Underexamined and underreported: New briefing on domestic abuse and suicidality

Domestic abuse by a partner is also known as Intimate Partner Violence (IPV). It is defined by the World Health Organization (WHO) as behavior within an intimate relationship which includes acts of physical violence, sexual violence, emotional (psychological) abuse, and controlling behaviors.

"Underexamined and Underreported," is a newly published briefing led by charity Agenda Alliance, and based on a new analysis of research conducted by academics from the VISION consortium at City, University of London.

The briefing suggests that:

• Women who experienced abuse from a partner are three times more likely to have made a suicide attempt in the past year compared to those who have not experienced abuse.
• Women living in poverty are especially at risk. Around half of women (47%) who are unemployed, or are unable to work due to sickness or disability, have experienced domestic abuse from a partner.
• Sexual abuse puts victims at raised risk of self-harm, suicidal thoughts and suicide attempts. With women ten times more likely than men to experience sexual abuse by a partner.

The new analysis is built upon research on responses to questions about suicidal thoughts, suicide attempts and non-suicidal self-harm from the most recent (2014) Adult Psychiatric Morbidity Survey (APMS).

Following the findings of the briefing, Agenda Alliance demands that:

• All public authorities must ensure staff are trained to understand the links between domestic abuse and suicidal thoughts and suicide attempts. This must be backed up with training on and investment in the appropriate response so survivors get the right support.
• A statutory duty should be placed on professionals working across public services, including health, justice, education and welfare to routinely ask whether people are safe. It should become standard practice for midwives, Job centers, Citizens Advice Bureaus, police and probation to make sensitive enquiries to establish whether women and girls have experienced violence and abuse. A routine enquiry about personal safety must be backed up with access to specialist advocates, helplines, refuges and support networks.
• Reduce the likelihood of economic abuse by improving women's opportunities to leave abusers. In particular, changes to how Universal Credit is paid being urgently needed. In 95% of cases of abuse by a partner, there is economic abuse. Household universal credit (UC) payments must be separate by default. Individual benefits must increase annually in line with inflation to ensure that poverty is not a barrier to those leaving abusers.
• In cases of suicides or unexpected deaths the police must record and investigate for history of domestic abuse. Police officers working on initial enquiries should make reasonable checks for a known history of domestic abuse crimes, to gain a full picture of the likely/probable causes of death and to make it more likely that perpetrators can be held to account to secure justice.
• All national policies and strategies, including the National Suicide Prevention Strategy (planned for 2023), the Tackling Violence Against Women and Girls Strategy and the Women's Health Strategy must explicitly recognize the links between gender, abuse by a partner and self-harm and suicidality. These strategies must make particular reference to the needs of Black, Asian, minoritised and migratised women and those with muiltiple unmet needs.
• Provide sufficient and long-term funding for domestic and sexual abuse charities and specialist service providers. Support services for women and girls in poverty, Black, Asian, minoritised and migratised women and girls, LBTQ+ survivors and those with disabilities must be appropriately provided for, taking into account the effect of systemic disadvantages.

Sally McManus, Senior Lecturer in Health at the Violence and Society Center based at City, University of London, led the research and new analysis used in the briefing. She said, "This new analysis casts light on a crucial but neglected topic, showing that when a woman presents to services in suicidal distress it is likely that she's a victim of domestic abuse. That likelihood rises for people living in poverty, especially those who are unemployed or disabled.

"Professionals working in job centers, housing associations and other welfare services have frequent contact with women facing financial stress and debt. It's vital that welfare professionals, as well as those working in health and social care, recognize the very high rates of domestic abuse experienced by such women, and are aware of the extent to which their distress can manifest in self-harm and suicidality. They should be trained to ask people if they are safe and supported to act accordingly."

Jess Southgate, Deputy CEO of Agenda Alliance said, "It is shameful that the clear link between domestic abuse and suicidal feelings amongst women has not previously been recognized as the public health crisis that it is. We at Agenda Alliance know that the most marginalized women are often those most at risk. Yet time and again their needs and experiences are overlooked. In the ongoing cost-of-living crisis it is essential that women are not left trapped in abusive situations.

"All public service professionals must be trained to ask if women are safe, and to support them to get the help they need. With a new Suicide Prevention Strategy promised this year, now is the time to demand appropriate action, training and support."