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Randomized Controlled Trial
. 2022 Aug;37(15-16):NP14310-NP14336.
doi: 10.1177/08862605211004177. Epub 2021 Apr 18.

Detection of Domestic Violence and Abuse by Community Mental Health Teams Using the BRAVE Intervention: A Multicenter, Cluster Randomized Controlled Trial

Roos Ruijne  1 , Cornelis Mulder  1   2 , Milan Zarchev  1 , Kylee Trevillion  3 , Roel van Est  2 , Eva Leeman  2 , Willemien Willems  4 , Mark van der Gaag  4   5 , Carlo Garofalo  6 , Stefan Bogaerts  6 , Louise Howard  2 , Astrid Kamperman  1
Affiliations
Randomized Controlled Trial

Detection of Domestic Violence and Abuse by Community Mental Health Teams Using the BRAVE Intervention: A Multicenter, Cluster Randomized Controlled Trial

Roos Ruijne et al. J Interpers Violence. 2022 Aug.

Abstract

Despite increased prevalence of domestic violence and abuse (DVA), victimization through DVA often remains undetected in mental health care. 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. We also aimed 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. We 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: β 3.21 (95% CI 1.18-4.60). Our trial showed that a training program on DVA knowledge and skills in CMH teams can increase knowledge and attitude towards DVA. However, our intervention does not appear to increase the detection or referral rates of DVA in patients with a severe mental illness. 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.

Keywords: domestic violence and abuse; interpersonal violence; outreaching healthcare; randomized controlled trial; severe mental illness; victimization.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.. Detection and referral rates of current DVA, rates of DVA form used and detection and referral rates for current DVA stratified for intervention fidelity.
Figure 2.
Figure 2.. The total scores and subscale scores on the BRAVE survey at the time points: baseline, 6 months and 12 months after start of the intervention.
See this image and copyright information in PMC

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