Preventing Intimate Partner Violence Survivors' Suicidal Behaviors: A Scoping Review

Background & Purpose
Suicidal behaviors, which include intentions, attempts, and completions to end one’s life, are significantly associated with intimate partner violence (IPV) victimization. Women who experience IPV are at an increased risk of suicidal behaviors, with 25-40% of women attempting suicide at some point during or after the termination of an abusive relationship. Unfortunately, efforts to address and prevent suicidality among IPV survivors are inconsistent and insufficient. Accordingly, to help advance practice and research knowledge in this area, we reviewed interventions to prevent suicide among IPV survivors. The following research questions guided this review: (1) What is the nature of the literature concerning interventions targeting suicidality among women who experience IPV? (2) What is known about the effectiveness of IPV interventions targeting suicidality? (3) What are the gaps in the research knowledge base?

Method
Given the limited and heterogeneous literature, a scoping review approach was applied (Arksey & O’Malley, 2005). Searches of electronic databases were conducted to identify intervention studies that had been published in peer-reviewed journals, with no date restrictions. Initially, 4,113 studies were identified as potentially relevant. Once duplicates and articles not meeting the selection criteria were removed, 12 articles were determined for full-text review. During full-text screening, 9 articles were also excluded: commentaries (n=4), intervention research for different groups, such as violence perpetrators (n=1) practitioners (n=1), and general interpersonal violence victims (n=1); and baseline study without intervention outcomes (n=2).

Results
Thus, three studies were analyzed. While all studies examined the same intervention, which focused on a culturally-informed and empowerment-based group therapy, each rigorously evaluated different outcomes. Across all of these studies, IPV survivors who received the intervention showed greater reductions in depressive symptoms and general distress in relation to women who had not received the intervention, though results concerning suicide ideation were mixed. Accordingly, the three research questions guiding this study were answered as follows. First, the nature of the literature is significantly limited; second, little evidence exists concerning interventions and their effectiveness; and third, the gaps in the knowledge base are considerable and worrisome.

Conclusions and Implications
This review determined that there is extremely limited evidence concerning IPV-focused interventions to prevent suicide, despite the importance and urgency of these intersecting issues. The one examined intervention showed promising outcomes across three studies. However, the generalizability of these studies’ findings remain an empirical question. For all these reasons, in addition to presenting our review results, our presentation will focus on providing recommendations from existing, evidence-based, suicide prevention programs to guide the development and testing of effective suicide intervention for IPV survivors. The presentation will also provide guidance for how social work scholars might take the lead in developing this pressing area of intervention research. Notably, previous research has found that abused women who are pregnant, seek shelter, and at middle age with adult children tend to be at high risk of suicide ideation. Accordingly, social worker scholars could make an important contribution to practice and research by developing diverse interventions targeting suicide prevention among IPV survivors.