‘Stark’ findings reveal scale of brain injury among domestic abuse survivors

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A new study conducted by Brainkind aims to shine a light on the prevalence of unrecognised brain injuries among domestic abuse survivors in the UK.

In a new paper, researchers interviewed 60 survivors of domestic abuse at eight different locations across England and Wales, all of whom identified as women, and were accessing support at a refuge or through community-based services.

Women were aged from 18 to 72-years-old and spanned a broad range of ethnicities and socioeconomic backgrounds.

As well as using a number of different tools to understand the prevalence of brain injury among participants, including the Brain Injury Screening Index (BISI), survivors were also asked about their experiences of domestic abuse and accessing support from frontline services.

‘Stark findings’

Their findings reveal that more than half (55 per cent) of women interviewed had a history indicative of brain injury, with 80 per cent having had at least one blow to the head, or significant blows to the head.

In addition, three quarters (75 per cent) of women said they had been held in a way that meant they couldn’t breathe and 46 per cent used the word ‘strangulation’, placing them at risk of a hypoxic brain injury.

“The purpose of this study was to explore the prevalence of brain injury among survivors of domestic abuse in this country,” explains, Dr Annmarie Burns, a consultant clinical neuropsychologist.

“Whilst people now have an awareness of brain injury in sporting populations, for example, and an understanding about the potential seriousness of it, the same can't be said of survivors of domestic abuse - and yet they are being exposed to repeated concussions.

“It’s a stark finding that essentially, one in two survivors of domestic abuse have potentially experienced a brain injury. Given that the prevalence level of brain injury in the general population is around 12 per cent, 55% is a much higher figure.

She adds: “The other finding that's really important is that 46% of women reported that they were strangled, but actually 75% said that they'd been held in a way where they felt they couldn't breathe.

"If we had just asked the question around strangulation, we would have missed about 30% of those women who potentially had a hypoxic brain injury.”

Questions aren’t being asked

The findings are reflective of research that has been carried out elsewhere. A recent study from Trinity College in the US, for example, found that the prevalence of brain injury among survivors of interpersonal violence may exceed that seen in sport.

The study showed that 60 per cent of women who are subject to interpersonal violence had symptoms consistent with having a brain injury. In comparison, the lifetime prevalence of traumatic brain injury in US collegiate football is between 21 and 25 per cent, previous research has revealed.

"It’s not going to be a one size fits all, because all survivors will have had different experiences.”

However, little work has been done to highlight the prevalence of this issue in the UK, until now.

Dr Burns admits that in her role working with brain injury patients in the NHS, the question around domestic violence is rarely asked.

Likewise, Stephanie Bechelet, Domestic Abuse and Brain Injury Researcher at Brainkind, has worked with survivors in refuges, charitable organisations and local authorities for the last 10 years, says brain injuries are ‘rarely part of the conversation’.

Often symptoms overlap with those of other common mental health issues, or could be attributed to trauma, and healthcare providers are not aware of the need to inquire about whether an underlying brain injury could be at the root of it.

“A lot of the signs and symptoms that people present with are often exclusively attributed to trauma,” explains Bechelet.

“It's not that that trauma doesn't exist but there is also a need to explore the types of and experiences someone has had, thinking about the potential for brain injuries and what that support might need to be.”

She continues: “It’s about raising the awareness among professionals, but also amongst survivors about things that they might be experiencing, such as sleep disturbance, fatigue, issues with memory, speech and concentration and slower rates of processing complex information, so that they can then start to have those conversations with professionals that they trust.

“It might mean that the traditional routes to support that we offer people in terms of mental wellbeing and post-traumatic stress need to be adjusted and adapted for people. It’s not going to be a one size fits all, because all survivors will have had different experiences.”

One piece of the jigsaw

When considering their next steps, both researchers are keen for survivors to be involved in the conversation around how services can be improved and what changes should be implemented to bridge the gap.

“We are very keen to co-produce this research. We're at the stage where we're meeting with survivors of domestic abuse and discussing our findings with them to hear what they think are good next steps,” says Dr Burns.

“We've got the support of Brainkind and we're also working with lots of other organisations within the domestic abuse and brain injury fields. But as with sporting concussion, this is not something that is going to be resolved overnight.”

"We are really committed to making positive social change, and to working in collaboration with survivors and domestic abuse professionals to enable people... to thrive, not just survive, with potential brain injuries.”

There is also a need for further research to examine in more depth the complexities that survivors experience across the UK.

“I think what we've got is a great preliminary start, one piece of the jigsaw of the intersections of brain injuries in the context of domestic abuse nationally, but I think it's going to take a lot more comprehensive research to really get to the crux of it,” adds Bechelet.

“As an organisation, we are really committed to making positive social change, and to working in collaboration with survivors and domestic abuse professionals to enable people to access the support they need and to thrive, not just survive, with potential brain injuries.”

Find out more about the work Brainkind is doing here.