Content Note: This article contains a detailed discussion of domestic violence and mental illnesses.

mucky skies and weeping / sunless days are forgotten / in this air / that cannot choke you / in the living room safe / I cocoon in your arms / this is not 2010 / that awful stolen spring.

It was the year my parents’ marriage imploded. The spring of divorce and my father’s rages. Living in the shadows of abuse is terrifying at the best of times. In those dark weeks of early lockdown, I often wondered what might have happened if the world had ground to a halt back then. What if, in 2010, a pandemic had sealed us in with him?

This is the reality that many domestic violence survivors are facing. Reported cases of domestic violence, which encompass physical, emotional and sexual abuse, have soared in tandem with the pandemic. Tactics of control, surveillance and coercion, often used by perpetrators of domestic violence, have been exacerbated by the restrictive measures of lockdown. Women experiencing domestic violence have reported how their abusers have used the pandemic to control and manipulate them further by preventing them from leaving the house, monitoring their behaviour and online activity more than usual, constantly trying to contact them, and even using the virus more directly by coughing and spitting on them.

The COVID-19 Task Force on Domestic Violence is a group of students, many of whom are based in Cambridge, dedicated to helping survivors of domestic violence during the COVID-19 pandemic. As well as a spike in domestic violence cases, the pandemic has brought with it a disruption to in-person mental health services. One of the current projects of the Task Force focuses on leveraging technology and remote support to treat mental health issues arising from domestic violence.

“...it seems that hysteria has simply followed a euphemism treadmill of new terms — Briquet’s syndrome, conversion disorder, psychogenic disease — and women’s symptoms are still not being taken seriously.”

The relationship between mental health and domestic violence is important but often overlooked. An analysis of the medical records of 18,547 women who had experienced domestic abuse indicated that they were twice as likely to develop a serious psychological disorder like bipolar disorder, depression or schizophrenia than women who had not been abused. Another study of women from multiple countries showed that there was an association between domestic violence and psychiatric problems such as anxiety, phobias, PTSD, suicidality, and alcohol and drug abuse. Of course, these studies cannot prove that domestic violence caused the onset of these mental illnesses. People who are predisposed to developing a mental illness may also be more at risk of finding themselves in abusive relationships. But previous studies have indicated that this is not the case, and that the mental illnesses experienced by survivors are outcomes of their abuse.

“Though [mental health apps and online therapies] are not new, they are underused, typical of the time lag between the innovation of new technologies and their use in practice.”

So, if there is an association between domestic violence and poor mental health, surely they should not be treated as isolated problems. Yet, when women who are experiencing domestic violence seek medical help for their mental health, often the role of their abuser in the decline of their mental health is not recognised and a victim-blaming stance is adopted. Perhaps this is just another example of the sexism deeply rooted in medicine, following centuries of unexplained symptoms in women being put down to hysteria. Though no longer a formal diagnosis, it seems that hysteria has simply followed a euphemism treadmill of new terms — Briquet’s syndrome, conversion disorder, psychogenic disease — and women’s symptoms are still not being taken seriously.

With in-person therapeutic services disrupted by the pandemic, there is a greater need for the use of mental health apps and online therapies. Though they are not new, they are underused, typical of the time lag between the innovation of new technologies and their use in practice. One of the aims of the COVID-19 Task Force on Domestic Violence is to bridge this gap. They have partnered with the charity CHAYN, to present their new remote programme, which helps women to cope with experienced trauma, to an audience of mental health practitioners, domestic violence charities and academics.

Though the use of technological intervention poses its own risk, including privacy concerns for its already-vulnerable users, there are benefits of leveraging technology which will hopefully persist in a post-Covid world. The current model of mental health support depends on patients being very proactive in seeking help but paradoxically, the symptoms of common mental health problems can often make it difficult to be proactive. Thus, removing the barrier of travelling may improve the accessibility of mental health support. The double stigma of domestic violence and mental health issues could also prevent survivors from seeking help, so the privacy of remote support could encourage survivors to seek the help that they need. Hopefully, the promotion of mental health apps and online therapies necessitated by the pandemic will act as a catalyst for a new dawn of mental health services and specifically for mental health services for survivors of domestic violence.