October is Domestic Violence Awareness Month, a time to raise awareness about the widespread impact of intimate partner violence and to advocate for the support and safety of survivors. Domestic violence remains alarmingly common—approximately 30% of women worldwide have experienced physical and/or sexual violence by an intimate partner (Lanchimba et al, 2023). Data from the World Health Organization (WHO) further reveals that 1 in 3 women reported feeling unsafe in their homes during the COVID-19 pandemic due to conflict with their partner (Lanchimba et al, 2023). While domestic violence primarily affects women, it is important to recognize that men are impacted as well and deserve access to support and resources. Beyond physical harm, domestic violence takes a significant toll on mental health, often leading to trauma, anxiety, depression, and other long-term psychological effects.
This awareness month presents an important opportunity to explore how psychiatric practices can play a vital role in supporting survivors—by fostering healing, promoting safety, and empowering individuals on their path to recovery.
Understanding Domestic Violence
Domestic violence is a broad term that encompasses not only physical harm, but also emotional, sexual, financial abuse, and coercive control. It includes any form of violent or controlling behavior directed toward family members or intimate partners that results in physical, sexual, or psychological harm (Lanchimba et al, 2023). This may involve threats, intimidation, manipulation, coercion, or the deprivation of liberty, all of which can be just as damaging as physical violence (Lanchimba et al, 2023).
A common misconception is that domestic violence only occurs in certain communities or only involves physical abuse. Intimate partner violence (IPV) and domestic violence can affect anyone, regardless of gender, socioeconomic status, race, or background. While the majority of IPV victims are women—an estimated 27% of women and girls aged 15 and older globally have experienced physical or sexual IPV—high rates are also reported among LGBTQ+ individuals, people with disabilities, migrants, and marginalized ethnic or Indigenous groups (Oram et al, 2022). It is also critical to understand that domestic violence does not always involve physical aggression (Walker-Descartes, 2021). Many survivors experience prolonged emotional, psychological, and financial manipulation that may leave invisible but lasting scars.The psychological impact on survivors is profound. Research continues to show that mental illness is often a consequence of abuse, not a cause—and the trauma associated with IPV can have lifelong effects (Walker-Descartes, 2021). Studies show that women who have experienced IPV are significantly more likely to be diagnosed with generalized anxiety disorder, depression, phobias, dysthymia, and to engage in harmful substance use (Walker-Descartes, 2021). Exposure to domestic violence, whether in childhood or adulthood, also increases the risk of suicidal ideation and suicide attempts (Oram et al, 2022). In the most tragic cases, homicide can be the fatal endpoint of a pattern of escalating abuse (Walker-Descartes, 2021).
The Role of Mental Health Professionals
Mental healthcare services play a critical role in both recognizing and responding to domestic and family violence (Fisher et al, 2022). Mental health providers are often in a unique position to identify signs of abuse, offer early intervention, and support survivors throughout their recovery.
A cornerstone of effective support is the use of trauma-informed care, which emphasizes safety, trust, empowerment, and collaboration. All mental health professionals should be well-informed about the dynamics of domestic and intimate partner violence and trained to recognize both overt and subtle signs of abuse (Oram et al, 2022). When done well, mental health systems and providers can have a transformative impact on a survivor’s path toward healing and resilience (Oram et al, 2022).
As part of a comprehensive approach, psychiatric evaluations are often needed to assess for conditions such as depression, anxiety, PTSD, and substance use disorders, which are commonly associated with the trauma of abuse.
It is essential that survivors are meaningfully involved in the development, evaluation, and delivery of support services—from survivor-led initiatives to formal mental health systems (Oram et al, 2022). Incorporating lived experience ensures that care is truly responsive, respectful, and effective.
A range of evidence-based therapeutic options can support recovery:
- Cognitive Behavioral Therapy (CBT) helps individuals identify and change harmful cognitive distortions (Karakurt et al, 2022).
- Eye Movement Desensitization and Reprocessing (EMDR) is particularly effective for processing trauma.
- Supportive therapy offers validation, stabilization, and emotional containment.
