Detection of and response to gender-based violence: a quality improvement project across three secondary mental health services in London

TL;DR

This paper describes a project to improve how mental health services in London detect and respond to gender-based violence through staff training and collaboration.

Contribution

The study introduces a collaborative, cost-neutral approach to increase GBV detection in mental health services.

Findings

Documented enquiry about GBV increased by up to 30% in some services after interventions.

Up to 56% of patient records showed psychiatric symptoms linked to GBV exposure.

The project highlights the need for better trauma-informed environments in mental healthcare.

Abstract

Our team of core and higher psychiatry trainees aimed to improve secondary mental health service detection of and response to gender-based violence (GBV) in South East London. We audited home treatment team (HTT), drug and alcohol (D&A) service and in-patient ward clinical records (n = 90) for female and non-binary patients. We implemented brief, cost-neutral staff engagement and education interventions at service, borough and trust levels before re-auditing (n = 86), completing a plan–do–study–act cycle.

Documented enquiry about exposure to GBV increased by 30% (HTT), 15% (ward) and 7% (D&A), post-intervention. We identified staff training needs and support for improving GBV care. Up to 56% of records identified psychiatric symptoms related to GBV exposure.

Moves to make mental healthcare more trauma-informed rely on services first being supportive environments for enquiry, disclosure and response to traumatic stressors. Our collaborative approach across clinical services increased GBV enquiry and documentation. The quality of response is more difficult to measure and requires concerted attention.

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