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Implications of changing domestic abuse measurement on the Crime Survey for England & Wales

The Office for National Statistics (ONS) is making a major decision this month on the future of Crime Survey for England and Wales (CSEW) Domestic abuse measurement and monitoring.

Last year, ONS ran an experiment where half of the CSEW sample got the domestic abuse module used since 2005, and the other half got a new module that is not comparable with the previous one. ONS intend to move over entirely to the new module in the next data collection (2025/26).

Loss of the existing module has major implications: it is world-leading, uses globally comparable items, and with trend data going back to 2005. Without consistently administered core items from that module, it will no longer be possible to:

  • Produce long-term trends over time in domestic abuse for England and Wales.
  • Group a decade of survey years together to have enough cases to robustly examine domestic abuse in particular regions, minoritised groups, and by other protected characteristics for many years. This is essential for understanding inequalities in violence and subsequent service contact, and whether these are changing.

The new module is problematic for many reasons:

  • Is not a standardised measure, has undergone little validation or psychometric testing, and is not comparable with anything used previously or in any other country or study.  
  • It separates data collection between former and current partner based on relationship status at the time of the interview, not at the time of abuse. This distinction creates confusion for interpretation of analysis and may be misinterpreted. The distinction is also problematic for classification of casual and other relationship types.
  • The overhaul of the module was intended to align measurement with the Domestic Abuse Act 2021 definition, but it appears that domestic abuse as recognised by that Act cannot be identified by this module.

We urgently recommend that before losing this world-leading time series and relying on an untested, not comparable, and flawed new approach to DA measurement in England and Wales, that ONS:

  1. Pause: continue the split-sample data collection for one more year.
  2. Test the new approach: fully compare data collected using the new and old modules data so the validity and utility of the new measures can be evaluated appropriately, and its impact on inequalities assessed.
  3. Publish these results publicly: and fully consult once stakeholders understand all the implications of having data collected in each way before the decision to roll out new data collection is finalised.
  4. With this information, then compare all options: such as maintaining some of the existing questions alongside adding new coercive control items. This straightforward approach would ensure the utility of the survey for national trends (in both England and Wales) and analysis of inequalities and minoritised groups, while also improving the measurement of coercive control.

We urge others who feel similarly to contact ONS at CrimeStatistics@ons.gov.uk  or contact us at VISION_Management_Team@city.ac.uk if you would like to discuss.

Note that ONS is planning a raft of further changes with similar implications for trends and analysis of minoritised groups, including:

  • Removal of the sexual victimisation module from next data collection (2025/26), with redevelopment at some future date.
  • Removal and redevelopment of the nature of partner abuse questions, which cover DA survivors service use and police contact and are essential to understanding whether some groups are underserved by services.

These will further undermine continuity of data for trends and the ability to analyse minoritised groups or by protected characteristics.

For researchers interested in combining CSEW waves to enable robust analysis of inequalities by protected characteristics and for minoritised groups, VISION researcher Niels Blom has published syntax: https://vision.city.ac.uk/news/new-possibilities-created-by-crime-survey-wave-integration/.

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The impact and risk factors of adolescent domestic abuse: A rapid systematic review

As a phenomenon, abusive behavior between adolescents in intimate relationships remains relatively invisible, due in part to the persistent yet unfounded assumption that domestic abuse is something that occurs between adults. There is an emerging body of evidence indicating that both victimization and perpetration in intimate partner relationships can and do occur well before adulthood.

This review seeks to improve understandings of intimate partner abuse between adolescents, focusing in particular on younger adolescents below the age of 16 and the impacts and risk and protective factors.

VISION researchers Dr Ruth Weir, Dr Olumide Adisa and Dr Niels Blom, with their collaborators, conducted a rapid systematic review by searching three electronic databases (PsycInfo, Embase, and Social Sciences Citation Index). The team utilized pre-existing systematic reviews to identify relevant primary studies. Findings of the included studies were described and summarized using narrative synthesis.

Seventy-nine studies were identified for inclusion. Synthesis of the findings of these studies identified five categories of risk and protective factors, including bullying and parental intimate partner violence, social and cultural factors, school and neighborhood environment and health and wellbeing. However, the review also identified a gap of qualitative research and a lack of attention to how ADA intersects with cultural factors, gender differences, criminalization, and poor mental health. Many of the studies report on school-based settings, limiting understanding of the role of neighborhood factors in prevention, protection and recovery. Participatory research on help-seeking behaviors of adolescents is rare.