- Mindfulness practices improve awareness and reduce symptoms of depression and anxiety (Karakurt et al, 2022).
Psychiatric medication management can help individuals who have experienced domestic violence by treating symptoms of trauma, anxiety, depression, or other mental health conditions, supporting emotional stability and recovery.
Barriers to Getting Help
Despite the serious and often life-threatening nature of domestic violence, many survivors face significant barriers when trying to seek help—both from healthcare providers and support systems. These obstacles can prevent timely intervention and deepen the psychological and physical impact of abuse.
One of the most common barriers is fear—fear of retaliation by the abuser, fear of not being believed, or fear that reaching out will lead to negative consequences, such as losing custody of their children (Heron et al, 2021). Survivors may also feel unsafe disclosing abuse if their abuser is present during medical or mental health appointments, which can further silence them (Heron et al, 2021). Emotional hurdles like shame, self-blame, and a profound sense of powerlessness can also make it incredibly difficult to speak up. Many survivors minimize or even deny the severity of their situation, often as a coping mechanism or due to long-term psychological manipulation (Heron et al, 2021). Healthcare-related challenges are another common barrier. Survivors may encounter providers with a lack of training in trauma-informed care, rushed or impersonal appointments, or no continuity of care, all of which can erode trust (Heron et al, 2021). If survivors sense that a healthcare provider does not truly understand or believe them, they are far less likely to disclose abuse. Financial dependence on the abuser and social isolation—both common tactics used in abusive relationships—can further trap survivors in unsafe environments (Heron et al, 2021). Without access to money, transportation, or supportive networks, seeking help may feel impossible. In many cases, cultural and systemic barriers play a role. These might include immigration status concerns, mistrust of medical or legal institutions, language barriers, or a strong desire to avoid official agencies due to fear of discrimination or deportation (Heron et al, 2021). For some, cultural stigma around domestic violence or mental health may also contribute to silence and suffering.
Understanding these barriers is essential for healthcare providers, community organizations, and policymakers to create safer, more accessible, and more compassionate pathways to care.
How Psychiatry Can Help Break the Cycle
Psychiatry plays a crucial role in interrupting the cycle of abuse and promoting recovery by:
- Identifying and addressing risk factors – Early recognition of mental health issues, trauma responses, or patterns of abuse can lead to timely intervention (Gulati & Kelly, 2020).
- Offering comprehensive support, advocacy, and treatment –
- Validating survivors’ experiences and helping them understand the psychological impact of abuse.
- Educating patients about their rights, safety, and recovery options.
- Collaborating with community resources such as shelters, advocacy centers, and legal aid services (Gulati & Kelly, 2020).
- Rebuilding autonomy and self-worth – Therapy can empower individuals to reclaim control over their lives and restore their sense of identity.
- Developing safety plans – Assisting both patients and their families in creating personalized strategies to stay safe and prevent future harm (Gulati & Kelly, 2020).
Recognizing the Signs (for patients, loved ones, and clinicians)
Understanding the warning signs of abuse is essential in helping someone find safety and support.
Behavioral Red Flags to Watch For
- Visible fear or anxiety around certain people or situations (B, 2024).
- Social withdrawal or sudden disinterest in daily life
- Unexplained physical injuries, such as bruises, busted lips, red marks, or sprains (B, 2024).
- Increased agitation or low self-esteem (B, 2024).
- Talk of hopelessness or suicidal thoughts (B, 2024).
How to Gently Start the Conversation
- Be present and attentive – Listen without judgment and observe for signs of distress or fear (B, 2024).
- Offer support, not pressure – Let them know you’re there, no matter what
- Share resources and discuss a safety plan if they’re open to it (B, 2024).
- Encourage support groups or professional help as a next step toward healing (B, 2024).
If you witness abuse or believe someone is in immediate danger, call 911 right away. Your action could save a life (B, 2024).
Resources and Crisis Support
It’s important to remember that survivors of domestic violence are never alone. Healing is possible—with the right support, safety, and care.
