Emily Vera, LCSW – Executive Director
Mental Health Association of Delaware

There is a documented link between suicide risk and domestic violence – two major public health crises that must be addressed in a coordinated fashion. Persons who suffer interpersonal violence usually report a range of negative mental and physical health outcomes, and survivors of intimate partner violence are twice as likely as the general public to attempt suicide multiple times.

Studies show that survivors of domestic violence have higher-than-average rates of suicidal thoughts, with as many as 23 percent of survivors having attempted suicide compared to 3 percent among those who have not experienced domestic violence.

This includes not only exposure to repeated physical or sexual abuse, but also exposure to psychological or emotional abuse. Such abuse may cause victims to experience depression, hopelessness and other forms of psychological distress, sometimes to the point of considering or attempting suicide.

Reasons for this correlation are complex and variable, but almost certainly include the severe and sustained stress that goes hand in hand with experiencing abuse, often encompassing humiliation, being controlled, isolation, and lack of access to money or other basic resources.

Protective factors that keep people from considering suicide include a sense of belonging and a sense of purpose, and these can often be disrupted in an abusive relationship where the victim is isolated from friends, family, and other social networks. Individuals may perceive that they are dependent on their abuser and as such, may perceive themselves as burdensome and purposeless. The act of suicide may also be seen as a means of taking back control in a situation when
one feels extremely helpless and powerless.

If an individual at risk for suicide because of interpersonal violence does not receive help, the risk of suicide may not abate even after the abuse ends. But there are things we can do increase safety from suicide among those who have experienced and are experiencing abuse.

One solution is to further connect the fields of mental health and domestic violence, who have historically worked in isolation, but are increasingly becoming more coordinated. When each field isn't educated about the other, grave outcomes can occur. For example, domestic violence workers may minimize suicide threats made by perpetrators of violence as simply attempts to manipulate partners.

Such threats, however, indicate a genuine risk of harm to both
perpetrators and their victims. Or, when someone makes a suicide attempt, their mental health worker may not ask about violence, and the person at risk may be too ashamed to bring it up, so no intervention is provided to mitigate the situation.

Learn more:
The Link Between Suicide Risk and DV

Domestic violence is a pattern of abusive behavior and coercive control that can happen in a dating, marital, or live-in intimate partner relationship. In an abusive relationship, one partner tries to maintain control over the other by using physical, psychological, verbal, and sexual violence. Although factors such as drug and alcohol use, stress, or a family history of abuse may contribute to the problem, domestic violence is primarily an issue of power and control.

Domestic violence looks different in every relationship.  An abuser may use a number of violent tactics to hurt and control their partner:

• Physical: Hitting; kicking; pushing; slapping; choking/strangling; punching; biting; refusing to help/withholding treatment when their partner is sick, injured, or pregnant; interfering with their partner’s basic needs (food, sleep); attacking with weapons; destroying personal property; stalking their partner
• Psychological: Making light of the abuse; shifting responsibility for abusive behavior; constant jealousy and control; verbal attacks or humiliation; playing mind games/gaslighting; harassing the victim about affairs the abusive partner imagines them to be having; isolating their partner from friends/family; intimidation/threats; excessive criticism; using race, age, sexual identity, immigration status, class, appearance, religion, HIV status, etc. against their partner
• Economic: keeping their partner from working; not allowing their partner access to family income; refusing to work and making their partner support the family; ruining their partner’s credit rating
• Sexual: pressuring their partner to engage in sexual activity when they don’t want to; forcing their partner to engage in sexual activity without prophylaxis (condoms, birth control, etc.)

Learn more about domestic violence here.

Erin Ridout
Domestic Violence & Community Health Project Manager

So, what is wellness and how do you do it? It’s the little things. Eating fruits and veggies, moving your body, getting outdoors, drinking water. It’s also the big things. Keeping up with medical and dental appointments. Your relationships with others. Your relationship with yourself.

Wellness is different than our efforts to avoid being unhealthy or avoid being sick. It is something much bigger – it is our overall picture. Wellness is about the choices you make to do things that fulfill you. Wellness is comprised of daily acts and choices toward being happy and healthy. Moving the needle from ‘getting there’ to ‘being there.’

Wellness includes your social life, what’s around you, what you are thinking, what you are feeling, what you believe in, how your work fulfills you, how your body feels, and how secure you feel.

Wellness moves us beyond the avoidance of illness and into healthier and happier existence. It is not a state you achieve (how are you? I am well), it is an ever-evolving, continuous process of growth.

There are many ways to engage in your own wellness. There are certainly books, videos, websites, and classes that may help you move yourself in the right direction, but I want to focus on something small you can start doing today. At the end of your day, as you get into bed or brush your teeth (dental health!), take 1 minute to think about what went well for you today. You can think about it, or you can go an extra step and write it down. What were your positives from the day? Jot them down quickly. One minute is all you need. Taking a moment to pause and reflect does two things.

First, you end your day thinking about the good stuff. Even if it was a terrible day, you are writing down maybe the one thing that actually was not terrible. Second, over time, you will start to see a pattern emerge. You’ll see the things in your life that make YOU feel good. For some, it may be a social connection – being with friends and family. For others, it may be exercise, a great meal, playing with your children. It may be that you knocked that one big report off your to-do list, that you helped others, or that you are seeing the seeds you have planted bloom (literally or metaphorically).

Now I believe this recognition of the stuff that makes you smile at the end of your day, this alone, can promote a feeling of increased wellness. But if you care to go one step further with me, once you start to pull out those things that make you feel good at the end of the day, do them more. Seek those things out. Especially on days that feel crummy. Days that are hard. When it’s been raining all week (again, literally or metaphorically) – do the things that you value and take note of the 1-2 things that actually have worked out and made you feel good.

So action steps (because wellness takes action):

1) Note what makes you feel good; brings you joy; fills your cup
2) Do the above more

Your health is important, but your wellness is everything.