Despite increased prevalence of domestic violence and abuse (DVA), victimization through DVA often remains undetected in mental health care. To estimate the effectiveness of a system provider level training intervention by comparing the detection and referral rates of DVA of intervention community mental health (CMH) teams with rates in control CMH teams. We also aimed to determine whether improvements in knowledge, skills and attitudes to DVA were greater in clinicians working in intervention CMH teams than those working in control teams. We conducted a cluster randomized controlled trial in two urban areas of the Netherlands. Detection and referral rates were assessed at baseline and at 6 and 12 months after the start of the intervention. DVA knowledge, skills and attitudes were assessed using a survey at baseline and at 6 and 12 months after start of the intervention. Electronic patient files were used to identify detected and referred cases of DVA. Outcomes were compared between the intervention and control teams using a generalized linear mixed model. During the 12-month follow-up, detection and referral rates did not differ between the intervention and control teams. However, improvements in knowledge, skills and attitude during that follow-up period were greater in intervention teams than in control teams: β 3.21 (95% CI 1.18-4.60). Our trial showed that a training program on DVA knowledge and skills in CMH teams can increase knowledge and attitude towards DVA. However, our intervention does not appear to increase the detection or referral rates of DVA in patients with a severe mental illness. A low detection rate of DVA remains a major problem. Interventions with more obligatory elements and a focus on improving communication between CMH teams and DVA services are recommended.

尽管家庭暴力和虐待 (DVA) 的发生率有所上升，但在精神卫生保健中，通过 DVA 造成的受害往往仍未被发现。通过将干预社区心理健康 (CMH) 团队的 DVA 检测率和转介率与对照 CMH 团队的检测率和转诊率进行比较，评估系统提供者级别培训干预的有效性。我们还旨在确定干预 CMH 团队中的临床医生对 DVA 的知识、技能和态度的改善是否比控制团队中的临床医生更大。我们在荷兰的两个城市地区进行了一项整群随机对照试验。在基线以及干预开始后 6 个月和 12 个月时评估检测率和转诊率。通过基线调查以及干预开始后 6 个月和 12 个月的调查来评估 DVA 知识、技能和态度。电子患者档案用于识别检测到和转诊的 DVA 病例。使用广义线性混合模型比较干预组和控制组之间的结果。在 12 个月的随访期间，干预组和控制组之间的检测率和转诊率没有差异。然而，在随访期间，干预小组在知识、技能和态度方面的改善比对照组更大：β 3.21 (95% CI 1.18-4.60)。我们的试验表明，CMH 团队的 DVA 知识和技能培训计划可以增加对 DVA 的了解和态度。然而，我们的干预措施似乎并没有提高严重精神疾病患者 DVA 的检出率或转诊率。 DVA 检出率低仍然是一个主要问题。 建议采取更具强制性要素的干预措施，并重点改善 CMH 团队和 DVA 服务之间的沟通。