Double damage: Partner violence impacts mental health of over half-million Californians

Using data from the 2009 California Health Interview Survey (CHIS), researchers found that of the 3.5 million Californians who reported ever having been the victim of intimate partner violence (IPV), more than half a million -- 594,000 -- said they experienced recent symptoms of "serious psychological distress," which includes the most serious kinds of diagnosable mental health disorders, such as anxiety and depression. Adult victims of IPV were more than three times as likely as unexposed adults to report serious psychological distress in the past year.

Victims of IPV were also far more likely than non-victims to seek mental health care and to engage in coping strategies like binge drinking.

"Violence does double damage to a victim, leaving both a physical and emotional scar," said the study's lead author, Elaine Zahnd, a sociologist and senior research scientist at the Public Health Institute, which works with the UCLA Center for Health Policy Research in conducting the California Health Interview Survey. "Policymakers and care providers need to ensure that support services and screenings are available to victims even weeks or months after an attack."

Women at risk

Women were more than twice as likely as men to have been the victim of IPV (20.5 percent vs. 9.1 percent), with almost 2.5 million women having experienced adult IPV. Although both female (17.5 percent) and male (15.3 percent) victims of adult IPV were more likely than non-victims to report serious psychological distress during the past year, larger numbers of female victims (428,000) were affected by serious psychological distress than male victims (166,000), since women make up the majority of IPV cases.

Alcohol, drugs and violence

Almost half of all IPV victims (47.6 percent) said that their partner appeared to be drinking alcohol or using drugs during the most recent violent incident.

Trying to cope

Nearly one in three adults (33.1 percent) who reported being an adult IPV victim said they needed help for a mental or emotional problem or an alcohol or other drug problem. In contrast, just 12.6 percent of non-victims reported needing similar help.

Adult IPV victims were two-and-a-half times more likely (23.9 percent) than non-victims (9.5 percent) to report seeing their primary care physician, a psychiatrist, a social worker or a counselor in the past year for problems with their psychological or emotional health and/or their use of alcohol or other drugs.

More than half of all IPV victims subjected to a recent IPV incident (52.4 percent) reported engaging in binge drinking over the past year, a significantly higher rate than those who had not experienced a recent IPV incident (35.1 percent). And 7 percent of recent IPV victims reported binge drinking on a daily to weekly basis, a higher level than those who were never exposed to IPV (4.5 percent).

The study authors recommended that health screening for IPV, for emotional health and for substance use problems among patients and clients, regardless of gender, should be expanded, standardized and made routine.

"The study shows that our response to violence as a society must be many-faceted and California's domestic violence service providers are able to offer an array of services to survivors of IPV, " said Peter Long, Ph.D., president and CEO of the Blue Shield of California Foundation. "But most of all, we must all work harder to prevent violence from occurring in the first place."

"We must treat and care for the victims at the time of the attack. But we must also support and screen victims for the signs of mental distress that may follow an attack. Most of all, we must all work harder to prevent violence from occurring in the first place."

Support for victims is imperiled by a steady decline in national spending on IPV victims' support services, even as there continues to be a critical need for additional mental health, substance use and domestic violence services, the authors noted. Although the California budget was recently passed, additional cuts to mental health services, alcohol and other drug services, and domestic violence programs are still possible if expected future revenues do not materialize.

Read the policy brief, "The Link Between Intimate Partner Violence, Substance Abuse and Mental Health in California."