Patton, N. & Schweinhart, A.
Intimate partner violence experiences and serious mental illness frequently overlap with studies showing that 40-97% of individuals with mental health concerns have also experienced violence and women who have experienced violence are more likely to have mental health comorbidities. Multiple conditions can make it challenging to work alongside people struggling with violence, mental illness, and substance use. This presentation discusses how a violence service provider in Louisville Kentucky, Center for Women and Families, assessed barriers and challenges to providing services for violence when an individual also struggles with mental health or substance use in an attempt to overcome them. CWF with the Pacific Institute for Research and Evaluation (PIRE) worked to review the current literature, assess the condition at CWF, survey providers, and interview women experiencing mental health and substance use concerns. A review of secondary data from 10 months of service with (CWF) clients (n = 1018) showed that the length of stay of clients with serious mental illness (24 nights) and/or substance use (21 either, 28 both) was twice as high as those without (10) and when both co-occur it is almost three times as high. Additionally, hospital runs are twice as high for serious mental illness (1) and substance misuse (.9) clients as those without either condition (.5). Finally those women experiencing violence with co-occurring mental health or substance use concerns are far more likely to return to shelter than those without.
The top barriers to both mental health and violence services reported by CWF staff were transportation, substance use, childcare and concern, fear, and stigma. An independent samples’ t-test was used to examine differences between violence and mental health service provider scores scales of public and self-awareness scales. Violence service providers were significantly more likely to rate the general public as needing more education and being uninformed about violence than mental health service providers (t(51) = 2.012, p = .05)). Violence service providers were also more likely to indicate burden and emotional stress/ difficulty at their job than mental health service providers (t(51) = 2.134, p = .03)). It should be noted, that both groups of service providers indicated that the general public had a fairly low rating of understanding of violent experiences (M = 1.7 overall). Violence service providers knowledge of mental health was surprisingly low with respondents only answering the true/false questions correctly 55% of the time. Knowledge of violence among mental health service providers was similarly low, mainly due to incorrect answers regarding laws and policy, substance use, and person-first language.
Both mental health and violence service providers scored poorly on the true/ false questions for their counter-target populations indicating that educational interventions among these groups could potentially help increase clients with co-occurring conditions seeking services. These findings indicate that the majority of service providers’ attitudes for both types of negative life experiences were positive. However, both types of service providers were slightly unsure of the legal reporting requirements for their counter-target populations. A multi-dimensional educational intervention for healthcare and service providers which includes information on the intersectional concerns of mental health, violence, substance misuse, and homelessness, and connects professionals with services in the local community to help break down institutional and external barriers is recommended.