The impact of patient mental health on the identification and referral to specialist services for Domestic Violence and Abuse before and during the COVID-19 pandemic: an observational cohort study

Problem

The COVID-19 pandemic has resulted in changes to service delivery within General Practice and public utilization of those services, the consequences of which are yet to be fully realised. Two of the most immediate impacts appear to be an increase in presentations for Common Mental Health Conditions at General Practice together with a concomitant suppression of disclosures of domestic violence and abuse (DVA) to services.

We aim to explore changes in primary care use (consultation type, reason for consultation and outcomes of consultation) within a DVA affected population of adults with and without prior Common Mental Health Conditions and co-morbidities (significant past or active problem) during the IRIS+ intervention period (June 2019 to 31 December 2020).

This population of primary care patients form part of a feasibility study which is testing an adaptation of IRIS called IRIS+ which involves a training and support programme to facilitate identification and referral to specialist services of patients affected by DVA, including women, men and children, through general practice.

Approach

The study uses a mixed methods approach incorporating an observational analysis of service data extracted from General Practice Electronic Medical Records and specialist DVA services across two UK Regions, and semi-structured interviews and questionnaires with healthcare professionals and patients.

Findings

We will present the results of the mixed methods analysis to describe changes in primary care use within a DVA affected population of patients comparing those with existing and past Common Mental Health Conditions and co-morbidities, before and during the COVID-19 pandemic, to identify those most vulnerable to presenting with Common Mental Health Conditions to General Practice during the pandemic. Data from qualitative semi-structured interviews will provide insight into the barriers and facilitators for identification and referral to specialist DVA services within this population.

Consequences

How the COVID-19 pandemic has impacted on the mental health of men and women affected by DVA is yet to be fully understood. Exploring the possible role of past and existing Common Mental Health Conditions and co-morbidities, within this already vulnerable group, on presentations to General Practice during the pandemic may help us understand better this impact and how best to target help and support to this group.