The Link Between Violence, Mental ILL Health & Substance Misuse

by Neseret on May 5, 2012

Flower“There is evidence that many mental health problems post-date experiences of abuse.

Therefore, ‘mental health issues should be treated as effects of abuse and not as  mental disorders per se.’

The association between woman abuse, substance use and mental health issues has been well documented across demographic groups and diverse treatment settings.

Strong evidence shows that women’s experiences of abuse precede their substance use and/ or mental health issue. At the same time, there is evidence that substance use and/or mental health issues can create a vulnerability to abuse and that the pre-existence of these conditions may exacerbate the effects of abuse.”

~ Building Bridges: Linking Woman Abuse, Substance Use and Mental ILL Health ~

I recently attended a “Building Bridges Workshop“, a wonderful provincial initiative of BC Women’s Hospital and Health Centre. In the workshop we were provided with a very powerful “summery document” that “provides the background information on the Building Bridges initiative and presents the preliminary findings from the provincial consultation with service providers and women impacted by abuse and mental ill health and substance use.”

If you are a mental health and addiction professional or work in any capacity with women, and any individuals who have or are experiencing trauma I would highly encourage you to read this document. It will absolutely change the way you approach your practise. It will also give you an amazing perspective on the link between violence, Mental Health issues, and Substance Misuse.

Personally I felt the findings and lived experiences of women was extremely validating on many levels.

The idea that trauma whether in the form of childhood abuse or current violent/toxic/unhealthy relationships pre-dates mental health and addictions issues makes so much sense.

I’ve seen this happen in my own life and come across it every single day in my line of work. I had come to the conclusion that trauma is the root cause of mental health and addiction issues. I LOVE, LOVE the statement

“‘mental health issues should be treated as effects of abuse and not as mental disorders per se.”

Unfortunately in psychiatry today we have the whole thing backwards. Psychiatry is still dominated by the old medical model paradigm of treating only the very obvious signs and symptoms and not addressing the underlying cause. Medication and the all too prevading “here and now” therepy modalities are not going to fix the effects of trauma.

“It is important to recognize that revictimization can take place in clinical interactions and that the distortion of meaning and denial of experiences that are used as tactics of psychological control in abusive relationships can be inadvertently repeated in health care encounters if the clinician is unable to

recognize and validate the traumatic context in which a person’s symptoms develop and are perpetuated.”

~ Dr. Carole Warshaw ~

Unfortunately as a mental health nurse I am too familiar and have witnessed this inadvertent “revictimization” and absolute refusal to acknowledge the devastating impact of trauma on clint’s lives. What is more frightening is the compartmentalization and lack of proper trauma informed care.

I see the frustration and hopelessness people experience when they feel they are being victimized by the very organizations and helping professionals they hope to receive help and support. Going through “the system”, whether that is income assistance, and or mental health and addiction services or any  other helping organization can be traumatizing in and of itself.

“Mental health issues are construed as separate from abuse (trauma) – now that’s crazy!” ~ Service Provider ~

I’m truly grateful to have had the opportunity to be a part of the “Building Bridges Workshop“. I’m truly thankful for the phenomenal work the BC Women’s Hospital and Health Centre is doing to raise awareness about trauma and how it impacts women’s health.

Please share your comments and experiences below. Please share this information on Facebook and Twitter.

Peace, Love & Gratitude,


{ 3 comments… read them below or add one }

Cathy | Treatment Talk May 8, 2012 at 3:48 am

Hi Neseret,

“The idea that trauma whether in the form of childhood abuse or current violent/toxic/unhealthy relationships pre-dates mental health and addictions issues makes so much sense.” This line speaks to me. Women self medicate to ease their pain and often mental health issues are involved as well. It is difficult to dissect what came first, especially with regards to the mental health issues or the substance abuse, but clearly the substance abuse needs to stop to make any progress. There is definitely a gender difference with why someone begins to abuse drugs or alcohol.

The summary document sounds interesting, something that would be valuable to read. Thanks for an informative post!


Neseret May 8, 2012 at 4:18 am

Hi Cathy,

You’re absolutely right about the gender differences in how addiction starts and develops overtime. Women have lower rates of addiction than men but they are more likely to suffer negative effects from addiction. Research show…

* that women are more likely to die from addiction than men
* they become addicted more quickly than men
* they’re more likely to develop health problems than men
* women are less likely to seek treatment than men
* women are imprisoned at higher rates than men, primarily due to substances
* women have more barriers to treatment than men
* women are judged more harshly for addiction than men
* women with addiction become more socially isolated than men
* addicted women suffer violence and don’t often recieve proper treatment for it
* women with addiction have more emotional problems than men

On the positive side women…

* respond better to treatment than men
* treating women effectively can have a positive impact on their children
* women have more awareness of substance abuse issues than men

The above information is from “A Woman’s Addiction workbook” by Lisa M. Najavitis, Ph.D.

As far as what came first trauma or substance use, the preliminary findings from this initiative are saying there is a strong evidence that violence/trauma precede substance use and mental ill health.

As a mental health nurse I would agree. I see this everyday in my practise. I find both men and women equally report they started to self medicate to cope with the impact of violence in their life.

Post traumatic Stress Disorder and substance abuse are closely linked. PTSD and substance abuse as concurrent disorders are extremely common.

The summery document is excellent. I’d love to hear your thoughts on it. Wishing you many blessings and peace,



Psychiatrist Soho January 30, 2013 at 2:05 pm

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