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

dc.contributor.authorTol, W A
dc.contributor.authorMurray, S M
dc.contributor.authorLund, C.
dc.contributor.authorBolton, P
dc.contributor.authorMurray, L K
dc.contributor.authorDavies, T
dc.contributor.authorHaushofer, J
dc.contributor.authorOrkin, K
dc.contributor.authorWitte, M
dc.contributor.authorSalama, L
dc.contributor.authorPatel, V
dc.contributor.authorThornicroft, G
dc.contributor.authorBass, J K
dc.date.accessioned2019-02-22T14:26:53Z
dc.date.available2019-02-22T14:26:53Z
dc.date.issued2019-02-14
dc.date.updated2019-02-17T04:16:39Z
dc.description.abstractBackground 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). Methods 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. Results 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. Conclusions 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.
dc.identifier.apacitationTol, W. A., Murray, S. M., Lund, C., Bolton, P., Murray, L. K., Davies, T., ... Bass, J. K. (2019). Can mental health treatments help prevent or reduce intimate partner violence in low- and middle-income countries? A systematic review. <i>BMC Women's Health</i>, http://hdl.handle.net/11427/29809en_ZA
dc.identifier.chicagocitationTol, W A, S M Murray, C. Lund, P Bolton, L K Murray, T Davies, J Haushofer, et al "Can mental health treatments help prevent or reduce intimate partner violence in low- and middle-income countries? A systematic review." <i>BMC Women's Health</i> (2019) http://hdl.handle.net/11427/29809en_ZA
dc.identifier.citationBMC Women's Health. 2019 Feb 14;19(1):34
dc.identifier.ris TY - Journal Article AU - Tol, W A AU - Murray, S M AU - Lund, C. AU - Bolton, P AU - Murray, L K AU - Davies, T AU - Haushofer, J AU - Orkin, K AU - Witte, M AU - Salama, L AU - Patel, V AU - Thornicroft, G AU - Bass, J K AB - Background 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). Methods 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. Results 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. Conclusions 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. DA - 2019-02-14 DB - OpenUCT DP - University of Cape Town J1 - BMC Women's Health LK - https://open.uct.ac.za PY - 2019 T1 - Can mental health treatments help prevent or reduce intimate partner violence in low- and middle-income countries? A systematic review TI - Can mental health treatments help prevent or reduce intimate partner violence in low- and middle-income countries? A systematic review UR - http://hdl.handle.net/11427/29809 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12905-019-0728-z
dc.identifier.urihttp://hdl.handle.net/11427/29809
dc.identifier.vancouvercitationTol WA, Murray SM, Lund C, Bolton P, Murray LK, Davies T, et al. Can mental health treatments help prevent or reduce intimate partner violence in low- and middle-income countries? A systematic review. BMC Women's Health. 2019; http://hdl.handle.net/11427/29809.en_ZA
dc.language.isoen
dc.publisherBioMed Central
dc.rights.holderThe Author(s).
dc.sourceBMC Women's Health
dc.source.urihttps://bmcwomenshealth.biomedcentral.com/
dc.subject.otherMental health
dc.subject.otherIntimate partner violence
dc.subject.otherLow- and middle-income countries
dc.subject.otherTreatment
dc.subject.otherMultisectoral interventions
dc.subject.otherSystematic review
dc.titleCan mental health treatments help prevent or reduce intimate partner violence in low- and middle-income countries? A systematic review
dc.typeJournal Article
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