Behavioral health concerns are common among survivors of domestic, sexual, and similar types of violence. According to the National Center on Domestic Violence, Trauma & Mental Health (NCDVTMH), a survey of 2,546 callers to the National Domestic Violence Hotline found that survivors of domestic violence were three times more likely to experience major depressive disorder, post-traumatic stress disorder, or self-injury; four times more likely to attempt suicide; and six times more likely to have a substance use disorder.
The connection between violence and behavioral health was also evident in one of our recent training sessions where participants who work within our network of survivor advocacy organizations reported through polling that 95–100% of their clients experience a behavioral health disorder.
Despite this intersection, advocates often have limited opportunities to develop their knowledge and skills related to behavioral health. As a result, they may feel uncertain about how to safely and effectively respond when a survivor is experiencing a mental health crisis or using substances.
Building Behavioral Health Knowledge and Skills
In response to this need, the Nebraska Coalition recently partnered with the Wellbeing Initiative to offer Advocacy at the Intersection of Trauma & Mental Health, a five-part training designed to increase behavioral health knowledge and skills among advocates.
Trainers Taisa Brumagen and Lisa DeCoteau, both Certified Peer Support Specialists, brought valuable expertise to the series through their professional experience, lived experience with mental health challenges, and experiences as survivors of violence.
Held from April through August this year, the sessions explored a range of topics, including:
- Destigmatizing behavioral health disorders
- Crisis intervention techniques
- The unique perspective and importance of peer support
- The intersection of gender-based violence and behavioral health disorders
- How a survivor’s mental health can be exploited as a tool of coercion, control, and abuse
- The Nebraska behavioral health system and tips for accessing resources
Understanding the Intersection of Violence & Behavioral Health
It is critical for advocates to recognize the many ways behavioral health can intersect with domestic, sexual, and similar types of violence. Experiencing violence can have significant and lasting effects on a person’s mental health. At the same time, mental health challenges can increase a survivor’s vulnerability to coercion and abuse by an intimate partner.
According to NCDVTMH, mental health coercion and substance use coercion can impact a survivor’s well-being, as well as their access to resources, such as treatment and peer support. People who abuse their partners may interfere with a survivor’s recovery efforts by:
- Coercing them into using substances
- Preventing them from accessing treatment
- Controlling their medication
- Sabotaging their recovery efforts
- Using their mental health or substance use history to discredit them with friends, family members, helping professionals, faith leaders, law enforcement, or the courts
Recognizing these tactics can help advocates better understand a survivor’s experiences, identify barriers to recovery, and provide more informed and considerate support.
What Advocates Took Away
A total of 29 survivor advocates participated in the series, with an average of 15 participants per session. Follow-up evaluations indicated that participants increased their knowledge of behavioral health issues and gained insight into the unique challenges faced by survivors experiencing both domestic violence and behavioral health concerns.
When asked to share one piece of information from the training that resonated with them, participants said:
- “What resonated with me was that trauma and mental health struggles can look different for everyone.”
- “Talking about mental illness and how we can vocalize it to help others feel more comfortable with their experiences.”
- “The importance of asking someone if they are experiencing suicidal thoughts.’”
- “Understanding addiction as a disease and that some survivors’ hierarchy of needs differs, especially when exposed to drugs before the age of 21.”
Strengthening Advocacy Through Understanding
The intersection of trauma, violence, and behavioral health is complex. Expanding advocates’ knowledge and confidence in responding to behavioral health concerns strengthens their ability to support survivors safely, reduce stigma, recognize coercive tactics, and connect survivors with resources that support healing and recovery. This training series provided advocates with an opportunity to build those skills.
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