‘Where is the help for me here?’ Female domestic violence survivors’ narratives of navigating and receiving secondary-care mental health services in the United Kingdom

Background
Mental health (MH) services are uniquely positioned not only to contribute to the identification of domestic violence but also to provide support. Survivors of domestic violence regularly access secondary-care MH services. Although several studies and reviews have been conducted globally, the limited literature exploring survivors’ experiences of MH services in England has focused on the acceptability of routine enquiry within MH services, MH service responses to domestic violence and abuse (DVA), and the facilitators and barriers to disclosure within community MH teams.

Objectives
This study explores domestic violence survivors’ narratives of navigating and receiving secondary-care MH services in the United Kingdom.

Design
A qualitative study was undertaken with seven women who had experienced domestic violence. The study adopted a feminist, qualitative, narrative approach to enable in-depth exploration of survivors’ accounts of secondary-care MH services.

Method
Seven participants were recruited from three community-based third sector DVA services in the United Kingdom. Women participated in a face-to-face narrative inquiry interview ranging from 45 to 90 min. Interviews were transcribed verbatim and analysed in two distinct phases using the Voice-Centred Relational Method and thematic analysis, respectively

Results
Results suggest that MH professionals (MHPs) consistently missed the connection between abuse and women’s presenting distress. The structure of MH services resulted in superficial interventions and relationships, with key windows of opportunity for support missed. Whilst all women found a ‘safe haven’ where they felt heard, understood and supported, this was consistently outside of statutory MH services.

Conclusion
Women’s experiences of secondary-care MH services often paralleled their experiences of abuse and were experienced as re-traumatising. Our findings suggest that adopting trauma-informed approaches, developing more integrated support, and considering alternative conceptualisations of distress beyond diagnosis could enable survivors to find safety and support.