What are some reasons that people with SMI may not disclose domestic violence against them?

People with SMI are at increased risk of becoming victims of domestic violence than those in the general population without SMI [1]. A literature review found that females were at higher risk than males [1]. Those with SMI may be afraid to disclose domestic violence because of fear of the consequences including shame, loss of benefits, child custody issues, fear of not being believed, and fear that disclosure may lead to further violence [2] among others. Some patients may fear they will not be believed or even blamed by health professionals [3]. Providers should encourage all patients to freely discuss domestic violence concerns.

There are many resources available to help clinicians help those with domestic violence concerns. These include the National Domestic Violence Hotline and numerous webinars from the SAMHSA Prevention Technology Transfer Center Network (PTTC). SAMHSA also offers a guide on Substance Abuse Treatment and Domestic Violence.

REFERENCES:

1. Trevillion K, Oram S, Feder G, Howard LM. Experiences of domestic violence and mental disorders: a systematic review and meta-analysis. PloS one. 2012;7(12).
2. Rose D, Trevillion K, Woodall A, Morgan C, Feder G, Howard L. Barriers and facilitators of disclosures of domestic violence by mental health service users: qualitative study. The British Journal of Psychiatry. 2011 Mar;198(3):189-94.
3. Hegarty K. Domestic violence: the hidden epidemic associated with mental illness. the British journal Of psychiatry. 2011 Mar;198(3):169-70.