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Influence of Domestic Violence on Mental Health

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (1 November 2022) | Viewed by 31460

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Special Issue Editors

Dr. Krim K. Lacey

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Chief Guest Editor

College of Arts, Sciences and Letters, University of Michigan-Dearborn, Dearborn, MI 48128, USA
Interests: intimate partner violence; mental and physical health; race and ethnicity; migration; Caribbean studies; inequality
Special Issues, Collections and Topics in MDPI journals

Dr. Rohan D. Jeremiah

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Assistant Guest Editor

Department of Human Development Nurse Science, University of Illinois-Chicago, College of Nursing, Chicago, IL, 60612, USA
Interests: trauma; substance use; HIV/AIDS; domestic violence; marginalized and vulnerable populations

Special Issue Information

Dear Colleagues,

We are extending this Special Issue call for papers on an important pervasive social problem that impacts the health and well-being of individuals. Characterized by such acts as physical abuse, psychological/emotional abuse, sexual abuse, economic abuse, and child abuse (ACE), years of research has indicated that that domestic violence can negatively and profoundly affect the mental health of its victims. As studies continue to illuminate the consequences of domestic violence, the scientific literature is still limited on: (1) the underlying factors that might exacerbate the intersection between domestic violence and mental health—a particular focus on the type of violence (i.e., physical, emotional, sexual abuse); and mental health outcomes (i.e., substance use, anxiety disorders, suicide); (2) whether certain (i.e., marginalized, vulnerable, and underrepresented) populations might exhibit unique mental health outcomes; and (3) how social and contextual factors (i.e., neighborhood characteristics, migratory factors, disaster/hazard-prone settings, discrimination) mitigate the relationship between domestic violence and mental health. We therefore call for papers that examine the relationship between domestic violence on mental health in order to expand and further our understanding of the association to inform the development of interventions. We especially welcome unpublished research that addresses social and contextual influences at that intersection specifically for underrepresented populations in the global context.

Dr. Krim K. Lacey
Dr. Rohan D. Jeremiah
Guest Editors

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Keywords

Domestic violence
Mental health
Social context
Environmental conditions
Systems of oppression
Underrepresented populations
Vulnerable groups

Published Papers (13 papers)

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23 pages, 1386 KiB

Open AccessArticle

Changes in Mental Health, Emotional Distress, and Substance Use Affecting Women Experiencing Violence and Their Service Providers during COVID-19 in a U.S. Southern State

by April Schweinhart, Camila Aramburú, Rachel Bauer, Ashley Simons-Rudolph, Katharine Atwood and Winnie Kavulani Luseno

Int. J. Environ. Res. Public Health 2023, 20(4), 2896; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20042896 - 07 Feb 2023

Viewed by 1472

Abstract

Research conducted during the COVID-19 pandemic has revealed many unintended consequences of mandated safety precautions, including increased perpetration of intimate partner violence (IPV), increases in substance use, and worsening mental health conditions. We conducted a repeated, cross-sectional survey of survivors of IPV, a longitudinal survey of service providers working in an IPV shelter, and interviews with both. We conducted surveys at the beginning of the pandemic and nearly half a year later to assess mental health and, for clients, substance use. Results showed that two small samples of survivors living in the shelter in 2020 and 2021 experienced both mental health decline and increased use of substances. Qualitative data from in-depth interviews suggest that COVID-19-related restrictions mirrored survivors’ experiences of power and control in violent relationships. Further, IPV service providers—essential workers during COVID-19—experienced stress associated with reports of burnout and mental fatigue. This study suggests that community-based organizations can help mitigate the impacts of COVID-19 on survivors of IPV but should avoid adding additional work for staff as service providers experienced mental and emotional stress. Full article

(This article belongs to the Special Issue Influence of Domestic Violence on Mental Health)

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19 pages, 3098 KiB

Open AccessArticle

Effects of the Response to the COVID-19 Pandemic on Assault-Related Head Injury in Melbourne: A Retrospective Study

by Juan F Domínguez D, Johnny Truong, Jake Burnett, Lata Satyen, Hamed Akhlaghi, Julian Stella, Nick Rushworth and Karen Caeyenberghs

