"Abused, Hopeless, and then It Made Me Think about Suicide": Exploring the Integration of Gender-Based Violence and Suicidal Crisis Intervention Services Among Survivors

Background and Purpose: Gender-based violence (GBV), including intimate partner violence (IPV), is a significant global public health problem, linked to myriad outcomes, including adverse mental health such as suicidal behavior. In the Philippines, one in four ever-married women has experienced IPV and suicide rates have increased dramatically over the past several decades in the country, multiplying 9-fold among Filipino women. Access to mental health and IPV support services in the Philippines, however, is lacking. Survivors of GBV/IPV in the Philippines frequently report discrimination and inadequate services that lack proper evaluation, safety planning, and support. Similarly, mental health service utilization in the Philippines is low due to stigma and inaccessible care. In response, this study sought to explore the needs of survivors of GBV/IPV in relation to overlapping suicidal behaviors, and their perceptions of recommendations towards integration of crisis services and safety planning to prevent and address these dual risks.

Methods: In 2025, participants were recruited from a local non-governmental organization serving survivors of GBV/IPV and human trafficking in Cebu, Philippines using purposive sampling to attend one 90-minute individual interview. Participants were eligible to participate if they identified as least 18 years of age, had previously experienced GBV/IPV, and had a history of suicidal behaviors, but were not actively in crisis. Participants included a total of 10 women, ranging from 27-51 years old. Interviews were transcribed in Cebuano and subsequently translated into English after which they were analyzed using thematic analysis (Braun & Clarke, 2006). Rigor was enhanced through reflective interview notes, post-interview debriefs, and regular team consultations with interviewers and transcript data coders.

Results: Five themes were identified during the analytic process, including (1) physical and emotional safety, (2) responsive and consistent support, (3) an integrated service model, (4) peer and community involvement, and (5) addressing logistical challenges. Specifically, participants overwhelmingly emphasized the importance of physical and emotional safety, expressing the need for a non-judgmental and trusting space for clinical conversations. Grounding activities were recommended. Second, staff’s responsiveness to client needs and consistent check-ins were described as critical, especially in crisis situations. Third, almost all participants supported an integrated service model to address dual risks of GBV/IPV and suicidal behavior, primarily due to the connectedness of experiencing GBV/IPV and its impact on their mental health; some participants felt this could reduce unnecessary burdens and confusion in service delivery and safety planning. Fourth, peer support and community education, particularly through leveraging the experiential knowledge of peer survivors, were considered beneficial. Finally, participants considered proactively addressing logistic challenges, such as transportation as necessary to promoting consistent service access.

Conclusions and Implications: Findings demonstrate the critical impact of provider support responses and its implications on safety and engagement in care as well as the support for streamlined interventions that address dual risks, including integrated safety planning and strategies to support survivor awareness of the linkages between experiences of GBV/IPV and suicidal behavior. Results additionally suggest the need to enhance service provision through potential inclusion of community psychoeducation and strategies that address structural barriers.