The review synthesized risk and protective factors associated with ADA, especially those occurring between younger adolescents. It highlighted the complex interplay and overlap between using and experiencing violence and abuse and the need for systematic research to inform the development of advocacy, interventions and prevention that is right for young people.

Highlights from the VISION ADA rapid review: Gaps, limitations & considerations for future research

  • Little recent academic interest on ADA in the UK
  • Focus in existing global literature on physical or sexual violence but less so on coercive control or emotional / psychological abuse
  • Lack of systematic examination of long-term consequences of ADA on wellbeing
  • Lack of intersectional analysis (ethnicity, sexual orientation, socioeconomic status, etc)
  • Little exploration of adolescents’ help-seeking behaviours and attitudes to different kinds of possible support
  • Research design limitations

To download the paper: Adolescent Domestic Abuse and Its Consequences: A Rapid Systematic Review | Journal of Family Violence

To cite: Weir, R., Adisa, O., Blom, N. et al. Adolescent Domestic Abuse and Its Consequences: A Rapid Systematic Review. J Fam Viol (2025). https://doi.org/10.1007/s10896-025-00813-4

For more information on this rapid review, please contact Ruth at ruth.weir@city.ac.uk

To view and / or download the list of systematic reviews included in this paper:

SRs included in Weir ADA journal articleDownload

Further ADA research across the VISION consortium:

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Positive experiences can mitigate negative effects in children with trauma

Children with traumatic experiences in their early lives have a higher risk of obesity. But as new research from VISION researcher Dr Ladan Hashemi and colleagues at University of Auckland, New Zealand, demonstrate, this risk can be reduced through positive experiences.

Their analysis of data from around 5,000 children in the Growing Up in New Zealand study revealed nine out of ten faced at least one significant source of trauma by the time they were eight years old. Multiple adverse experiences were also prevalent, with one in three children experiencing at least three traumatic events. Notably, certain traumatic experiences (including physical abuse and parental domestic violence) related more strongly to obesity than others. This highlights the strong connection between early-life adversity and physical health outcomes.

Whilst researching the associations between obesity and childhood trauma, the team also explored the protective and mitigating effects of positive experiences. They defined positive experiences as:

  • mothers interacting well with their children
  • mothers involved in social groups
  • children engaged in enriching experiences and activities such as visiting libraries or museums and participating in sports and community events
  • children living in households with routines and rules, including those regulating bedtime, screen time and mealtimes
  • children attending effective early childhood education

The findings were encouraging. Children with more positive experiences were significantly less likely to be obese by age eight. For example, those with five or six positive experiences were 60% less likely to be overweight or obese compared to children with zero or one positive experience. Even two positive experiences reduced the likelihood by a quarter.

Among children exposed to multiple adversities, positive experiences can help mitigate the negative effects of childhood trauma. However, at least four positive experiences were required to significantly counteract the impact of adverse experiences.

Recommendations

  • Traditional weight-loss programmes focused solely on changing behaviours are not enough to tackle childhood obesity. To create lasting change, children need positive social environments and life experiences as well as support to address the emotional scars of early trauma shaping their lives.
  • Fostering positive experiences is a vital part of this holistic approach. These experiences not only help protect children from the harmful effects of adversity but also promote their overall physical and mental wellbeing. This isn’t just about preventing obesity – it’s about giving children the foundation to thrive and reach their full potential.
  • Sure Start and providers of early childhood education and support for parents could help reduce the health inequalities resulting from exposure to violence.

To download the paper: Identification of positive childhood experiences with the potential to mitigate childhood unhealthy weight status in children within the context of adverse childhood experiences: a prospective cohort study | BMC Public Health

To cite: Mellar, B.M., Ghasemi, M., Gulliver, P. et al. Identification of positive childhood experiences with the potential to mitigate childhood unhealthy weight status in children within the context of adverse childhood experiences: a prospective cohort study. BMC Public Health 25, 8 (2025). https://doi.org/10.1186/s12889-024-20727-y

For further information on the research:

Or for further information, please contact Ladan at ladan.hashemi@city.ac.uk

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Adverse childhood experiences associated with childhood obesity

Adverse childhood experiences (ACEs) are potentially traumatic events or environmental factors occurring during childhood that can disrupt a child’s sense of safety, stability, and bonding. ACEs include child abuse and maltreatment, family dysfunctions, and exposure to violence outside the family. Individuals impacted by ACEs are at greater risk of developing obesity in adulthood, however, few studies have prospectively measured ACEs and obesity during childhood. Associations with the adoption of obesogenic behaviours during childhood, which directly contribute to obesity are also understudied.

