@citystgeorges.ac.uk

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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

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Employment consequences of intimate partner violence and abuse

Intimate partner violence and abuse (IPVA) is a global problem. Despite its prevalence, few studies have investigated the employment impact of IPVA, with existing studies spread across multiple disciplines including criminology, economics, and public health. Investigating the employment impacts of IPVA are crucial for understanding the consequences to victim-survivors and wider society.

This systematic review, Employment consequences of Intimate Partner Violence and Abuse, conducted by VISION researcher Dr Niels Blom and Flavia Andrea Lamarre, provides an overview of the main findings on the topic and identified research gaps and opportunities for future research.

Niels and Flavia identified studies via Embase, APA PsycInfo, PubMed, Social Sciences Citation Index, and two related reviews. The studies concerned the association between IPVA and absenteeism, time off from work, unemployment, and/or job loss and were peer-reviewed, English-language, quantitative studies. 

Overall, the 48 identified studies indicated a clear relationship between IPVA and absenteeism/time off work, but evidence was more mixed regarding the association between IPVA and job loss or unemployment. The limitations of current research were discussed, which included that the far majority of studies concerned the United States, investigated only victimization among women, and few used nationally representative data. Male victim-survivors, differences by ethnicity or socioeconomic class, perpetration, and how employment circumstances may help or hinder victim-survivors’ labor market involvement had received limited attention in the literature.

Filling these gaps would provide a stronger evidence-base for effective policies, enabling victim-survivors to retain their employment.

Recommendations

  1. Managers and colleagues should have access to training and assistance in aiding victim-survivors where appropriate, potentially with mandatory training for managers and HR staff.
  2. The large majority of studies stemmed from the United States, which makes it less evident whether the found associations also apply to other societal contexts. Cross-national or cross-state research could help.
  3. For a topic where employment is the central aspect, there has been remarkably little attention to employment circumstances and employers’ role. Further research is needed to examine variation across these aspects to understand what enables victim-survivors to retain employment and long-term productivity. 
  4. A minority of the studies included men. Future work could explore what explains gender differences in the employment impact of IPVA, and when they are more pronounced. Differences by race, ethnicity, sexual orientation, gender identity, and age have received limited attention, warranting further research.
  5. There has been a limited amount of work on IPVA perpetrators and their employment. Further work in this area is important.

To cite: Blom, N., & Lamarre, F. A. (2025). Employment Consequences of Intimate Partner Violence and Abuse: A Systematic Review. Trauma, Violence, & Abuse, 0(0). https://doi.org/10.1177/15248380251395105

For further information: Please contact Niels at niels.blom@manchester.ac.uk

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“How are young people supposed to stay safe when we have nowhere safe to go?”

 

VISION was pleased to support the Lambeth Peer Action Collective (LPAC) with funding and mentoring in their recent project, Built on Trust: The role of youth spaces and trusted adults in reducing young people’s exposure to violence. Working at the community level and with young adults was inspiring – and the impact was powerful particularly for Dr Elizabeth (Lizzie) Cook, Dr Estela Capelas Barbosa and Dr Alexandria (Andri) Innes, the mentors. Many congratulations to High Trees, LPAC and their partners for the hard work and brilliant report. Please read the blog below, written by the young adults who conducted the research and wrote and delivered their report which can also be found below. They are an amazing group!

 

“How are young people supposed to stay safe when we have nowhere safe to go?”

 

by Anisa Hassan on behalf of the Lambeth Peer Action Collective

 

The Lambeth Peer Action Collective (LPAC) recently published their newest research Built on Trust: The role of youth spaces and trusted adults in reducing young people’s exposure to violence. LPAC was launched by High Trees Community Development Trust in 2021. It’s made up of young people and six local youth organisations working together to create better futures for young people in Lambeth through youth-led research and social action.

What was the research about?

This round of research explored what can be done to reduce young people’s risk of experiencing violence. With the support of High Trees, VISION, Partisan and other LPAC partners, we worked on this project for nearly 18 months, conducting and analysing 46 peer interviews. We found that with access to trusted adults and trusted spaces young people were less likely to be exposed to different types of violence.

This produced four key findings:

  1. The violence affecting young people takes many forms and is often complex in nature.
  2. Youth organisations provide unique spaces where young people can feel safe and build belonging.
  3. When youth practitioners can build trust with young people, they are able to provide them with practical and emotional support to navigate violence.
  4. Youth organisations offer young people alternative pathways and visions for their future.

An afternoon of conversation and community

The launch event was a chance for the LPAC team to connect and show stakeholders and community members our research, get feedback and start to think about how we can work together to make change. Attendees described the event as “hopeful”, “inspiring”, and “empowering”, with many of them pledging support. The team left the event with hope for the next phase of the project – social action that builds long-lasting change for young people in our communities.

What’s next?

“No research without action”

Since the research launch in October, the LPAC team have been busy, taking action in response to our findings.

We were invited to the Lambeth Safeguarding Children Partnership’s Annual Conference to present our research findings to organisations at the forefront of protecting young people. This event gave us an opportunity to highlight key insights from our research and how they can shape safeguarding practices and policies.

We have also been designing our own trusted adult training workshop, which takes inspiration from interviews with young people focusing on characteristics and practical advice that youth practitioners can use to build and maintain trust. We are planning to trial the training with local youth workers early next year.

LPAC team members have also attended workshops hosted by the Met Police and the Mayor’s Office for Policing and Crime (MOPAC), where we had the opportunity to ask questions and make suggestions about their MPS Children’s Strategy based on young pe  ople’s experiences that they told us about through our research.