Int. J. Environ. Res. Public Health 2023, 20(1), 63; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20010063 - 21 Dec 2022

Viewed by 1521

Abstract

Assault is the leading preventable cause of death, traumatic brain injury (TBI), and associated mental health problems. The COVID-19 pandemic has had a profound impact on patterns of interpersonal violence across the world. In this retrospective cross-sectional study, we analysed medical records of 1232 assault victims (domestic violence: 111, random assault: 900, prison assault: 221) with head injuries who presented to the emergency department (ED) at St Vincent’s Hospital in Melbourne, Australia, a city with one of the longest and most severe COVID-19 restrictions worldwide. We examined changes in prevalence in the assault group overall and in domestic violence, random assault, and prison assault victims, comparing data from 19.5 months before and after the first day of COVID-19 restrictions in Melbourne. Moreover, we investigated differences driven by demographic factors (Who: age group, sex, and nationality) and clinical variables (Where: assault location, and When: time of arrival to the ED and time from moment of injury until presentation at ED). Descriptive statistics and chi-square analyses were performed. We found the COVID-19 pandemic significantly affected the Where of assault-related TBI, with a shift in the location of assaults from the street to the home, and the increase at home being driven by random assaults on middle-aged adults. Overall, we observed that 86% of the random assault cases were males, whereas 74% of the domestic assault cases were females. Meanwhile, nearly half (44%) of the random assault victims reported alcohol consumption versus a fifth (20%) of domestic violence victims. These findings will have direct implications for developing screening tools and better preventive and ameliorative interventions to manage the sequelae of assault TBI, particularly in the context of future large-scale health crises or emergencies. Full article

(This article belongs to the Special Issue Influence of Domestic Violence on Mental Health)

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18 pages, 535 KiB

Open AccessFeature PaperArticle

Suicidal Behaviour as an Emerging Factor in Female Victims of Gender-Based Violence within a Relationship: An Exploratory Study

by Ismael Puig-Amores, Isabel Cuadrado-Gordillo and Guadalupe Martín-Mora-Parra

Int. J. Environ. Res. Public Health 2022, 19(22), 15340; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192215340 - 20 Nov 2022

Cited by 1 | Viewed by 1690

Abstract

Intimate partner violence (IPV), in addition to being an important public health problem, is a risk factor for suicidal behaviour (SB). The objective of this study was to explore the risk of suicidal behaviour associated with the different forms of abuse and the consequences derived from it. This exploratory study was conducted on a sample of women who experienced IPV (N = 70) in the Extremadura Region (Spain). Demographic factors, abuse experience, suicidal ideation (SI), suicidal communication (SC), and suicide attempts (SAs) were analysed according to the type of abuse. We found that a very high prevalence of psychological violence (IPVp) was accompanied, in most cases, by some other type of abuse (IPVp+). Additionally, a significant relationship was found between IPV and SB. Logistic regression revealed a greater risk of SI and SA in the IPVp+ group. The results of this study could be useful to healthcare service professionals in preventing suicidal behaviour. Full article

(This article belongs to the Special Issue Influence of Domestic Violence on Mental Health)

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13 pages, 351 KiB

Open AccessArticle

Using Mindfulness to Improve Mental Health Outcomes of Immigrant Women with Experiences of Intimate Partner Violence

by Ashley Vroegindewey and Bushra Sabri

Int. J. Environ. Res. Public Health 2022, 19(19), 12714; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191912714 - 05 Oct 2022

Cited by 3 | Viewed by 1973

Abstract

Immigrant women are disproportionately affected by intimate partner violence (IPV), which poses risk for mental health problems, such as PTSD and depression. Post-migration barriers limit immigrant women’s access to supportive services, which can further debilitate their mental health symptoms and their safety. The Being safe, Healthy, and Positively Empowered (BSHAPE) digital intervention was designed to address physical safety and healthcare needs of immigrant women through a multi-component approach that integrated mindfulness-based stress reduction (MBSR) practices. This paper reports qualitative feedback findings from eighteen Black immigrant women with recent IPV exposure and co-occurring mental health symptoms, who participated in the mindfulness sessions of BSHAPE. We identified elements of mindfulness that women perceived as beneficial in their healing. Women’s feedback indicated healing and empowerment through positive appraisals and coping strategies. The benefits were noted for mindfulness elements promoting self-compassion, self-actualization, intentionality of moving forward in life, and developing positivity or a sense of optimism. Other helpful elements were relaxation, self-care and reflection, self-awareness, self-control and focused thinking. Our findings show that incorporating mindfulness practices in interventions can be beneficial for promoting the healing and empowerment of immigrant women in abusive relationships. Full article

