Why do domestic abuse victims/survivors need specialist mental health support?

May 9, 2023

Women & children fleeing domestic abuse are faced with a number of difficult challenges, including mental health issues such as post-traumatic stress disorder. Bromley & Croydon Women’s Aid (BCWA) has…

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Women & children fleeing domestic abuse are faced with a number of difficult challenges, including mental health issues such as post-traumatic stress disorder. Bromley & Croydon Women’s Aid (BCWA) has seen a 200% increase in women needing support with their mental health but with long waiting lists and a drastic decline in the services available for women, very few are able to access the support they need. 

Ahead of Mental Health Awareness Week (15-21 May), we chatted with Bromley & Croydon Women’s Aid’s Clinical Lead and Counselling Services Manager, Kamilah Tomlinson, to understand the challenges a victim/survivor faces when accessing appropriate mental health support and how BCWA are helping to empower women on their journey to recovery.  

Hi Kamilah, could you please start by telling us what’s the link between domestic abuse and poor mental health? 

“Domestic abuse affects all areas of a women’s life. Survivors report experiencing low self-esteem, low confidence, the inability to trust one’s own decision making and feeling isolated. Clients also speak about the impact abuse has on their interpersonal relationships and their children’s development. Domestic abuse can have a lasting impact both emotionally and physically. Therefore, the impact on survivors can be complex, multilayered and different for each person.  

There is a significant correlation between abuse and poor mental health. It is commonly understood that the impact of domestic abuse can lead to depression, anxiety, post-traumatic stress (PTS), eating disorders, self-harming behaviours and suicidal ideation. It is essential that survivors of domestic abuse have emotional and practical support that is tailored towards their safety and healing. Support that is informed by understanding the ways in which survivors are impacted from a culturally adaptive and trauma-informed perspective.  

What do you see as the biggest barrier for victims/survivors to accessing appropriate mental health support? 

“Quite simply there is not enough trauma-informed or culturally adapted mental health support available. Third sectors organisations do frontline, specialist work, with the least amount of funding. We know survivors seek support from other services, such as GPs, IAPT and other primary care services who often have higher levels of funding than third sector organisations, however, are not able to provide specific trauma informed, counselling for survivors in relation to gender based violence.  Services users are often left with no support or are then referred to third sector organisations, who oversubscribed, whilst being underfunded due to the specialist service they provide. This is a systemic issue within the public and private sector, which the lack of capacity being the joining thread. In addition, there needs to be serious acknowledgment that NHS’ support for survivors of gender-based violence is wholly inadequate.  

When I say trauma informed, I am referring to therapeutic services that truly understand what domestic abuse is and how it impacts the people it is perpetrated against. Practitioners need to understand the social issues in which gendered based violence presides within. We need more services that work with clients with varying presenting issues.  Where no client is turned away for being ‘too traumatised’ or ‘too complex’ to work with. Services where the practitioners are supported and encouraged to work in creative and transformative ways. 

Working with survivors of gender-based violence is specialist work – that takes compassion, care and understanding.  Over the 12 years that I have worked in the sector I have heard several saddening and concerning experiences of survivors who have been re-traumatised by professionals across different sectors who have perpetuated myths about domestic abuse and sexual violence. Saying things like “well why didn’t you just get up and leave?” or “oh but you did mention that you were drinking” so there is still much work to be done so all professionals who encounter survivors of gendered based violence are adequality trained.  

Our service users repeatedly tell us about how difficult it is to get counselling and mental health support which they need to help them recover and rebuild their lives and those of their children. Which is why we are very proud of our recently implemented in-house counselling service to offer survivors of domestic abuse, specialist trauma-informed counselling.   

What kind of issues are discussed during a counselling session? 

“We do not dictate what the client can explore in counselling and what clients want to talk about varies. For example, if a client has just moved into refuge, they may spend time talking about the immediate feeling around moving to refuge or the recent circumstances which have led to the move. They may want to talk about the actual harm that happened, but they may also talk about the wider impact such as how the abuse has impacted their confidence or relationships with family.  

If we are working with an outreach client who may be in an abusive relationship, we may explore logical things like safety planning or explore their current situation without judgment, which clients often do not have a space to do so. We do not tell them what they are supposed to be doing or how they are supposed to be feeling, instead we create an open, safe environment in which the client can use the space however they need to.  

We recognise that providing therapeutic spaces for survivors is often more than what the client presents in the room. We think about the communities in which they live in, the impact on their body, their children – working with the client holistically as a whole.”  

As you know, we are raising funds for a therapeutic garden office for counselling sessions to take place. Why is this so important?  

“It is so important that we have our own spaces to conduct counselling sessions so a garden office would be an amazing addition. We currently use third-party spaces which are not set up therapeutic work. Our current outreach counselling location is in an office which can be noisy and sterile, not offering the ideal warm and cozy space we want for survivors. Survivors need a dedicated quiet, reflective space.  If we had our own dedicated counselling space it would be cozy and relaxing and completely confidential. This would mean we could work to our own schedule, which would not be limited by the time and days that the third- party can offer. More availability would mean more flexibility, being able to offer sessions more quickly and overall, a service which is adaptable and accessible, meeting the needs of our service users.”  

Can you help to provide a warm and welcoming environment and increase access to appropriate mental health support for marginalised women? All donations made to our campaign page here from Monday 15th May to Monday 22nd May will be doubled! A £5 donation will be turned into £10 thanks to match funding from The Big Give Trust. Any amount you contribute will greatly help towards our target of £5,000.  

About Kamilah Tomlinson:  

Kamilah is an experienced trauma informed psychotherapist, researcher and social activist. The main body of her clinical work involves providing emotional support predominately to self-identifying women who have survived gendered based sexual violence. Kamilah’s work embodies a clinical ethos that seeks to foster new creative ways of working which honour varying identities. She brings an intersectional, transformative approach to therapeutic practice, working with the awareness of the impact of social and political systems of oppression on the mind, body and spirit.  

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