VISION researcher Dr Ladan Hashemi, along with colleagues from the University of Auckland, New Zealand, examined associations between individual and cumulative ACEs, obesity, and obesogenic behaviours during childhood (up to age 8). Using data from eight waves of the Growing Up in New Zealand study—the country’s largest birth cohort study—they developed an index to measure nine ACEs: child physical and psychological abuse, witnessing domestic violence against the mother, parental separation or divorce, parental incarceration, parental substance abuse, parental mental illness, peer bullying, and experiences of ethnic discrimination.  Their research, Associations between specific and cumulative adverse childhood experiences, childhood obesity, and obesogenic behaviours, discovered that:

  • ACEs were prevalent among children in New Zealand with almost nine out of ten experiencing at least one ACE. Multiple adverse experiences were also prevalent, with one in three children experiencing at least three traumatic events.
  • Higher ACE scores and experience of each specific ACE were significantly more prevalent among those identified as Māori or Pacific, those living in food insecure households or in the most deprived areas.
  • Experience of two or more ACEs was associated with higher risk of adopting obesogenic behaviours such as excessive consumption of unhealthy foods and drinks, inadequate consumption of fruits and vegetables, inadequate sleep duration, excessive screen time, and physical inactivity. The risk increased as the number of ACEs increased.   
  • Six of nine assessed ACEs were associated with the development of childhood obesity. A dose-response pattern was observed, with obesity risk increasing as the number of ACEs increased.

Exposure to ACEs contributes to the population-level burden of childhood obesity, potentially influencing obesity outcomes through associations with unhealthy, obesogenic behaviours. The findings highlight the importance of a holistic understanding of the determinants of obesity, reinforcing calls for ACEs prevention and necessitating incorporation of ACEs-informed services into obesity reduction initiatives.

Recommendations

  • Childhood obesity reduction efforts may benefit from considering the role of ACEs. Understanding and addressing the social determinants of obesity, such as family and social environments, may be important in the context of traditional behavioural change interventions targeting nutrition, sleep, screen time, and physical activity
  • Interventions that reduce children’s exposure to violence could help reduce levels of obesity and associated ACEs
  • Violence reduction and family support should feature in the government’s Tackling Obesity strategy

To download the paper: Full article: Associations between specific and cumulative adverse childhood experiences, childhood obesity, and obesogenic behaviours

To cite: Hashemi, L., Ghasemi, M., Mellar, B., Gulliver, P., Milne, B., Langridge, F., … Swinburn, B. (2025). Associations between specific and cumulative adverse childhood experiences, childhood obesity, and obesogenic behaviours. European Journal of Psychotraumatology, 16(1). https://doi.org/10.1080/20008066.2025.2451480

Or for further information, please contact Ladan at ladan.hashemi@city.ac.uk

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Adverse childhood experiences in firstborns associated with poor mental health of siblings

Adverse childhood experiences (ACEs) often affect multiple children within families, yet studies tend to focus on the health outcomes of individual children, underestimating the needs of affected families. First author Dr Shabeer Syed (UCL Great Ormond Street Institute of Child Health), VISION Director and Professor Gene Feder, and colleagues aimed to examine the association between firstborns exposed to ACEs between 1 year before and 2 years after birth (the first 1000 days) and the risks of mental health problems, mental health-related health-care contacts, and all-cause hospital admissions in multiple children from the same mother, compared to firstborns without ACEs.

The first-of-its-kind study, published in The Lancet Public Health and funded by the National Institute for Health and Care Research Policy Research Programme, found that mothers whose firstborns had experienced adverse childhood experiences had a 71% increased risk of having children (aged five -18) with mental health problems, compared to mothers whose firstborn did not experience adversity.

This translates to 12 additional children with mental health problems for every 100 mothers whose firstborn experienced adversity.

These findings underscore the pervasive risk that early adversity can have on multiple children in the family, and the importance of early identification and sustained support for vulnerable families beyond the first 1,000 days of a child’s life.

