|
Abstract
|
Inquest in England links domestic abuse and suicide for the first time
A coroner's inquest in England has concluded that the underlying cause of a 34 year old woman's suicide was domestic abuse.1 She had previously attended an emergency department with cut wrists and expressed suicidal thoughts to police and other agencies, in the context of domestic abuse. The coroner recommended greater recognition of the link between domestic abuse and suicide among first responders and improved coordination between agencies to prevent future deaths.1 Although this is the first time that a coroner in the UK has cited domestic abuse as having a causal role in death by suicide, this case will be distressingly familiar to related services and researchers.23
The 2021 Domestic Abuse Act in England and Wales defines domestic abuse as any incident of threatening behaviour, violence, or abuse towards someone to whom the perpetrator is personally connected. This includes coercive controlling behaviour, intimate partner violence (including by a former partner), and harm perpetrated by others in the family or household. Research has largely focused on intimate partner violence, finding that it is highly gendered internationally.4 The latest Crime Survey for England and Wales found that 74% of people subject to domestic abuse were female, and the overwhelming majority (97%) of domestic homicides were perpetrated by men.5 Young women are more commonly affected than older women, including by domestic homicide and severe, repeated abuse.4
Mental health conditions, including suicidality, have a well established link with intimate partner violence.4 Systematic reviews of longitudinal studies and evidence from a World Health Organization study in multiple countries have found significant associations between intimate partner violence and both suicidal thoughts and suicide attempts.67 Analysis of the 2014 English Adult Psychiatric Morbidity Survey found that 35% of women who had attempted suicide in the past year had experienced intimate partner violence in the same period. After potential confounding was adjusted for, intimate partner violence was associated with an adjusted odds ratio of 2.82 (95% confidence interval 1.54 to 5.17) for suicide attempts. Higher odds of suicidality were also associated with experiencing more than one type of intimate partner violence.8 However, more longitudinal data, including from low and middle income countries and marginalised groups, are required to examine context, mechanisms, and protective factors.4
In the US national reporting system for violent deaths, intimate partner violence was noted in 37% of suicides associated with pregnancy.9 The latest UK Confidential Enquiry into Maternal Deaths and Morbidity found that suicide was the leading cause of maternal death in the first postnatal year. Domestic abuse was documented in 33% of suicides and 70% of deaths related to substance use.10
Although intimate partner violence is associated with suicidal ideation, its relation with suicide is less clear because of limited data collection...
Language: en |