(This article belongs to the Special Issue Influence of Domestic Violence on Mental Health)

16 pages, 1109 KiB

Open AccessArticle

PTSD and Depression Symptoms Increase Women’s Risk for Experiencing Future Intimate Partner Violence

by Katherine M. Iverson, Fernanda S. Rossi, Yael I. Nillni, Annie B. Fox and Tara E. Galovski

Int. J. Environ. Res. Public Health 2022, 19(19), 12217; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191912217 - 26 Sep 2022

Cited by 2 | Viewed by 1768

Abstract

Psychological distress may impact women’s risk for future intimate partner violence (IPV). Yet, limited research has utilized longitudinal research designs and there is a scarcity of research looking at the three most commonly implicated mental health factors—posttraumatic stress disorder (PTSD), depression, and alcohol use—within the same study. Research is especially scarce for women veterans, who experience substantial risk for these mental health concerns and experiencing IPV. This study examined the role of PTSD symptoms, depression symptoms, and alcohol use in increasing risk for experiencing future IPV while simultaneously accounting for the impact of recent IPV experience on subsequent mental health. This study included a sample of 1921 women veterans (M_age = 36.5), who were asked to complete three mail surveys over the course of 8 months as part of a larger longitudinal survey study of US veterans’ health and well-being. The survey assessed experiences of IPV, PTSD symptoms (PCL-5), depression symptoms (PHQ-9), and alcohol use (AUDIT-C) at each of the three time points. Results from separate path analysis models provided support for the role of PTSD symptoms and depression symptoms (but not alcohol use) in increasing risk for IPV experience over time. However, the path analysis models provided little support, with the exception of PTSD, for the impact of IPV experience on subsequent mental health symptoms. Findings point to the importance of better understanding the mechanisms by which PTSD and depression symptoms can increase risk for IPV to inform theory and prevention and treatment efforts. Detection and treatment of PTSD and depression symptoms among women may help reduce risk for future violence in intimate relationships. Full article

(This article belongs to the Special Issue Influence of Domestic Violence on Mental Health)

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20 pages, 1293 KiB

Open AccessArticle

The Post-Traumatic Growth Journey of Women Who Have Survived Intimate Partner Violence: A Synthesized Theory Emphasizing Obstacles and Facilitating Factors

by Hulda S. Bryngeirsdottir, Denise Saint Arnault and Sigridur Halldorsdottir

Int. J. Environ. Res. Public Health 2022, 19(14), 8653; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19148653 - 16 Jul 2022

Cited by 4 | Viewed by 3358

Abstract

Suffering intimate partner violence (IPV) is a devastating personal experience and post-traumatic growth (PTG) is a positive, psychological change in a person, following trauma such as IPV. There is a gap in the literature when it comes to theories on PTG after surviving IPV. The aim of this theory development was to synthesize an approach to understanding the PTG journey of female IPV survivors. According to our theory, their PTG journey includes eight main components: 1. The women’s early experience of trauma, 2. The consequences of that trauma, 3. Their experiences of IPV, 4. The consequences of IPV, 5. The facilitating factors to PTG, 6. The hindering factors to PTG, 7. Their experience of PTG, and 8. The lingering effects of IPV. According to our findings, PTG is a real possibility for female IPV survivors, and it is likely to improve their mental health, well-being, and quality of life, as well as that of their children, loved ones, and communities, thereby decreasing the damaging effects of IPV. The theory can be useful for professionals when guiding female survivors of IPV to promote their recovery and healing. Due to the lack of research in this field, additional research is needed to further develop this theory. Full article

(This article belongs to the Special Issue Influence of Domestic Violence on Mental Health)

