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On the Margins: the Challenges of Identifying Domestic Violence in Mental Health Services. Findings of a Qualitative Irish Study
Journal of Family Violence ( IF 2.7 ) Pub Date : 2020-10-19 , DOI: 10.1007/s10896-020-00205-w
Elaine Donnelly , Stephanie Holt

Although the relationship between mental ill health and the experience of domestic violence (DV) is well established, service users frequently report an absence of appropriate professional responses to disclosures. This study explored how professionals in an Irish mental health (MH) setting understand, identify and respond to DV in a multidisciplinary practice context. An exploratory qualitative approach using semi structured focus group interviews was employed. The data consisted of six focus group interviews with occupational therapists, nurses, consultant psychiatrists, junior doctors, social workers and psychologists working in acute MH care (n-27) in Ireland in 2018. Data was analyzed using Braun and Clarke’s Qualitative research in psychology, 3(2), 77-101, Braun and Clarke (2006) six stages of thematic analysis. Study findings suggest that a prevailing medical model along with an exclusive focus on physical forms of violence shaped the [in]visibility of the DV in this practice setting. DV issues were marginalized from MH care due to its construction as a social problem, with resultant patient needs related to DV not considered within the remit of MH services. This disconnected construction was influenced by several factors including training and education, fear, professional roles and team working in a dominant medical model. This study supports the need for conceptual frameworks that do not marginalize issues of DV in the discourse of MH care delivery but provide a foundation for service user centered collaboration across professional disciplines. The potential benefits of trauma informed care models in increasing recognition and response to DV in MH services are indicated by the present study.



中文翻译:

关于利润:在心理保健服务中识别家庭暴力的挑战。定性爱尔兰研究的结果

尽管精神疾病与家庭暴力(DV)的关系已经很好地建立了关系,但服务使用者经常报告缺乏对披露的适当专业回应。这项研究探索了爱尔兰精神卫生(MH)环境中的专业人员如何在多学科实践环境中理解,识别和应对DV。采用半定性焦点小组访谈的探索性定性方法。数据包括2018年在爱尔兰接受急性MH护理的职业治疗师,护士,顾问精神病学家,初级医生,社会工作者和心理学家的六个焦点小组访谈(n-27)。使用Braun和Clarke的心理学定性研究对数据进行了分析。,3(2),77-101,Braun and Clarke(2006)六个阶段的主题分析。研究结果表明,一种流行的医学模式以及对暴力形式的专门关注,在这种实践环境中塑造了DV的隐身性。由于MH护理被视为社会问题,因此DV护理在MH护理中处于边缘地位,因此在MH服务范围内未考虑与DV相关的患者需求。这种脱节的建设受到多种因素的影响,包括培训和教育,恐惧,专业角色以及在主要医学模型中的团队合作。这项研究支持对概念框架的需求,这些概念框架不能在MH护理提供过程中边缘化DV问题,但可以为跨专业领域的以服务用户为中心的协作提供基础。

更新日期:2020-10-19
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