If you or someone you know is experiencing abuse, the following resources can help:
- National Domestic Violence Hotline: https://www.thehotline.org/
- 24/7 crisis hotline, chat online, or text options available; safety planning resources also accessible on website.
- Call: 800-799-SAFE (7233)
- Chat: https://www.thehotline.org/#
- Text START to 88788
- National Dating Abuse Helpline: https://www.loveisrespect.org/
- 24/7 crisis hotline, chat online, or text options available; information about healthy relationships on website.
- Call: 1-866-331-9474
- Text LOVEIS to 22522
- Ohio Domestic Violence Network: https://www.odvn.org/
- 24/7 hotline available or chat online for local resources.
- Call: 1-800-934-9840
- Call: 614-781-9651
- ACTION Ohio: https://www.actionohio.org/
- Promotes quality resources, programs and services to survivors.
- Call: 888-622-9315
- Call: (614) 825- 0551
- Southeastern Ohio Legal Services: https://www.seols.org/
- Provides legal aid and resources available to low-income individuals across southeastern Ohio.
- Call: 844-302-1800
- Asha-Ray of Hope: https://asharayofhope.org/
- Offers a 24/7 hotline, domestic violence crisis services, and resources for women & children whose country of origin includes: Bangladesh, India, Nepal, Pakistan and Sri Lanka.
- (614) 565-2918 or (614) 326-2121
- LSS CHOICES: https://lssnetworkofhope.org/
- Services include a 24/7 hotline, temporary emergency shelter, legal advocacy, domestic violence counseling, and peer support groups.
- (614) 224-4663
Concerned about your mental health? Contact us today to schedule with a licensed psychiatric nurse practitioner in Columbus, Ohio.
Fisher, C. A., Jones, S., Brickell Smith, C., Stokes, L., Cairns, G. & Withiel, T. D. (2022). Domestic and family violence knowledge and skills: A private mental health service survey of nurses, allied health, and medical clinicians. International Journal and Mental Health Nursing. 31(4), 952-961. https://doi.org/10.1111/inm.13004
Gulati, G & Kelly, B. D. (2020). Domestic violence against women and the COVID-19 pandemic: What is the role of psychiatry? International Journal of Law and Psychiatry. 71. https://doi.org/10.1016/j.ijlp.2020.101594
Heron, R. L. & Eisma, M, C. (2021). Barriers and facilitators of disclosing domestic violence to the healthcare service: A systematic review or qualitative research. . 29(3), 612-630. https://doi.org/10.1111/hsc.13282
Karakurt, G., Koc, E., Katta, P., Jones, N., Bolen, S. (2022). Treatments for Female Victims of Intimate Partner Violence: Systematic Review and Meta-Analysis. Frontiers in Psychology. 13. https://doi.org/10.3389/fpsyg.2022.793021
Lanchimba, C., Diaz-Sanchez J. P., & Velasco, F. (2023). Exploring factors influencing domestic violence: a comprehensive study on intrafamily dynamics. Frontiers in Psychiatry.
Oram, S., Fisher, H. L., Minnis, H., Seedat, S., Walby, S., Hegarty, K., Rouf, K., Angénieux, C., Callard, F., Chandra, P. S., Fazel, S., Garcia-Moreno, C., Henderson, M., Howarth, E., MacMillan, H. L., Murray, L. K., Othman, S., Robotham, D., Rondon, M. B., … Howard, L. M. (2022). The Lancet Psychiatry Commission on intimate partner violence and mental health: Advancing Mental Health Services, research, and policy. The Lancet Psychiatry, 9(6), 487–524. https://doi.org/10.1016/s2215-0366(22)00008-6
T, B. (2024, April 23). Top Warning Signs of Domestic Abuse<. Verywell Mind. https://www.verywellmind.com/signs-someone-is-being-abused-66535
Walker-Descartes, I., Mineo, M., Vaca Condado, L. & Agrawal, N. (2021). Domestic Violence and Its Effects on Women, Children, and Families. Pediatric Clinics of North America, 68 (2), 455-464. https://doi.org/10.1016/j.pcl.2020.12.011