As part of the study, researchers analysed linked GP and hospital health records from 333,048 first-time mothers and their 534,904 children (firstborns and siblings) born in England between 2002 and 2018. They focused on six different forms of adverse childhood experiences in the firstborn child recorded during their first 1,000 days of life (from conception up until the age of two).

These included: child maltreatment, intimate partner violence, maternal substance misuse, maternal mental health problems, adverse family environments (e.g. homelessness), and high-risk presentations of child maltreatment (e.g. unexplained child injuries).

Over a third (37.1%) of firstborn children had at least one recorded adverse childhood experience. The most common adverse childhood experiences were living with maternal mental health problems (21.6%), followed by adverse family environments (14.5%) such as parental criminality and housing instability.

Approximately one in five (19.8%) mothers had at least one child with a recorded mental health problem between the ages of 5 and 18.

The risk of mental health problems was consistent across all siblings, regardless of birth order (firstborn vs thirdborn), in families where the firstborn experienced adverse childhood experiences.

Lead author Dr Syed said: “Whilst previous research has focused on the impact of adverse childhood experiences on individual children, our study reveals a cascading health risk that extends beyond the individual, impacting on the health of siblings as well.

“This likely stems from the continuation of adverse childhood experiences within the family. When a child or parent presents with mental health concerns, violence or other forms of adversity, it’s essential to ask about the wider family context.”

As a result of their findings, the team are also calling for further research into the impact of early health visiting and primary care support.

Co-author, Professor Feder, said: “General practice teams have a key role in identifying first-born children experiencing adverse childhood experiences and in supporting first-time parents to help reduce the impact of adverse childhood experiences on the whole family, including subsequent children.

“We need further evidence for effective interventions to reduce that impact, particularly on mental health.”

Study limitations

The researchers could not investigate adverse childhood experiences related to fathers’ mental health or substance use as healthcare data from fathers could not be linked to their children.

The study found that adverse childhood experiences in firstborns were associated with mental health outcomes in the first and subsequent children, but this does not necessarily mean that adverse childhood experiences cause mental health problems.

Additionally, electronic health-care records underestimate intimate partner violence and child maltreatment due to non-disclosure and/or detection and under-recording by clinicians.

To download the paper: Adverse childhood experiences in firstborns and mental health risk and health-care use in siblings: a population-based birth cohort study of half a million children in England – The Lancet Public Health

Or for further information, please contact Shabeer at s.syed.16@ucl.ac.uk

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Cybercrime victimisation and the association with age, health and sociodemographic characteristics

By Ben Havers, PhD Candidate at the Dawes Centre for Future Crime, University College London

The UK has an ageing population; the Office for National Statistics (ONS, 2024) has predicted that the number of people aged 85 and over will increase from 1.6 million (2.5% of the total population) to 2.6 million (3.5%) over the next 15 years. Concerningly, a recent Age UK report (2024) revealed that more than one in three over 65s lack the basic skills to use the internet successfully. This would suggest that the number of older adults ill-equipped to deal with online threats is set to grow.

This blog describes a recent study conducted by Ben Havers (University College London) and colleagues, including Professor Sally McManus from VISION, exploring how cybercrime victimisation, repeat victimisation and financial impact are associated with age and other sociodemographic and health-related characteristics.

The authors analysed data from the 2019-2020 Crime Survey for England and Wales, an annual national crime victimisation survey carried out by the ONS. The survey is administered via face-to-face interviews with more than 35,000 adults across England and Wales. Participants are asked whether they have been a victim of crime in the past 12 months, and other personal information on topics such as housing, work and health.

Some of the key findings of the study were:

  • People aged 75+ were most likely to experience repeat cybercrime victimisation and associated financial loss than younger demographics.
  • Men were more likely to experience victimisation and repeat victimisation than women. A plausible explanation is that men, who have been found to take more risks than women generally (Hudgens & Fatkin, 1985), may also engage in riskier behaviour or activities online, leaving them more vulnerable to malicious actors.
  • People of Black and mixed/multiple ethnicity were more likely to be cybercrime victims than participants of White ethnicity. Research on the drivers behind ethnic disparities in crime victimisation in the UK and abroad is limited. Salisbury and Upson’s ( 2004) crime survey analysis found that people of Black and minority ethnicity are more likely than White people to fall victim to crime in general. Future research might explore differing patterns and types of internet use, and systemic disadvantages, for example linguistic barriers to safe cyber navigation.
  • Worse cognitive, physical, mental and general health were associated with greater risk, across the ages. This relationship is likely to be bidirectional as poor health might increase the risk of cybercrime (Abdelhamid, 2020) and being a victim of cybercrime may worsen mental health (Rhoads, 2023).

