Domestic violence and mental illness/substance abuse; A survey of 39 refuges

Debbie Hager 2007

Domestic violence and mental illness/substance abuse • Last year at least 257 women were unable to access refuge services because they were perceived to have mental health and/or substance abuse problems. • These women – and their children – are trapped in abusive relationships, with all of the attendant long-term effects of experiencing violence.

Health effects of dv

As well as the injury associated with domestic violence it also causes: • 12% of psychological distress • 7% of physical illness For adult women in NZ

Long Term Effects of Domestic Violence

• Lack of volition • Diminished ability to deal with stress • Being superwoman • Vigilance – constantly watchful • Suspicion • Depression • On going fear - including for the children

Long term effects cont.

• Worn down/Shattered • Isolation • Disassociation • Blocking out – having gaps in their lives • Fragile sense of reality

Effects of dv from the literature

Suicide • Studies from around the world put the statistics of suicide related to domestic violence at: 1/4 of suicides of all women in America, 1/2 of all suicides by African American women and 41% of Fiji Indian women suicides.

Effects of dv from the literature Alcohol abuse.

• About one third of abused women will abuse alcohol or drugs. Most abused women only begin drinking heavily after the abuse has started.

Effects of dv from the literature Mental illness diagnoses

Women who have been abused are diagnosed as suffering from: • major depression • trauma • anxiety disorders including panic attacks • eating disorders • obsessive compulsive disorder • multiple personality and personality disorders.

Effects of dv from the literature

• sleeping disorders • self-neglect • malnutrition • aggression towards ones-self and/or others including repeated self injury • dissociative states • compulsive sexual behaviours • sexual dysfunction or pain

Women I spoke to had been diagnosed as having:

• Clinical depression • Bi-polar disorder • Schizophrenia • Post traumatic stress disorder (finally)

Women start using drugs or alcohol

• As a way of coping with the abuse • Because they are forced to drink or use • Because they are forced to deal (and/or commit other crimes) • Their partner is their dealer • Women already use…

Domestic violence and mental illness/substance abuse • If women access mental health/drug and alcohol services, they run the risk of losing custody of their children to either the state or the abusive partner, and of their partner gaining even more control over them because of the stigma attached to their diagnosis.

Key themes

• Abuse, especially emotional abuse, makes women think they are crazy. • Being labeled results in problems with stigma and discrimination and lowered self esteem and can decrease women ’ s grasp of reality • Women ’ s explanations of their own experience are either not believed or reinterpreted • Services can deepen and reinforce the feelings of abuse. • Abuse must be named

Abuse, especially emotional abuse, makes women think they are crazy

.

•

They, (mental health services) need to understand… that… the most damaging part of domestic violence is actually the unseen part, the emotional. If you can imagine if someone is taking abuse all the time, and someone is telling you you’re no good and someone is telling you you can’t do something, how are you going to end up? You’ll end up feeling…I’m just here to be used and abused, I’m not worth anything else, I can’t do that so I won’t do it. You’ll have no goals, no thoughts, you’ll just get by day by day. For me that was the connection, it wasn’t physical…the worst part is the words, the words are really cruel…Sticks and stones will break your bones but names will never hurt you…but it does hurt

(C1)

•

The effects of being labelled

When I went to Carrington I had a physical illness, I had pleurisy, I was totally worn out. I was bringing up two children on my own because we had separated, and I had just finished a relationship with someone I was in love with for the first time in my life, so I wasn’t really sure about my emotions and that kind of thing. My husband came on the scene because I rang him and said I need your help with the kids because I’m not well. He rang Carrington because I wasn’t sleeping well and he said I was acting strange – but acting strange was I was crying a lot…and I can’t see he had any reason to put me in Carrington

(J5)

Women’s explanations of their own experience are either not believed or reinterpreted.

•

I would have liked to have been listened to…but really listened to. Not just the thing that seems to happen, where people seem to want to talk at me rather than collect what I’m saying (S1)

•

I’m very nervous about going through court. He’s a very powerful, plausible man and I just shrink when I’m in the room with him…He’s got custody of two sets of daughters before. The fact that he’s got this far when he’s not her father just astonishes everybody – it doesn’t astonish me – he’s impressed the professionals all the way along (R2)

Services can deepen and reinforce the feelings of abuse.

•

They were treating me for all these things, bipolar, schizophrenia,… but I wasn’t responding…I was on fifteen drugs, three times a day…I became an addict because of the drugs… (B1)

•

I haven’t had any sign from any psychiatrist … that my anxiety and fear are normal and are linked to other people’s behaviour and actions towards me (S1)

What compounded these feelings?

