This Mental Health Awareness Week, the Government’s recently renewed Women’s Health Strategy rightly recognises violence against women and girls as a public health crisis with profound mental health consequences and reaffirms its ambition to halve it within a decade. It commits to expanding NHS Talking Therapies for common mental health conditions in the general population, improving referral pathways and investing in services for survivors.
But there is a critical gap at the heart of this approach: generic, one-size-fits-all mental health provision does not work for survivors of domestic abuse.
Women who experience domestic abuse are more likely to attempt suicide, self-harm, and experience PTSD. The figures are stark. There are more domestic abuse-related deaths by suicide than by homicide, with at least two women dying by suicide every week following domestic abuse (NPCC, 2024).
Meanwhile, one in eight women in England and Wales experienced domestic abuse, sexual assault, or stalking in the year ending March 2025 (Women’s Health Strategy). Eight in ten domestic abuse survivors identify long-term counselling and mental health support as their top priority need, yet only four in ten are able to access support nationally (Domestic Abuse Commissioner, 2023).
Survivors of domestic abuse do not present with typical forms of anxiety or depression. Their distress cannot be separated from the gender inequalities, power imbalances, gender norms and expectations that shape women’s lives, experiences of abuse, and access to support.
Survivors are often coping with complex trauma, coercive control and ongoing risk. Many are also navigating post-separation abuse, stalking, family court proceedings, housing insecurity and financial control.
Yet too often they are routed into short-term, protocol-driven talking therapies that are not designed to address trauma of this nature. These approaches can individualise distress while failing to recognise the wider dynamics of power and control underpinning abuse.
Many women disengage, are judged resistant or ‘not ready’, or leave feeling disbelieved, blamed or misunderstood.
The Strategy’s focus on identification and referral is welcome, as is its commitment to trauma-informed care. Without specialist understanding of coercive control and traumatic abuse dynamics, survivors can be retraumatised by systems that minimise, misread or individualise their experiences.
Woman’s Trust is the leading mental health specialist for women recovering from domestic abuse. For 30 years, it has addressed trauma and helped rebuild lives long after the violence ends.
We see every day that recovery requires tailored, long-term support delivered by practitioners who understand the dynamics and impact of abuse. This requires practitioners trained not only in trauma, but in coercive control, post-separation abuse, risk, gendered power dynamics and the long-term psychological impact of abuse.
Services must also recognise how survivors’ experiences and access to support are shaped by intersecting identities including race, disability, neurodivergence, sexuality, immigration status and poverty.
If the Government is serious about improving women’s mental health and tackling violence against women and girls, it must go beyond expanding generic provision. Trauma-informed care cannot simply mean increasing access to standardised short-term interventions. It must include specialist, gender-responsive services designed around the realities of domestic abuse.
Specialist services improve safety, recovery, engagement and trust because survivors are more likely to feel believed, understood and appropriately supported.
The Government must invest in specialist services and ensure clear, consistent referral pathways from the NHS into them.
Without this, the promise of the Women’s Health Strategy will remain out of reach for the very women it aims to support.
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