Can mental health treatments help prevent or reduce intimate partner violence in low- and middle-income countries? A systematic review.

Journal: BMC women's health

Volume: 19

Issue: 1

Year of Publication: 2019

Affiliated Institutions:  Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, N Broadway, HH, Baltimore, MD, , USA. wtol@jhu.edu. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, N Broadway, HH, Baltimore, MD, , USA. Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. Department of Psychology and Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ, USA. Blavatnik School of Government and Centre for the Study of African Economies, University of Oxford, Oxford, UK. Department of Economics and Centre for the Study of African Economies, University of Oxford, Oxford, UK. Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA. Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Abstract summary 

Epidemiological research suggests an interrelationship between mental health problems and the (re)occurrence of intimate partner violence (IPV). However, little is known about the impact of mental health treatments on IPV victimization or perpetration, especially in low- and middle-income countries (LMIC).We conducted a systematic review to identify prospective, controlled studies of mental health treatments in LMIC. We defined 'mental health treatment' as an intervention for individuals experiencing mental ill health (including substance misuse) including a substantial psychosocial or pharmacological component. Studies had to measure a mental health and IPV outcome. We searched across multi-disciplinary databases using a structured search strategy. Screening of title/abstracts and full-text eligibility assessments were conducted by two researchers independently, data were extracted using a piloted spreadsheet, and a narrative synthesis was generated.We identified seven studies reported in 11 papers conducted in five middle-income countries. With the exception of blinding, studies overall showed acceptable levels of risk of bias. Four of the seven studies focused on dedicated mental health treatments in various populations, including: common mental disorders in earthquake survivors; depression in primary care; alcohol misuse in men; and alcohol misuse in female adult sex workers. The dedicated mental health treatments targeting depression or alcohol misuse consistently reduced levels of these outcomes. The two studies targeting depression also reduced short-term IPV, but no IPV benefits were identified in the two alcohol-focused studies. The other three studies evaluated integrated interventions, in which a focus on substance misuse was part of efforts to reduce HIV/AIDS and violence against particularly vulnerable women. In contrast to the dedicated mental health interventions, the integrated interventions did not consistently reduce mental ill health or alcohol misuse compared to control conditions.Too few studies have been conducted to judge whether mental health treatments may provide a beneficial strategy to prevent or reduce IPV in LMIC. Key future research questions include: whether promising initial evidence on the effects of depression interventions on reducing IPV hold more broadly, the required intensity of mental health components in integrated interventions, and the identification of mechanisms of IPV that are amenable to mental health intervention.

Authors & Co-authors:  Tol Murray Lund Bolton Murray Davies Haushofer Orkin Witte Salama Patel Thornicroft Bass

Study Outcome 

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Statistics
Citations :  Garcia-Moreno C, Zimmerman C, Morris-Gehring A, Heise L, Amin A, Abrahams N, et al. Addressing violence against women: a call to action. Lancet. 2015;385(9978):1685–1695.
Authors :  13
Identifiers
Doi : 34
SSN : 1472-6874
Study Population
Female
Mesh Terms
Adolescent
Other Terms
Intimate partner violence;Low- and middle-income countries;Mental health;Multisectoral interventions;Systematic review;Treatment
Study Design
Study Approach
Country of Study
Kenya
Publication Country
England