Institutional abuse, such as: • Not being heard, not believed by the people they accessed for help • Being given psychiatric drugs • Being released into the care of the abuser – from hospital • No-one asking women why they were in the state they were in • Power and control behaviour of professionals

What compounded these feelings?

• Being labelled – the stigma of being crazy • Being told that you are the cause of your own problems • Being counselled about how to change their behaviour so that they wouldn ’ t upset their partners

Study

• 48 refuges - affiliated with the National Collective of Independent Women’s Refuges • Written questionnaire • Followed up with phone calls • Results from 39 refuges

347 women accepted into refuge

• “

Most women do self abuse – they don ’ t come to us until it ’ s the last straw. It ’ s the majority (who have drug and alcohol or mental health problems) because of all the stuff that ’ s happened to them.

”

447 dependant children

•

A woman may have had 6 children, but only come in with two because the others have been taken off her

•

One woman had 6 children removed

•

These children have huge behavioural issues

79 of these 347 women were moved out of refuge

• This affected 81 children • Refuge staff felt that the women were a danger to other residents Or • That they, the staff, didn’t have the expertise to work with them

Outcomes for these women

• • • •

“ All women went back home. Some went back to a dangerous situation.

” “ To friends then to an apartment or motel ” “ Families, home? – outcomes.

” don ’ t know the “ To her friend … touch with her.

” I think another refuge is in

Outcomes for these women

•

“One went home – the other wandered the streets and ended up in the mental health section of the hospital.”

•

“One women went home to the abuser who was her dealer, five were referred to other services, one, unsure – may have gone to Salvation Army emergency housing. One found a home through the City Council.”

Outcomes for these women

•

“ When they leave the refuge they slip through the gap. There is nothing there for them. They end up in the psych ward or on the streets.

”

178 women denied access to refuge

•

“ A lot end up in caravan parks – WINZ pay women ’ s benefits to caravan parks or stick women in cul-de-sacs full of drug addicts and drunks, which women have tried so hard to change and they put them straight back where they come from. Refuge is a safe haven, we see them re-bonding with their children – huge changes, then they move backwards when they have to go into bad housing.

”

Outcomes for women

•

One is still being supported. It ’ s a terrible situation. She ’ s had a stroke, she ’ s very young – it causes mental health and physical problems – he brings in lovers, all sorts of things, there ’ s no-where else for her to go.

”

Outcomes for women and children

• •

“ One child was removed and placed with grandparents.

” “ One mother gave the children over to the care of the father. She is now going through a custody battle to get her children back.

” “ The woman who ended up in hospital met a woman in a park who agreed to look after her children for a few weeks.

”

Bad mothers?

•

“ CYFs become involved because the children are in danger – although the mothers are good mothers, their choice of partners places the children in danger.

”

Refuge

•

“ In the last 12 months there are more and more women with mental health and drug and alcohol issues. There is nowhere else for them to go. Sometimes a mental health worker will ring and ask refuge to take a client. Refuge agrees on condition that it ’ s only one night – but it ’ s always longer.

”

Refuge

•

“ CYFs send women with huge drug issues and expect us to work with them – they even have their babies removed. CYF only pay for 28 days and expect women to be fixed.

”

•

“ One women, a drug addict with 6 children, stayed for a year, we couldn ’ t get her a house.

”

Refuge

•

“ We only manage it (caring for women with mental health problems) by extraordinary means. It ’ s not the easiest task … . I ’ ve slept in cars at people ’ s properties to keep people safe in their homes – you can ’ t even get mental health help and support let alone respite – there is a great shortage of beds in mental health, let alone mental health and domestic violence.

”

Specialised services

• • •

“ Definitely need specialised services. These women fall through the cracks – there is nowhere to go. We don ’ t have the skills to manage women with mental health issues, - don ’ t know how to handle medication ” They (CYF) take children and put them where? It ’ s not like you have this little utopian farm to put them on!

” “ If you ’ re taking drug and alcohol and mental illness you ’ ll be inundated – you ’ ll always be full.

”

Lets do something

•

These women are possibly the most victimised; it was him or abject loneliness. They deserve our utmost compassion.

References for further information

• Debbie Hager • Angela Taft ys.html

• Jacqui Barron rochure.pdf

www.homeworkstrust.org.nz

research, thesis and papers . The thesis and papers have a range of reference material that can be followed up • www.homeworksturst.org.nz

www.austdvclearinghouse.unsw.edu.au/publications • Go to Issues Papers - Violence and pregnancy is Issues Paper no 6 and Mental Health Issues Paper no 8.

• Cathy Humphreys http://www.socialwork.unimelb.edu.au/aboutus/contactus/humphre Publications list http://www.womensaid.org.uk/downloads/WA%20Publications%20B . The easiest way to Jacqui ’ New Zealand s work is by putting her name in the search bit.