10 item checklist about the intersection of domestic violence, substance abuse and mental health issues

by David Mandel, MA, LPCDomestic violence frequently co-occurs with mental health and substance abuse issues.   A batterer may be diagnosed correctly or inappropriately with mental health issues.  A domestic violence survivor may also have a substance abuse problem.  A child who has been exposed to batterer's behaviors may have mental or behavioral health issues. Frequently our response to these issues are "siloed," meaning we prioritize one over the other or even completely ignore one issue to focus on another.  For instance substance abuse and mental health counselors may not screen for domestic violence or if domestic violence perpetration  is identified as an issue it may seen as a symptom of the substance abuse.  A survivor's recovery plan may be developed without consideration of how the perpetrator might try to sabotage her recovery.   Or a child's behavioral health issues are not evaluated in the context of historic and current domestic violence.The following is a 1o item checklist to help begin the conversation about the intersection of domestic violence, substance abuse and mental health issues.  I share this list with the idea that raising our awareness by asking questions about the connection between different issues can be huge step forward in our ability to help families.

1. What is the relationship between domestic violence, substance abuse, mental health issues?
2. How have the batterer’s behavior created or exacerbated mental health/behavioral health and/or substance abuse issues for the adult survivor and/or child?
3. What is the relationship between the batterer’s abusive behavior and any of his mental health and/or substance abuse issues?
4. How is the batterer interfering with/supporting the treatment and recovery of family members?
5. How are family members more vulnerable to the batterer because of their mental health and/or substance abuse issues?
6. How is child welfare and others assessing for domestic violence when the presenting issue is adult or child behavioral/mental health/ substance abuse?
7. What are important case or treatment plan steps when domestic violence is co-occurring with substance abuse and/or mental health issues?
8. What are skill level/policy/practices of substance abuse and mental service providers regarding assessing for domestic violence, safety planning and the integration of co-occurring issues into their treatment plan?
9. What information do mental health and substance treatment providers have access to regarding the domestic violence?
10. What is the training and skill level of mental health or substance abuse evaluators/assessors regarding domestic violence in general and more specifically regarding the co-occurrence of domestic violence with substance abuse and/or mental health issues?

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