Mental Health Awareness Week: Mental health reform will fail survivors unless domestic abuse is recognised as a specialist trauma issue
The Government’s new strategy to transform mental health care promises expanded access to therapy, earlier intervention and more community-based support.
These reforms are welcome. But there is a critical gap at the heart of the 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 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. 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.
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 and ongoing trauma shaping their lives. Many are coping with coercive control, post-separation abuse, stalking, family court proceedings, housing insecurity and financial control.
Yet too often survivors are routed into short-term, protocol-driven services, such as Talking Therapies, that are not designed around the realities of coercive control and traumatic abuse. Survivors are frequently misunderstood, misdiagnosed or retraumatised within mainstream pathways.
For 30 years, Woman’s Trust has specialised exclusively in the mental health impact of domestic abuse, supporting thousands of survivors and developing specialist expertise in recovery from coercive control and gender-based trauma.
Our intersectional, trauma-informed model is designed specifically around the realities of domestic abuse and meets women where they are in their lives right now. This means recognising the ongoing impact of coercive control, power, safety, inequality and trauma, rather than treating women’s distress as isolated symptoms detached from the realities of abuse.
Our experience demonstrates that survivors achieve better engagement, safety and recovery outcomes when support is delivered by specialist practitioners with expertise in domestic abuse dynamics.
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 transforming mental health care, it must go beyond expanding generic provision. Trauma-informed care must include specialist, gender-responsive services designed around the realities of domestic abuse, alongside clear and consistent referral pathways into them.
As mental health services are reformed, specialist domestic abuse organisations must not simply be viewed as referral partners, but as essential experts in designing trauma-informed responses for survivors. Policy reform developed without specialist domestic abuse expertise risks repeating the very gaps survivors already face within mainstream mental health provision.
Without this, survivors will continue to fall through the gaps of a system not built around the realities of abuse.