LPAC at High Trees were thrilled to win the Power of Community award at the Locality Awards 2025 in Liverpool. The award celebrates community organisations working with local people to shape their own future and to build a fairer society where everyone in the community thrives.

We are also proud to announce that in the new year LPAC will be starting a new round of research, funded by the Youth Endowment Fund, focusing on mental health support for young people affected by violence, and we are excited to continue our collaboration with VISION on this project.

If you’re interested in finding out more about LPAC’s work visit www.lambethpac.com  or get in touch with us on action@high-trees.org.

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Re-imagining responses to gender-based violence

 

Dr Olumide Adisa

VISION Co-Investigator, Dr Olumide Adisa, has written a personal blog, Behind the book, highlighting her journey behind the scenes writing, compiling, and publishing her first edited book, Tackling Domestic Abuse and Sexual Violence: A Systems Approach.

In the blog, Olumide discusses her drive to have a meaningful impact in the fight against gender-based violence. Her enthusiasm, advocacy and growing expertise for systems theory and complex systems approaches combined with ongoing work across different systems and with various collaborators led to the project and was an invaluable experience.

For further information, please contact Olumide at olumide.adisa@citystgeorges.ac.uk

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Frontline practitioner’s understanding of the roots of violence, and why it matters for policy and prevention

Violence continues to be a concern for policymakers and communities, notably so in urban contexts in which socio-demographic change, retrenched social support and evolving forms of exclusion affect its distribution and intensity. While many European cities experience relatively low levels of violence, the caveat to this is that many sub-areas and specific communities experience considerable variations in the form and intensity of such violence.

In this paper, Violence reduction in a changing European urban context: Frontline practitioner’s understanding of the roots of violence, and why it matters for policy and prevention, the research team, including VISION Co-Investigator Dr Elizabeth Cook, present findings from a comparative, qualitative study investigating how key stakeholders – civic and policy actors working at the interface of violence prevention and European urban communities – perceive its cause and overall nature.

Lizzie and colleagues explored the accounts of key support workers, practitioners and local policymakers because they represent essential intermediaries in processes of policy implementation, transfer and reform. The perspectives of practitioners provide insight into how social problems are constructed and under what conditions, which groups are most affected by these conditions, how solutions to such problems should be delivered in city settings (and delivered more effectively) and who should be assigned responsibility for generating effective responses. 

Informed by scholarship on street-level bureaucracy and local knowledge, the paper presents accounts that connect the risk of violence with austerity conditions and their erosion of vital social and institutional fabrics, which thereby worsening localised violence in these ‘ordinary’ cities.

The research team identified the key operating theories, ideas and observations circulating among civic actors tasked with tackling urban violence. Local practitioners understand violence to be linked to macro-economic conditions and social inequalities that sit outside their jurisdiction, but which ultimately present major challenges to the fabric of local urban life and risks to particular communities. Their commentaries build a cumulative picture that is in many ways at odds with the main thrust of many of the policies, political discussions, policing priorities and resource cuts evident in many cities across Europe in recent years.

The strongest shared conclusion is that urban violence cannot be tackled where these deeper conditions, influences and a lack of resources remain unaddressed.

Recommendations

  1. Support and invest in long-term collaborative partnerships and policy initiatives which take account of the spatial discrepancies within cities.
  2. Encourage connections between civic and state authorities which could help to relieve these frustrations, rebalance power relations and provide accountability in top-down approaches to cities experiencing destructive social, political and economic change.
  3. To increase trust in political institutions, policies must also tackle the scarcity of investment in public services, while encouraging better representation of marginalised communities in decision-making processes.

To cite: Cook, E. A., Jankowitz, S., & Atkinson, R. (2025). Violence reduction in a changing European urban context: Frontline practitioner’s understanding of the roots of violence, and why it matters for policy and prevention. European Urban and Regional Studies, 0(0). https://doi.org/10.1177/09697764251386774

For further information: Please contact Lizzie at elizabeth.cook@citystgeorges.ac.uk

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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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Inequalities in how work and care responsibilities are distributed impact on the gender pay gap

Despite decades of progress, the gender pay gap remains a persistent feature of the UK labour market. Currently women in the UK earn approximately 11% less than men.

VISION researcher and Reader at City St George’s UoL, Vanessa Gash, writes in her article, The gender pay gap looks different depending where you are on the income ladder, for The Conversation, that the gender pay gap is not just because of differences in education or job type, but due to deeper inequalities in how work and care responsibilities are distributed.

Based on a study investigating barriers to equal pay, Vanessa and colleagues examined different predictors of the gender pay gap at the mean and for different income groups. Using the United Kingdom Household Panel Survey (UKHLS), the team provided a detailed analysis of the effects of individual work histories, with up to 40 years of retrospective data to uncover how these inequalities play out across income groups.

Findings

  • Equal pay policies must be tailored to the needs of different income groups. For wealthier households, policies that support full-time work and chip away at sex segregation may be effective so that women can more readily access better-paid jobs. But for poorer households, the focus should be on improving access to stable and better-paid jobs, while reducing discrimination and supporting flexible work arrangements.
  • Efforts to close the gender pay gap must avoid pitting the gains of high-earning women against the losses of low-earning men. In an era of rising political populism, this could undermine support for equality.
  • Promotion of good-quality employment for all and supporting equalised caregiving responsibilities is necessary.

By failing to address the barriers that prevent men and women from participating fully in both paid work and unpaid care work, reductions in the gender pay gap are unlikely any time soon.

For further information: Please contact Vanessa at vanessa.gash@citystgeorges.ac.uk

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