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Linking abuse and recovery through advocacy: an observational study

Published online by Cambridge University Press:  30 April 2013

K. Trevillion*
Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King's College, London, UK
S. Byford
Centre for the Economics of Mental and Physical Health, Health Service and Population Research Department, Institute of Psychiatry, King's College, London, UK
M. Cary
Centre for the Economics of Mental and Physical Health, Health Service and Population Research Department, Institute of Psychiatry, King's College, London, UK
D. Rose
Service User Research Enterprise, Health Service and Population Research Department, Institute of Psychiatry, King's College, London, UK
S. Oram
Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King's College, London, UK
G. Feder
School of Social and Community Medicine, University of Bristol, Bristol, UK
R. Agnew-Davies
Domestic Violence Training Ltd, Surbiton, Surrey, UK
L. M. Howard
Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King's College, London, UK
*Address for correspondence: Dr Kylee Trevillion, Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. (Email:



High numbers of psychiatric service users experience domestic violence, yet limited interventions exist for these victims. We piloted a domestic violence intervention for community mental health services to explore the feasibility of a future cluster randomized controlled trial.


Quasi-experimental controlled design within five Community Mental Health Teams (three intervention and two control teams). The intervention comprised domestic violence training for clinicians' and referral to domestic violence advocacy for service users. Clinicians' (n = 29) domestic violence knowledge, attitudes and behaviours were assessed before and 6 months post-training. Service users' (n = 34) safety behaviours, unmet needs, quality of life and frequency/severity of abuse were examined at baseline and 3 months follow-up. Process evaluation data were also collected.


Clinicians receiving the intervention reported significant improvements in domestic violence knowledge, attitudes and behaviours at follow-up (p < 0.05). Service users receiving the intervention reported significant reductions in violence (p < 0.001) and unmet needs at follow-up (p < 0.05).


Interventions comprising domestic violence training for clinicians and referral to domestic violence advocacy may improve responses of psychiatric services. Low rates of identification among teams not receiving training suggest that future trials using service user outcomes are unlikely to be feasible. Therefore, other methods of evaluation are needed.

Original Articles
Copyright © Cambridge University Press 2013 

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