The findings from this study indicate that future developments in online platform and process design, as well as multi-agency collaboration and information sharing, should focus on (a) empowering older adults to detect fraudulent activity before loss is incurred, and (b) removing barriers to reporting so that support can be provided before the individual is victimised a second or third time.

To read or download the article for free: Cybercrime victimisation among older adults: A probability sample survey in England and Wales | PLOS ONE

To cite: Havers, B., Tripathi, K., Burton, A., McManus, S., & Cooper, C. (2024). Cybercrime victimisation among older adults: A probability sample survey in England and Wales. PLOS ONE, 19(12), e0314380. https://doi.org/10.1371/journal.pone.0314380

Or for further information, please contact Ben at benjamin.havers.20@ucl.ac.uk

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Reaching a consensus: Technology-facilitated abuse conceptualisation, definition, terminology, and measurement

The rapid development of digital systems has benefited modern societies but also created opportunities for the proliferation of harms. Specifically, the term ‘technology-facilitated abuse’ (TFA) describes the misuse or repurposing of digital systems to harass, coerce, or abuse. It is a global problem involving both existing and emerging technologies.

TFA is regularly discussed in the context of domestic abuse, where it is perpetrated via a range of systems, including phones, laptops, and tablets, smart home/Internet of things appliances, as well as online accounts, that are either shared or accessed without the partner’s consent. In the United Kingdom, 32% of women and children who sought support for domestic abuse in 2022 to 2023.

The research field lacks comprehensive and standardised measurement tools and in 2022, the UN Secretary-General emphasized that the absence of agreed definitions and measures impedes any efforts to understand the true scale of TFA. Despite significant work across research, policy, and practice to understand the issue, the field operates within linguistic, conceptual, and disciplinary silos, inhibiting collaboration.

To address this, the present study led by Dr Nikolaos Koukopoulos (University College of London) in collaboration with VISION researchers Dr Madeleine Janickyj and Dr Leonie Tanczer used the Delphi technique to reach a consensus on TFA conceptualization, definition, terminology, and measurement among subject experts.

Following a literature review, a global, cross-disciplinary sample of academics, practitioners, and policymakers (n = 316) reflected on TFA across three survey rounds. The results showed both aligned and opposing perspectives. “Technology” and “facilitated” were the most preferable terms. Still, there was uncertainty regarding the need for additional terminologies to denote the scope of abuse, such as gendered descriptors. Participants had little familiarity with existing TFA measurement tools, with two-thirds unaware of any.

Most experts agreed on conceptualising TFA based on the perpetrator’s behaviour, the victim’s harm and impact, and consent. They also supported an expansive TFA definition, beyond intimate relationships, that can involve groups and communities as perpetrators or targets. However, they were more reluctant to perceive TFA as a distinct abuse form, or one guided by social norms, legal thresholds, or involving child perpetrators.

Recommendations:

  • The fragmentation and contrasting conceptualisations of TFA observed in this research underscore the need for greater cross-disciplinary communication among researchers, practitioners, and policymakers to move closer toward a unified understanding of TFA. Some form of standardization is particularly crucial, given the rapidly developing ways existing and emerging technologies are weaponized in the digital realm. Concrete, practical steps could help bridge these divides by consolidating published work into a searchable database. This could include suggestions for conceptually similar terminology across various sectors and subject areas.
  • Furthermore, an interactive online map of key TFA stakeholders and research groups could facilitate greater collaboration and knowledge-sharing, which the research team is now working on.

To download the paper: Defining and Conceptualizing Technology-Facilitated Abuse (“Tech Abuse”): Findings of a Global Delphi Study – Nikolaos Koukopoulos, Madeleine Janickyj, Leonie Maria Tanczer, 2025

To cite the paper: Koukopoulos, N., Janickyj, M., & Tanczer, L. M. (2025). Defining and Conceptualizing Technology-Facilitated Abuse (“Tech Abuse”): Findings of a Global Delphi Study. Journal of Interpersonal Violence, 0(0). https://doi.org/10.1177/08862605241310465

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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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VISION researcher, Lizzie Cook, speaks at Dutch Embassy Just Talk(s) event on femicide

On 10 December 2024, celebrated globally as Human Rights Day and the final day of the 16 Days of Activism against Gender-based Violence campaign, the Dutch Embassy in London organised a panel discussion on femicide and the criminalisation of violence against women and girls.

