Addressing the Mental Health Needs of Domestic Violence Survivors at the Durham Crisis Response Center

The psychological effects of Domestic Violence have been well documented. Golding’s (1999) meta-analysis found that 47.6% of survivors experience depression, 63.8% have PTSD symptoms, 17.9% exhibit suicidality, 18.5% have alcohol abuse problems, and 8.9% live with substance abuse problems. Unfortunately, due to severe budgetary and staff constraints, it is difficult for domestic violence agencies to address these mental health needs. 69% of centers are operating with less than 20 paid staff members and 42% of programs operate with a budget of less than $500,000 per year (National Census on Domestic Violence, 2007). Although service providers rank mental health as an important priority, these programs are the first to be cut because emergency safety and legal services must take precedence (Macy et al., 2010).

This study found that major programs available in shelters for trauma and mental health effects include support group, supportive counseling from shelter staff, and peer support. Some of the shelters interviewed were able to offer clinical services as well. However these services were described as limited and almost all shelters will refer clients to trauma, substance abuse, and
mental health services in the community to supplement care.

Shelter directors identified an important gap between the amount of women who could benefit from counseling and the amount of women who actually receive services. One provider estimated that 60% could benefit from counseling, but about 20-30% received care in the end. Another provider estimated that the gap was larger with 60% exhibiting symptoms and 2-3% seeing a practitioner. Although shelters recognize the need for mental health services and refer their clients, few clients are actually receiving services from a mental health practitioner.

This research documents the efforts of domestic violence shelters to provide services for women under severe budgetary and staffing constraints and identifies 20 barriers that influence whether a client will or will not receive clinical counseling. Various solutions are identified to mitigate these barriers. These solutions are suggestions that arose out of interviews and have not been researched as efficacious solutions.