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15 pages, 382 KiB

Open AccessArticle

The Effect of Adverse Mental Health and Resilience on Perceived Stress by Sexual Violence History

by Katherine M. Anderson, Kiyomi Tsuyuki, Alexandra Fernandez DeSoto and Jamila K. Stockman

Int. J. Environ. Res. Public Health 2022, 19(8), 4796; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19084796 - 15 Apr 2022

Cited by 4 | Viewed by 2468

Abstract

Sexual violence, including nonconsensual sexual initiation and rape, remains pervasive, with impacts including adverse mental health and dysregulated stress response. Resilience is a promising interventional target. To advance the science, we examined the potential for resilience as an interventional tool by estimating associations between resilience, adverse mental health, and perceived stress among women by sexual violence history and partner perpetration. We analyzed 2018–2020 baseline survey data from 65 women enrolled in a prospective case-control study of sexual violence and HIV susceptibility in San Diego, CA. Multiple linear regressions were performed to examine associations, stratified by sexual violence history. About half of women experienced nonconsensual sexual initiation and/or rape; half of rapes were partner-perpetrated. Post-traumatic stress disorder (PTSD) was significantly associated with perceived stress among survivors (in regressions with depression and resilience, nonconsensual initiation: β = 6.514, p = 0.003, R² = 0.616; rape: β = 5.075, p = 0.030, R² = 0.611). Resilience was associated with lower perceived stress for all women; the effect appeared stronger among survivors of sexual violence (nonconsensual initiation: β = −0.599, p < 0.001 vs. β = −0.452, p = 0.019; rape: β = −0.624, p < 0.001 vs. β = −0.421, p = 0.027). Partner perpetration of rape was not associated with perceived stress. Our findings support leveraging resilience and addressing PTSD to reduce perceived stress among women with lifetime experiences of sexual violence. Full article

(This article belongs to the Special Issue Influence of Domestic Violence on Mental Health)

19 pages, 627 KiB

Open AccessArticle

Women Tell All: A Comparative Thematic Analysis of Women’s Perspectives on Two Brief Counseling Interventions for Intimate Partner Violence

by Danielle R. Shayani, Sara B. Danitz, Stephanie K. Low, Alison B. Hamilton and Katherine M. Iverson

Int. J. Environ. Res. Public Health 2022, 19(5), 2513; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19052513 - 22 Feb 2022

Cited by 3 | Viewed by 2959

Abstract

Background: Intimate partner violence (IPV) is a significant public health problem that is commonly experienced by women and associated with psychosocial health issues. Recovering from IPV through Strengths and Empowerment (RISE) is a brief, clinician-administered, variable-length (1–6 sessions), modular, individualized psychosocial counseling intervention developed for women experiencing IPV. We present qualitative feedback and quantitative helpfulness ratings from women patients of the Veterans Health Administration who completed a randomized clinical trial (RCT) comparing RISE to a clinician-administered advocacy-based Enhanced Care as Usual (ECAU; a single structured session consisting of psychoeducation, safety-planning, resources, and referrals). Methods: 58 participants (_Mage = 39.21) completed post-intervention semi-structured qualitative interviews, including helpfulness ratings, at two follow-up assessments (10- and 14-weeks post-enrollment) to assess the acceptability, usefulness, and perceived fit of the interventions for women’s needs. Interviews were transcribed and analyzed using a hybrid deductive-inductive analytic approach. Results: While both the RISE and ECAU interventions were deemed helpful (interventions were rated as ‘highly helpful’ by 77% of RISE and 52% of ECAU participants), differences were identified in perceived impacts of the intervention, application of content, approach to patient-centeredness, and implementation recommendations. Conclusions: Findings shed light on women Veterans’ experiences and preferences for IPV psychosocial counseling interventions. Such knowledge can inform evidence-based, trauma-informed, and individualized care for women Veterans who experience IPV and may have relevance to other populations of women who experience IPV. Full article

(This article belongs to the Special Issue Influence of Domestic Violence on Mental Health)

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13 pages, 339 KiB

Open AccessArticle

Physical Intimate Partner Violence, Childhood Physical Abuse and Mental Health of U.S. Caribbean Women: The Interrelationship of Social, Contextual, and Migratory Influences

by Krim K. Lacey, Regina Parnell, Sasha R. Drummond-Lewis, Maxine Wood and Karen Powell Sears

