Should Programs Designed to Help IPV Survivors Screen for Mental Health Related Problems: Voices From the Field

Background: Intimate Partner Violence (IPV) is the actual or threatened physical, sexual, emotional, or psychological abuse by an intimate (romantic) partner. Often occurring within the larger context of other lifetime trauma and stress (e.g., childhood abuse, community violence, etc.), it should be no surprise that women who suffer abuse are at an increased risk for developing mental health symptoms (e.g., reliving the traumatic event, hyperarousal, avoiding event reminders, depression, sleep disruption) that sometimes warrant diagnosable conditions (e.g., depression, PTSD, ASD, anxiety related conditions). Thus, when appropriate, mental health assessment, diagnosis, and treatment can greatly benefit this vulnerable population.  

Unfortunately, a conundrum exists in that diagnostic labels have potential repercussions in court proceedings, custody arrangements, and interactions with the abuser. Together with limited programmatic resources and the need to address pressing immediate concerns, many programs designed to help IPV survivors intentionally do not systematically/routinely screen for mental health problems. Professionals dedicated to ending IPV articulate this problem in practice discussions, conceptual works, and training materials. Yet, no empirical articles published to date address provider views about mental health screening of IPV survivor clients.

Purpose: In an effort to better understand the realities that arise in the field, the proposed paper qualitatively explores opinions of service providers by addressing the following research question: Should agencies designed to help IPV survivors screen for mental health related problems? 

Method: An on-line Internet survey was administered to 325 helping professionals working in programs whose primary focus is serving the needs of IPV survivors. Participants were recruited from programs across the US (including Washington, DC) and the US protectorates. The proposed paper reports qualitative analysis from an open-ended response option included on this survey. A modified concept mapping approach to data analysis was selected because it is a participatory mixed-method approach that reduces qualitative data into a quantitatively formulated visual presentation. Based on the work of Trochim (1989a, 1989b) and Jackson and Trochim (2002), concept mapping consists of 5 distinctive stages where qualitative data are reduced and sorted into meaningful categories that consider the relationship between identified constructs. Eight (8) independent coders with varying experience working with IPV survivors conducted the sort.

Results: Multidimensional scaling using proxscal procedure revealed a stable solution (NRS = .0347; DAF =  .9653) after 23 iterations. Hierarchical cluster analysis then reveled 14 distinct clusters. Central themes for each cluster were identified using information provided by the original 8 coders and the primary research personnel. The concept map was then organized into a phenomenological presentation describing the central themes, nesting concepts, and conceptual linkages.

Conclusion/Implications: Findings indicate IPV helping professional have positive opinions about screening their IPV survivor clients for mental health related problems. However, a need for agencies to implement best practices that do not increase client risk through stigma and labels was highlighted. Further discussion is needed to develop, assess, and implement service delivery models that balance the consequences that arise with diagnostic labels with the equally real difficulties related to mental health symptoms/problems when working with IPV survivors.