On October 7th at Dover Downs in Dover, the Domestic Violence Prevention Enhancement and Leadership Through Alliances (DELTA) Program Coordinators held a statewide teacher training on their Department of Education-approved "Healthy Relationships" curriculum. This day-long training for teachers and youth service providers focused on the implementation of the curriculum and provided helpful tips and tools for using the curriculum in their classrooms. The goal of the DELTA Program is to work with communities to strategize how to address the root causes of abuse before it ever occurs, so that we can move closer to eliminating the tragic and pervasive social problem of violence against women. These strategies work to change knowledge, attitudes, beliefs, and behaviors around underlying factors, such as gender norms and forms of oppression, that contribute to domestic violence. These strategies are at the core of the Healthy Relationships curriculum. Read more about DELTA in Delaware. 

Last year DCADV, with community partners NAMI Delaware and The Center for Disabilities Studies at the University of Delaware, was awarded a three-year grant from the Office of Violence Against Women to improve and expand services to individuals with disabilities, including mental illness, who experience domestic violence. This project complements the Mental Health and Trauma work begun by DCADV in a national collaborative in 2009. This article is Part 2 of a series on Disabilities and Domestic Violence; Part 3 will focus on the trauma-informed approach to care.

What is Mental Illness?
Mental illness refers to a wide range of mental health conditions: disorders that affect a person's mood, thinking, and behavior. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders, and addictive behaviors.

 While 1 in 4 adults experience a mental health condition in any given year, about 1 in 17 lives with a serious mental illness, such as schizophrenia, major depression, or bipolar disorder (read more at www.nami.org). Some conditions, such as those on the autism spectrum, are considered both a mental illness and a developmental disability. When a mental illness seriously impacts one's ability to function, the experience is considered a psychiatric disability.

People with these conditions may find it especially difficult to cope with the challenges of life. While there is no "cure" for mental illness, recovery (a way of living a satisfying, hopeful, and contributing life even with limitations caused by the illness) is the goal of treatment.

Why Focus on Women with Mental Illness and Domestic Violence?
The relationship between mental illness and domestic violence is complex. The experience of domestic violence is traumatic, and the reactions to trauma, including survival strategies, can mimic the symptoms associated with a mental illness. Also, the direct impact of domestic violence and abuse may lead to depression, anxiety, and other emotional problems.

In addition, a women who is diagnosed with a mental health problem may feel stigmatized, which can result in social isolation and exclusion, and make it even harder than other women to report or even to name their experience as domestic violence. When they do seek help, their credibility may be questioned and they may be unable to access any suitable sources of support.

A Challenge to Providers
Domestic violence is very prevalent among women seeking mental health services; some surveys indicate that at least half of all women who use mental health services have experienced domestic violence, and about 20% of them are experiencing current abuse.
 
Abused women are very likely to attempt suicide, with some surveys indicating that one third of all female suicide attempts are related to domestic violence. Women who have been abused are 15 times more likely to abuse alcohol and 9 times more likely to abuse drugs than women who have not been abused. In 2002, the Department of Justice found that 36% of victims in domestic violence programs also had substance abuse problems.
 
Mental health and substance abuse service providers are not routinely trained to address the social factors that entrap victims in abusive relationships, which can result in falsely interpreting survival strategies as disorders, and may not be aware of the advocacy needs (shelter, legal assistance, safety planning) of domestic violence victims, which impact the success of treatment.

We're very excited about our collaborative disability and mental health projects that are aimed at increasing knowledge among all providers who interact with victims of domestic violence and work to improve the services available to them.