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MENTAL HEALTH MATTERS Domestic violence and mental health

But the effects of domestic violence reach far beyond the momentary fear of a situation. Even after it is stopped (if it is stopped), domestic violence continues to extract a cost.

In many cases, domestic violence is not a feature of the relationship from the get-go. It often starts to ramp up when the stakes are raised, like during pregnancy. In a previous column, Mental Health Matters explored the effects of depression on new mums and mums-to-be, most significantly, the deleterious effect on bonding and attachment with baby. Feelings of depression and anxiety are unavoidable when one is subjected to domestic violence. Public maternity units screen pregnant women for domestic violence and mental health problems in pregnancy.

Of course, you can fudge it if you want to, and many women do just that. Fear of a social worker’s “interference” can be even stronger than fear of the perpetrator. Some women will concede their feelings of anxiety, fear and depression to health staff without disclosing the violence, and present themselves for “treatment”. Treating these “symptoms” is a tall order for any psychiatrist and many feel understandably uncomfortable about pathologising the victim when the violence eventually comes to light.

If a frightened mother is unable to provide the stable figure for attachment for her baby, the baby will not be able to develop its own stable sense of self. These babies may grow up into children and adolescents with problems learning, communicating and relating to the world. They will likely come to the attention of Child and Adolescent Mental Health Services and may need considerable additional support in their schooling. They may have difficulty functioning as adults.

Mental health is impossible for a child repeatedly exposed to domestic violence. Childhood is the time when our brains are growing, our neural pathways laid out. In this sense, the true damage bill of domestic violence is incalculable, but astronomical. In health dollars, education dollars, corrective services dollars, public housing dollars (but not enough of this), and much more.

Domestic violence costs more than the relatively few presentations to Accident and Emergency with physical injuries.

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