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

Roos Ruijne; Cornelis Mulder; Milan Zarchev; Kylee Trevillion; Roel van Est; Eva Leeman; Willemien Willems; Mark van der Gaag; Carlo Garofalo; Stefan Bogaerts; Louise Howard; Astrid Kamperman

doi:10.1177/08862605211004177

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

Roos Ruijne^*, Cornelis Mulder, Milan Zarchev, Kylee Trevillion, Roel van Est, Eva Leeman, Willemien Willems, Mark van der Gaag, Carlo Garofalo, Stefan Bogaerts, Louise Howard, Astrid Kamperman

^*Corresponding author for this work

Psychiatry

Research output: Contribution to journal › Article › Academic › peer-review

6 Citations (Scopus)

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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.

Original language	English
Pages (from-to)	NP14310–NP14336
Journal	Journal of Interpersonal Violence
Volume	37
Issue number	15-16
Early online date	18 Apr 2021
DOIs	https://doi.org/10.1177/08862605211004177
Publication status	Published - Aug 2022

Bibliographical note

Funding Information:
The authors would like to thank Harriet Gussinklo who was one of our raters of the electronic patient files. We would like to thank Femke Jongejan for her contribution in maintaining contact with the community mental health teams and retrieving all BRAVE survey data. We would like to thank Karima Baddi for assessment of the intervention fidelity scale and Katinka Lünnerman for her contribution to the design of this study. We also thank Milan Zarchev for reviewing this article. Lastly, we thank all participating community mental health teams for participating in the study.

Publisher Copyright:
© 2021 SAGE Publications.

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Cite this

Ruijne, R., Mulder, C., Zarchev, M., Trevillion, K., van Est, R., Leeman, E., Willems, W., Gaag, M. V. D., Garofalo, C., Bogaerts, S., Howard, L., & Kamperman, A. (2022). Detection of Domestic Violence and Abuse by Community Mental Health Teams Using the BRAVE Intervention: A Multicenter, Cluster Randomized Controlled Trial. Journal of Interpersonal Violence, 37(15-16), NP14310–NP14336. https://doi.org/10.1177/08862605211004177

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

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.",

author = "Roos Ruijne and Cornelis Mulder and Milan Zarchev and Kylee Trevillion and {van Est}, Roel and Eva Leeman and Willemien Willems and Gaag, {Mark van der} and Carlo Garofalo and Stefan Bogaerts and Louise Howard and Astrid Kamperman",

note = "Funding Information: The authors would like to thank Harriet Gussinklo who was one of our raters of the electronic patient files. We would like to thank Femke Jongejan for her contribution in maintaining contact with the community mental health teams and retrieving all BRAVE survey data. We would like to thank Karima Baddi for assessment of the intervention fidelity scale and Katinka L{\"u}nnerman for her contribution to the design of this study. We also thank Milan Zarchev for reviewing this article. Lastly, we thank all participating community mental health teams for participating in the study. Publisher Copyright: {\textcopyright} 2021 SAGE Publications.",

year = "2022",

month = aug,

doi = "10.1177/08862605211004177",

language = "English",

volume = "37",

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Ruijne, R , Mulder, C , Zarchev, M, Trevillion, K, van Est, R, Leeman, E, Willems, W, Gaag, MVD, Garofalo, C, Bogaerts, S, Howard, L & Kamperman, A 2022, 'Detection of Domestic Violence and Abuse by Community Mental Health Teams Using the BRAVE Intervention: A Multicenter, Cluster Randomized Controlled Trial', Journal of Interpersonal Violence, vol. 37, no. 15-16, pp. NP14310–NP14336. https://doi.org/10.1177/08862605211004177

Detection of Domestic Violence and Abuse by Community Mental Health Teams Using the BRAVE Intervention: A Multicenter, Cluster Randomized Controlled Trial. / Ruijne, Roos ; Mulder, Cornelis ; Zarchev, Milan et al.
In: Journal of Interpersonal Violence, Vol. 37, No. 15-16, 08.2022, p. NP14310–NP14336.

Research output: Contribution to journal › Article › Academic › peer-review

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T1 - Detection of Domestic Violence and Abuse by Community Mental Health Teams Using the BRAVE Intervention

T2 - A Multicenter, Cluster Randomized Controlled Trial

AU - Ruijne, Roos

AU - Mulder, Cornelis

AU - Zarchev, Milan

AU - Trevillion, Kylee

AU - van Est, Roel

AU - Leeman, Eva

AU - Willems, Willemien

AU - Gaag, Mark van der

AU - Garofalo, Carlo

AU - Bogaerts, Stefan

AU - Howard, Louise

AU - Kamperman, Astrid

N1 - Funding Information: The authors would like to thank Harriet Gussinklo who was one of our raters of the electronic patient files. We would like to thank Femke Jongejan for her contribution in maintaining contact with the community mental health teams and retrieving all BRAVE survey data. We would like to thank Karima Baddi for assessment of the intervention fidelity scale and Katinka Lünnerman for her contribution to the design of this study. We also thank Milan Zarchev for reviewing this article. Lastly, we thank all participating community mental health teams for participating in the study. Publisher Copyright: © 2021 SAGE Publications.

PY - 2022/8

Y1 - 2022/8

N2 - 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.

AB - 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.

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

Abstract

Bibliographical note

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