PhD student: Eleanor Watson; Partner: Office of the West Midlands Police and Crime Commissioner; Supervisors: Prof. James Rockey and Prof. Heather Flowe; School: Birmingham Business School.
Recent research the supervisory team conducted identified extensive service access gaps for domestic abuse victims that exacerbate conditions for suicidality. Findings revealed that despite most victims contacting police or health services, supports often failed to fully address the severity of victims’ situations, partly due to victims withholding details fearing perpetrator retaliation. As such, a key recommendation was developing a tool to enable proactive multiagency gathering of information to identify suicidality. Unlike risk assessments that overlook suicidal ideation (e.g. the Domestic Abuse, Stalking, Harassment and Honour Based Violence Risk Identification Checklist, or DASH), this tool specifically captures abuse experiences and psychological state erosion empirically linked to victims losing the will to live. While prevailing suicide risk tools demonstrate low predictive utility, prompting advice against reliance on them, the tool does not share the same focus on forecasting longer-term outcomes; rather it aims to rapidly recognise victims whose abuse-trauma is indicating imminent suicidality, through a more tailored detection framework, including raising victim insight, and prompting intervention activation. This aligns with system obligations to employ every feasible innovation to prevent death.
Research Questions
What is the utility, usability, and effectiveness of the tool for healthcare workers and police officers in risk identification?
How does use impact victim awareness of danger signs and help-seeking?
What are optimal tool usage procedures and healthcare and police settings?
How effectively does it elicit disclosure of abuse details and emotional states?
What are perceived barriers and facilitators to effective implementation?
Methods
A mixed-methods approach will be implemented across purposively selected sites/services: a GP surgery with co-located maternity care, a health visiting service and West Midlands police force, over a 12-month timeframe. A scoping review of existing literature will be undertaken across four areas relevant to the research questions on domestic abuse, suicide risk and interventions promoting the re-establishment of individual protective factors. Findings will be qualitatively and quantitatively analysed and synthesised to articulate a theory of change around common components and mechanisms identified as underpinning effective interventions. These elements will inform development of a conceptual framework outlining key requirements for the identification of suicidality and the re-establishment of protective factors. This encompasses domains such victims trusting healthcare workers and police officers, victim-centredness, practitioner knowledge (of suicidality risk factors), addressing whole needs, relationship strengths, practitioner empathy and organisational support. Requirements will be further delineated into observational criteria and experiences to shape data capture tools.
Anticipated Outcomes
This study will provide robust evidence on the tool’s effectiveness within healthcare and police settings, strengthening the care system for domestic abuse victims. It has potential for widespread adoption across healthcare and policing networks, informing domestic abuse and suicide prevention strategies in the UK and beyond. Findings will inform training, best practice recommendations and policy targeting healthcare and criminal justice responses to domestic abuse and suicide prevention.