Domestic abuse and mental ill-health: Twin shadow pandemics stalk the second wave

The coronavirus crisis has been stalked by two shadow pandemics—one of domestic abuse and one of mental health. Since the first outbreak of the virus, numerous reports have highlighted a marked increase in forms of domestic violence and abuse, especially intimate partner violence and domestic homicide. The pandemic has also been linked to rising rates of mental health issues around the world.

These two phenomena are intrinsically linked: research shows there is a strong association between mental ill-health and domestic abuse. This raises significant concerns as a second wave of the pandemic crashes upon us. Cities, regions and whole countries are going back into lockdown—a measure that has previously been reported to have increased rates of both domestic violence and mental health problems. This time around, we need to be better prepared to support victims and survivors.

Lockdowns exacerbate domestic abuse

UN Secretary General Antonio Guterres has described the rise in domestic violence in 2020 as a "horrifying global surge." Evidence compiled by UN Women from the UK, the United States, France, Australia, Cyprus, Singapore, Argentina, Canada, Germany, and Spain shows a rise in demand for access to women's refuges and other support services this year.

The UK charity Refuge reported a 700% increase in calls during a single day in April and by June calls had risen by 800% compared with pre-lockdown figures. The charity also reported a 300% increase in visits to its National Domestic Abuse Helpline website and a 950% rise in visits to their website.

It is likely that these statistics reflect a glimpse of the overall picture given the known difficulties of reporting abuse, which are now intensified for households where the perpetrator is more frequently or consistently at home due to COVID-19 measures. The incidence and prevalence of domestic violence does tend to increase during any stressful event or emergency, whether it is a natural disaster, or whether it is man-made.

The surge in domestic violence has not just been associated with instructions to stay home, but also linked to the economic and social stresses on households that have resulted from this pandemic. These include the growth in unemployment, uncertainty around furloughing and job security and the effects of social isolation.

The toll on mental health

The results of COVID-19 measures on mental ill-health have been widely covered with concerns that further mental health devastation is imminent as we face a second wave. Infection control measures such as social distancing and shielding lead to a higher risk of mental health problems such as anxiety, fear and sleep disturbances for general populations and can aggravate symptoms for people living with existing mental health conditions.

Research shows women who experience abuse from their partner are three times more likely to suffer depression, anxiety or severe conditions such as schizophrenia or bipolar disorder. Whether these are new or pre-existing problems, this impact is likely to be severe and long-lasting, resulting in more demands placed on already overburdened mental health systems.

The conditions associated with the pandemic have presented heightened risks and barriers to those who want to seek help. People's means and opportunity to contact services may be restricted and access to support networks might be limited or wholly unreachable.

Those with existing mental health conditions might have limited access or difficulty accessing medication or therapy which, in turn, exacerbates mental ill-health. This can trigger self-harm, substance use or suicidal ideation. Every day in the UK, almost 30 women attempt suicide and every week three women take their own lives to escape domestic abuse.

Taking on two problems at once

As we are now at the onset of a second wave of the pandemic, it is likely we'll see another surge in domestic abuse and its associated negative impacts on mental health. Obstacles to accessing support will continue and perhaps multiply during further lockdowns and services will remain frustrated by persistent underfunding and deficient resources in the face of greater demands.

Two already overburdened systems risk becoming even more frayed at the edges in the months to come. To respond to the severe, long-lasting impacts of domestic abuse and mental ill-health following COVID-19, governments should invest in evidence-based research and mainstream interventions that target the connections between the two phenomena. This includes screening for both domestic abuse and mental health problems by practitioners across both sectors, providing online interventions and safety planning. Governments should also encourage different services to work together, through more substantial funding and a policy response which recognizes and responds to these overlapping issues.

COVID-19 will not be the last emergency we face with the potential to increase rates of domestic abuse and mental ill-health. We should use the lessons we have learned from this pandemic to prepare ourselves to better respond to other crises in future. These lessons can also help us understand the impact of emergencies on those experiencing domestic violence and mental-ill health at the same time.