Int. J. Environ. Res. Public Health 2022, 19(1), 150; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19010150 - 23 Dec 2021

Cited by 2 | Viewed by 3192

Abstract

The literature has shown an increased risk for mental health conditions among victims of domestic violence. Few studies have examined the relationship between mental health disorders and domestic violence among Caribbean women, and how the association might be influenced by migratory and contextual factors. This study addresses the mental well-being of U.S. Caribbean Black women victims of domestic violence, and the relationships between acculturation, discrimination, and demographic influences. An analysis of data from the 2001–2003 National Survey of American Life (NSAL) re-interview, the first and most complete study on U.S. Caribbean Blacks, was conducted. Bivariate analysis revealed an association between acts of physical domestic violence and mental health conditions, with generally higher risk among women who reported both severe physical intimate partner violence and childhood physical abuse. Multivariate logistic regression indicates an association between specific mental disorders and acts of domestic violence. Acculturation, length of residence in the United States, age, education, poverty, and country of origin were also associated with mental health. The study highlights future directions for exploration including additional investigation of the influence of acculturation on the physical health of victims of domestic violence. Full article

(This article belongs to the Special Issue Influence of Domestic Violence on Mental Health)

13 pages, 367 KiB

Open AccessFeature PaperArticle

Interrelationships of Economic Stressors, Mental Health Problems, Substance Use, and Intimate Partner Violence among Hispanic Emergency Department Patients: The Role of Language-Based Acculturation

by Carol B. Cunradi, Raul Caetano, William R. Ponicki and Harrison J. Alter

Int. J. Environ. Res. Public Health 2021, 18(22), 12230; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212230 - 21 Nov 2021

Cited by 1 | Viewed by 1855

Abstract

We analyzed the interrelationships of economic stressors, mental health problems, substance use, and intimate partner violence (IPV) among a sample of Hispanic emergency department patients and probed if Spanish language preference, which may represent low acculturation and/or immigrant status, had a protective effect, in accordance with the Hispanic health paradox. Study participants (n = 520; 50% female; 71% Spanish speakers) provided cross-sectional survey data. Gender-stratified logistic regression models were estimated for mental health problems (PTSD, anxiety, depression), substance use (risky drinking, cannabis, illicit drug use), and IPV. Results showed that economic stressors were linked with mental health problems among men and women. Among men, PTSD was associated with greater odds of cannabis and illicit drug use. Men who used cannabis and illicit drugs were more likely to report IPV. Male Spanish speakers had lower odds of anxiety and cannabis use than English speakers. Female Spanish speakers had lower odds of substance use and IPV than English speakers. The protective effect of Spanish language preference on some mental health, substance use, and IPV outcomes was more pronounced among women. Future research should identify the mechanisms that underlie the protective effect of Spanish language preference and explore factors that contribute to the observed gender differences. Full article

(This article belongs to the Special Issue Influence of Domestic Violence on Mental Health)

14 pages, 347 KiB

Open AccessArticle

Intimate Partner Violence and the Role of Child Maltreatment and Neighborhood Violence: A Retrospective Study of African American and US Caribbean Black Women

by Krim K. Lacey, Hira R. Shahid and Rohan D. Jeremiah

Int. J. Environ. Res. Public Health 2021, 18(5), 2245; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052245 - 24 Feb 2021

Cited by 1 | Viewed by 2956

Abstract

Background: Research suggests that intimate partner violence (IPV) is associated with childhood maltreatment and violence exposure within the neighborhood context. This study examined the role of child maltreatment and violence exposure on intimate partner violence, with the moderating effects of mental disorders (IPV) among US Black women. Methods: Data from the National Survey of American Life (NSAL), the largest and most complete sample on the mental health of US Blacks, and the first representative sample of Caribbean Blacks residing in the United States was used to address the study objectives. Descriptive statistics, chi-square test of independence, t-test, and logistic regression procedures were used to analyze the data. Results: Bivariate results indicate an association between child abuse and intimate partner victimization among US Black women. Witnessing violence as a child as well as neighborhood violence exposure was also related to IPV but shown to differ between African American and Caribbean Black women. Multivariate findings confirmed the influence of mental disorders and social conditions on US Black women’s risk for IPV. Moderating effects of child maltreatment and mental disorders in association with adult IPV were not found. Conclusions: The study addressed the short and long-term impact of child maltreatment and the contribution to the cycle of intimate violence among US Black women including African American and Caribbean Blacks. The study suggests the need for prevention and intervention efforts to improve structural conditions for at-risk populations and communities predisposed to violence and other negative outcomes. Possibilities for future research are also discussed. Full article

