“Domestic violence is a crime, and no one deserves to feel controlled, threatened, be assaulted or to live in fear.”
That is the view of consultant psychiatrist Prof Gautam Gulati of the University of Limerick's school of medicine. It is a timely observation, following an investigation he undertook with consultant psychiatrist Prof Brendan D Kelly of Trinity College Dublin into domestic violence during the Covid-19 pandemic, and published in the International Journal of Law and Psychiatry.
Prof Gulati says that Covid-19-related measures seem to be associated with an increased risk of domestic violence: “Social isolation, exposure to financial and psychological stressors, an increase in negative coping mechanisms – such as alcohol or substance misuse – appear to play a part. For victims, an inability to access support mechanisms or escape abusive households, owing to quarantine measures or travel restrictions, heightens vulnerability.”
Prof Gulati and Prof Kelly cite evidence showing that since governments around the world restricted travel to prevent the spread of Covid-19, concerns about domestic violence have been expressed in many countries, including China and Italy.
"And in Ireland, " Prof Gulati explains, "there is evidence that An Garda Síochána received 25 per cent more domestic violence-related calls in April/May 2020 compared to a year earlier. Organisations who play a crucial role in supporting victims also reported substantial increases in calls for help. This rise is in keeping with the international picture seen in countries such as France, China, Italy, and the UK."
Global challenge
And the nature of this global challenge is confirmed by research Frontiers | Editorial: New Perspectives on Domestic Violence: From Research to Intervention | Psychology reporting that one in four women in EU member states have been affected by domestic violence, with consequences including "lack of self-esteem, feeling shame and guilt, difficulties in expressing negative feelings, hopelessness and helplessness, which, in turn, lead to difficulties in using good coping strategies, self-management, and mutual support networks".
Prof Gulati and Prof Kelly considered whether mental health services have a specific role to play in addressing increased domestic violence during this pandemic, and they make three main points.
First, although there is an association between mental illness and violence, the vast majority of people with mental illness will never be violent;
If you are suffering domestic violence right now, get out of the situation as best you can
Second, people with severe mental illness are at increased risk of becoming victims of domestic violence;
And third, as the Covid-19 pandemic has evolved, “referral rates to mental health and psychology services decline during lockdowns, despite a likely increase in psychological distress, victimisation and mental illness”.
Gulati and Kelly are concerned at the possibility “that many people are not seeking help owing to fears that services are overwhelmed, and that attending face-to-face appointments might put them at risk.”
Mental health services
Yet, as Prof Gulati emphasises, mental health services are key to providing continuity of care, especially for marginalised populations such as the homeless; people with severe illness; people with comorbid drug or alcohol use disorders; and the many people with mental illness who live in poverty: “A lack of consistent and assertive follow-up,” Prof Gulati argues, “will increase risks of mental illness, physical ill-health – including Covid-19 – and domestic violence, especially among potential victims who may depend on mental health services for safety, advocacy and facilitating the wellbeing of their children. It is therefore vital that parity of esteem is maintained for mental and physical health services over the course of this pandemic.”
What practical steps can be taken by victims of domestic violence?
Prof Kelly is clear: “If you are suffering domestic violence right now, get out of the situation as best you can. Do your best to adhere to the public health guidelines and restrictions as you do so, but remember that your personal safety, and that of your children, is an urgent matter, even in a pandemic.”
Some countries have developed phone apps allowing victims to seek help and make hotel rooms available for those at risk
Prof Kelly further advises that if necessary, ring your local Garda station or, in an emergency, 999. "You can also ring the Women's Aid National Freephone Helpline on 1800 341 900," he says, adding that the helpline is open 24 hours a day, seven days a week: "If you feel you cannot do these things, reach out to someone with whom you can talk: a family member, a friend or someone else. Remember, the Covid-19 pandemic and the public health restrictions do not mean that anyone has to stay in a situation of domestic violence."
Phone apps
Offering a broader perspective, Prof Gulati notes that some countries in Europe have developed phone applications allowing victims to seek help and make empty hotel rooms available for those at risk. Addressing domestic violence, explains Prof Gulati, requires a careful combination of legal measures – arresting perpetrators, barring orders, safety orders; societal responses – bystander responses, advocacy services, shelters; and heightened awareness in frontline community services like medical services, where victims can present with physical or psychological trauma, sexually-transmitted infections, neglect or other sequelae of abuse. "There are key roles," he says, "for mental health services in the identification and management of certain risk factors like substance misuse and providing support, advocacy and treatment services to victims.
“It is crucial that both mental health services and the charities sector, which supports victims, are supported by governmental policy and adequate resourcing through the pandemic.”
Supporting charities
And Prof Gulati and Prof Kelly further underline the importance of supporting charities such as Women’s Aid “who provide an indispensable service and are often the first point of contact for victims”.
In 1993 the World Conference on Human Rights asserted that violence against women is a human rights concern, affecting their fundamental human dignity. Delegates' demands included the elimination of sexual harassment and the eradication of conflicts between the rights of women and the harmful effects of "certain traditional practices, cultural prejudice and religious extremism".
Almost three decades later, the work of Profs Gulati and Kelly reminds us of the continuing importance of that message.
Read: ‘It’s the kids we don’t know about. That is the worry’
