This study addressed the gap in detection of domestic violence and abuse (DVA) by estimating the effectiveness of a system provider level training intervention and determining whether improvements in knowledge, skills, and attitudes to DVA were greater in clinicians working in intervention CMH teams than those working in control teams.
This study aimed (1) to estimate the effectiveness of a system provider level training intervention by comparing the detection and referral rates of DVA of intervention community mental health (CMH) teams with rates in control CMH teams; and (2) to determine whether improvements in knowledge, skills, and attitudes to DVA were greater in clinicians working in intervention CMH teams than those working in control teams. The trial showed that a training program on DVA knowledge and skills in CMH teams can increase knowledge and change attitudes towards DVA, but the intervention does not appear to increase the detection or referral rates of DVA in patients with a severe mental illness. Despite increased prevalence of domestic violence and abuse (DVA), victimization through DVA often remains undetected in mental health care, and a low detection rate of DVA remains a major problem. Interventions with more obligatory elements and a focus on improving communication between CMH teams and DVA services are recommended. The authors conducted a cluster randomized controlled trial in two urban areas of the Netherlands. Detection and referral rates were assessed at baseline and at 6 and 12 months after the start of the intervention. DVA knowledge, skills and attitudes were assessed using a survey at baseline and at 6 and 12 months after start of the intervention. Electronic patient files were used to identify detected and referred cases of DVA. Outcomes were compared between the intervention and control teams using a generalized linear mixed model. During the 12-month follow-up, detection and referral rates did not differ between the intervention and control teams. However, improvements in knowledge, skills, and attitude during that follow-up period were greater in intervention teams than in control teams. (Published Abstract Provided)