Lizzie Cook was invited to speak as part of the event which was opened by the Dutch Ambassador Paul Huijts and Liaison Magistrate Wendela Mulder, and moderated by Lotte Wildeboer. The afternoon consisted of talks by Professor Sandra Walklate (of the VISION Advisory Board), Judith van Schoonderwoerd den Bezemer-Wolters (Dutch Public Prosecutor for Domestic and Sexual Violence), Katie Hoeger and Angela Whitaker (VKPP and College of Policing), and Janine Janssen (Dutch Police Academy). The event was part of a series of Just Talk(s) organised by the Dutch Embassy which seek to foster dialogue and exchange ideas on particular issues.

The panel addressed a range of themes including challenges in current definitions of femicide, the implications for data and measurement, and what this means for prevention.

To read more about some of the themes discussed in this panel, do take a look at Lizzie, Sandra and Kate Fitz-Gibbon’s 2023 special subsection of Current Sociology: Re-imagining what counts as femicide which brings together contributions on femicide from the UK, South Africa and Latin America.

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Natural Language Processing: Interrogating free text in mental healthcare records to capture experiences of violence

Violence can be categorised in a variety of ways for example physical, sexual, emotional, and domestic but all cause significant physical and mental morbidity within general populations. Individuals with a severe mental illness have been found to be significantly more likely to experience domestic, physical, and sexual violence compared to the general population. For these individuals, experiences of violence are important risk factors however, this is not routinely collected by mental health services.

In general data on all forms of violence has been inadequately available from healthcare records. This is partly due to the lack of routine enquiry by professionals at points of clinical contact, and partly because instances of violence are difficult to identify in healthcare data in the absence of specific coding systems.

A general challenge for using health records data for research is that the most valuable and granular information is frequently contained in text fields (e.g., routine case notes, clinical correspondence) rather than in pre-structured fields; this includes mentions of violence whether experienced as a victim or perpetrated. Capturing violence experiences across mental healthcare settings can be challenging because most instances are likely to be recorded as unstructured text data. Therefore, natural language processing (NLP), is increasingly in use to extract information automatically from unstructured text in electronic health records, particularly in mental healthcare, on clinical entities.

Dr Ava Mason from Kings College London and VISION researchers Professor Robert Stewart, Dr Angus Roberts, Dr Lifang Li, and Dr Vishal Bhavsar worked with colleagues to apply NLP across different clinical samples to investigate mentions of violence. They ascertained recorded violence victimisation from the records of 60,021 patients receiving care from a large south London NHS mental healthcare provider during 2019. Descriptive and regression analyses were conducted to investigate variation by age, sex, ethnic group, and diagnostic category.

Results showed that patients with a mood disorder, personality disorder, schizophrenia spectrum disorder or PTSD had a significantly increased likelihood of victimisation compared to those with other mental health diagnoses. Additionally, patients from minority ethnic groups for Black and Asian had significantly higher likelihood of recorded violence victimisation compared to White groups. Males were significantly less likely to have reported recorded violence victimisation than females.

The researchers demonstrated the successful deployment of machine learning based NLP algorithms to ascertain important entities for outcome prediction in mental healthcare. The observed distributions highlight which sex, ethnicity and diagnostic groups had more records of violence victimisation. Further development of these algorithms could usefully capture broader experiences, such as differentiating more efficiently between witnessed, perpetrated and experienced violence and broader violence experiences like emotional abuse.

To download the paper: Frontiers | Applying neural network algorithms to ascertain reported experiences of violence in routine mental healthcare records and distributions of reports by diagnosis

To cite: Mason AJC, Bhavsar V, Botelle R, Chandran D, Li L, Mascio A, Sanyal J, Kadra-Scalzo G, Roberts A, Williams M, Stewart R. Applying neural network algorithms to ascertain reported experiences of violence in routine mental healthcare records and distributions of reports by diagnosis. Frontiers in Psychiatry 2024 Sep 10. doi:103389/fpsyt.2024.1181739

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