Transcript Document

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
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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.
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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
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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:
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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? – don’t know the
outcomes.”
• “To her friend… I think another refuge is in
touch with her.”
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
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Debbie Hager www.homeworkstrust.org.nz New Zealand
research, thesis and papers . The thesis and papers have a range of
reference material that can be followed up
www.homeworksturst.org.nz
Angela Taft 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
ys.html Publications list
Jacqui Barron
http://www.womensaid.org.uk/downloads/WA%20Publications%20B
rochure.pdf. The easiest way to Jacqui’s work is by putting her
name in the search bit.