(This article belongs to the Special Issue Influence of Domestic Violence on Mental Health)

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14 pages, 2145 KiB

Open AccessSystematic Review

The Effectiveness of Culturally Specific Male Domestic Violence Offender Intervention Programs on Behavior Changes and Mental Health: A Systematic Review

by Lata Satyen, Ashlyn Hansen, Jane Louise Green and Laura Zark

Int. J. Environ. Res. Public Health 2022, 19(22), 15180; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192215180 - 17 Nov 2022

Cited by 4 | Viewed by 2570

Abstract

The objective of domestic violence intervention programs is to address perpetrator behavior. However, the suitability and effectiveness of these programs in confronting problematic behavior for ethnically diverse groups is unclear. Therefore, the aim of this systematic review was to cohesively examine whether such programs are effective in reducing recidivism, changing perpetrator behavior, and addressing mental health issues for culturally diverse groups. Several databases were searched for peer-reviewed articles that included culturally specific components or ethnically diverse cohorts in offender intervention programs. 10 articles met the inclusion criteria. The findings demonstrate greater effectiveness of programs with greater cultural engagement: through culturally trained facilitators, addressing the cultural and patriarchal norms relevant to the specific client group, and discussion of gender roles and attitudes to gender equality specific to the cultural context. Such programs achieved some positive outcomes including: reduced recidivism, improved mental health, and better attitudes to gender equality. However, the findings are limited to a few ethnically diverse groups, and not all studies measured all outcomes listed above. This review suggests the development and implementation of suitable offender intervention programs that address perpetrator behavior and mental health in ethnically diverse client groups. When culturally relevant and effective programs are implemented, it could lead to men’s modification of perpetrating behavior and create safer family relationships. Full article

(This article belongs to the Special Issue Influence of Domestic Violence on Mental Health)

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12 pages, 294 KiB

Open AccessBrief Report

Crisis Work Embedded in a Global Crisis: The Early Phase Impact of COVID-19 on Survivors of Intimate Partner Violence and Service Provisions

by Vithya Murugan, Terri L. Weaver, Theresa Schafer and Quin Rich

Int. J. Environ. Res. Public Health 2022, 19(8), 4728; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19084728 - 14 Apr 2022

Cited by 7 | Viewed by 1547

Abstract

COVID-19, as a global pandemic, was a public health inflection point for individuals affected by intimate partner violence (IPV) and those who provide IPV services. Public health guidelines that were intended to reduce risk of exposure to the virus impacted vulnerability factors for IPV survivors and associated systems of services. We aimed to (1) explore the effect of COVID-19 on survivors of IPV; (2) assess the effect of COVID-19 on IPV-related service provisions and service providers; and (3) explore challenges and opportunities in the wake of COVID-19 on broader IPV services and advocacy. Method: Twelve directors of IPV shelter, criminal justice, and other advocacy services within a diverse, Midwestern metropolitan area were recruited to participate in in-depth, semi-structured interviews in June–August 2020. Interviews were transcribed verbatim and analyzed using Dedoose. Data were coded and analyzed through thematic analysis. Results: Four major themes, contextualized by COVID-19 and racial injustice, emerged from the data analysis: (1) IPV-related trends; (2) impact on IPV survivors, services, and agency morale; (3) inter-agency collaborations; and (4) future opportunities for innovative service delivery. Gaps and opportunities for developing culturally congruent, trauma-informed services were identified. Conclusion: Findings suggest that responsive and accessible IPV resources and associated advocacy services can make the difference between life and death for survivors. Full article

(This article belongs to the Special Issue Influence of Domestic Violence on Mental Health)

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