Title: Effective responses to long-term consequences of violence, trauma and abuse
Funder: Department of Health (England)

Abstract: Background Delivering better outcomes for victims and survivors of violence and abuse is a DH/NHS goal, reflecting the Government’s vision of tackling violence against women and children through prevention, early intervention and effective support. This project directly addresses the aims of this Themed Call and the two evidence challenges identified under Priority 5. Aims To identify the prevalence of different types of child and adult abuse and violence and how these cluster together; understand the associations between past abuse and current health, mental health, service use and other factors; and, explore the predictors of re-victimisation and resilience. To identify what works in implementing routine exploration of violence and abuse in mental health assessments; how this gets embedded in practice and the impact it has on the experiences of service users. To ascertain how experience of trauma impacts on the use of health and support services across the life course of survivors and what makes health and other services helpful/unhelpful. To develop an outcomes tool relevant to services working with survivors in both voluntary sector and NHS settings, which is grounded in user and practice expertise as well as research evidence. Research plan and methods of investigation The study will be composed of three strands. 1. We propose to carry out statistical analysis of the 2007 Adult Psychiatric Morbidity Study (APMS) dataset to: a) Calculate the prevalence of different types of child and adult abuse and violence and understand how these cluster together; b) Describe the associations between past abuse and current health, mental health, service use and other factors; c) Identify predictors of re-victimisation and resilience. d) Develop a typology of different groups of survivors. The analysis will identify risk factors through multivariate regressions after controlling for other significant factors. A key aspect of the investigation will be the application of Latent Class Analysis to identify how abusive experiences cluster in the population, and regression analyses to look at the treatment and mental health characteristics of class membership. We will build regression models to look at predictors of re-victimisation and resilience. 2. We intend to conduct a follow up study of the implementation of routine enquiry (RE) of violence and abuse in 15 NHS Trusts. Our methods for this strand of the study will be primarily qualitative and will explore the extent to which RE has become embedded within these Trusts. We will identify four Case Study Trusts to carry out in-depth fieldwork involving interviews and focus groups with managers, staff and service users. We will produce guidance on the effective implementation of RE and maximising its benefits for service improvement. 3. drawing on practice and user-based knowledge as well as evidence from research, and building on work already initated, we will develop an outcomes tool for VCS and NHS services working with survivors. drawing on the findings of strands 1 and 2, data collected from service providers and existing outcome measures, we will develop a tool to be piloted across diverse settings, including some services from the Case Study Trusts involved in strand 2. After piloting, the tool will be revised and made available for general use. Team The team of researchers from NatCen, the Child and Women Abuse Studies Unit and Inequality Agenda, has a strong track record of policy relevant research, evaluation and implementation of participatory methodologies in the fields of violence, abuse and mental health. Potential impact/influence It will result in practical knowledge and tools to support the future development and evaluation of policy and practice and enable services to develop more robust data on the efficacy of their interventions.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: MENTAL HEALTH