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Enduring and Distancing: a Grounded Theory and Photovoice Study about Women’s Help-Seeking for Suicidality in the Wake of Intimate Partner Violence

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Abstract

Purpose

Intimate partner violence and women’s suicidality are known to be positively correlated; however, behaviour patterns and processes on managing these experiences are not well known. The purpose of this study was to understand how women with a history of intimate partner violence seek help for suicidality through an exploration of women’s perspectives on the opportunities and barriers to getting help.

Methods

A qualitative grounded theory and photovoice study using a critical theory philosophical underpinning was used to understand women’s experience seeking help for suicidality within health services. One-to-one interviews occurred with 32 women from [Area of Country], 7 of whom participated in 5 group meetings where they shared self-generated photos that reflected their experiences. Interview and photovoice meeting transcripts were analyzed with a grounded theory approach.

Results

Women sought to Feel Human by Enduring and Distancing, a way of managing System Entrapment or a sense of dehumanization from health care providers’ invalidation. Women Endured unfair treatment to avoid bothering health care providers and Distanced from the system to protect against invalidation even if it means not having access to professional help. Patterns of Enduring System Entrapment and Distancing from the System was found to parallel ways of managing coercive control from an abusive partner, named Abuser Entrapment, and managing hopelessness related to suicidality, named Trauma Entrapment.

Conclusion

Trauma and violence informed interventions are discussed, including using a relational approach to understanding how the use of self, the environment, and systemic structures influences women’s capacity to continue living.

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References

  • American Psychiatric Nurses Association (2018). Seclusion and restraint standards of practice. https://www.apna.org/files/public/Resources/APNASeclusionRestraintPositionPaperRev2018.pdf

  • Arunagiri, V. (2021). Adapting DBT skills in a community center for south Asian women who have experiences with intimate partner violence (2020–79976-175; Issues 3-B) [ProQuest Information & Learning]. https://login.proxy.hil.unb.ca/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2020-79976-175&site=ehost-live&scope=site

  • Australia’s National Research Organisation for Women’s Safety (ANROWS) (2020). Preventing gender-based violence in mental health inpatient units (Research to Policy and Practice, 01/2020). NSW: ANROWS. https://20ian81kynqg38bl3l3eh8bf-wpengine.netdna-ssl.com/wp-content/uploads/2020/01/ANROWS-RtPP-VAW-in-mental-health-units.pdf

  • Bränström, R., Stormbom, I., Bergendal, M., & Pachankis, J. E. (2022). Transgender-based disparities in suicidality: A population-based study of key predictions from four theoretical models. Suicide and Life-Threatening Behavior. https://doi.org/10.1111/sltb.12830

  • Browne, J., Coffey, B., Cook, K., Meiklejohn, S., & Palermo, C. (2019). A guide to policy analysis as a research method. Health Promotion International, 34(5), 1032–1044. https://doi.org/10.1093/heapro/day052

    Article  PubMed  Google Scholar 

  • Button, M. E. (2016). Suicide and social justice: Toward a political approach to suicide. Political Research Quarterly, 69(2), 270–280. https://doi.org/10.1177/1065912916636689

    Article  Google Scholar 

  • Canner, J. K., Giuliano, K., Selvarajah, S., Hammond, E. R., & Schneider, E. B. (2018). Emergency department visits for attempted suicide and self-harm in the USA: 2006–2013. Epidemiology and Psychiatric Sciences, 27(1), 94–102. https://doi.org/10.1017/S2045796016000871

    Article  CAS  PubMed  Google Scholar 

  • Chan, C.-H., Wong, H.-K., & Yip, P. S.-F. (2018). Exploring the use of telephone helpline pertaining to older adult suicide prevention: A Hong Kong experience. Journal of Affective Disorders, 236, 75–79. https://doi.org/10.1016/j.jad.2018.04.093

    Article  PubMed  Google Scholar 

  • Cross, W. F., Crean, H. F., Gould, M. S., Campbell, J., Amezcua, N., Jones, K. R., … & Cerulli, C. (2017). Development and initial evaluation of a suicide prevention curriculum for domestic violence hotline workers. Journal of Family Violence, 32(8), 775–785. https://doi.org/10.1007/s10896-017-9922-7

  • Culbreth, R., Swahn, M. H., Osborne, M., Brandenberger, K., & Kota, K. (2021). Substance use and deaths by suicide: A latent class analysis of the National Violent Death Reporting System. Preventive Medicine: An International Journal Devoted to Practice and Theory, 150. https://doi.org/10.1016/j.ypmed.2021.106682

  • Cully, G., Leahy, D., Shiely, F., & Arensman, E. (2020). Patients’ experiences of engagement with healthcare services following a high-risk self-harm presentation to a hospital emergency department: A mixed methods study. Archives of Suicide Research, 1–21. https://doi.org/10.1080/13811118.2020.1779153

  • Davies, L., Ford-Gilboe, M., Willson, A., Varcoe, C., Wuest, J., Campbell, J., & Scott-Storey, K. (2015). Patterns of cumulative abuse among female survivors of intimate partner violence: Links to women’s health and socioeconomic status. Violence Against Women, 21(1), 30–48. https://doi.org/10.1177/1077801214564076

    Article  PubMed  Google Scholar 

  • de Brito, E. S., & Ventura, C. A. A. (2019). Involuntary psychiatric admission: Comparative study of mental health legislation in Brazil and in England/Wales. International Journal of Law and Psychiatry, 64, 184–197. https://doi.org/10.1016/j.ijlp.2019.04.005

    Article  PubMed  Google Scholar 

  • Doane, G., & Varcoe, C. (2007). Relational practice and nursing obligations. Advances in Nursing Science, 30(3), 192–205.

    Article  PubMed  Google Scholar 

  • Downey, L. H., Ireson, & Scutchfield. (2009). The use of photovoice as a method of facilitating deliberation. Health Promotion Practice, 10(3), 419–427.

    Article  PubMed  Google Scholar 

  • Finlayson-Short, L., Hetrick, S., Krysinska, K., Harris, M., Salom, C., Bailey, E., & Robinson, J. (2020). A survey of people with lived experience of suicide-related behavior in Queensland, Australia: Their experiences with available resources. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(1), 39–46. https://doi.org/10.1027/0227-5910/a000602

    Article  Google Scholar 

  • Ford-Gilboe, M., Wuest, J., & Merritt-Gray, M. (2005). Strengthening capacity to limit intrusion: Theorizing family health promotion in the aftermath of woman abuse. Qualitative Health Research, 15(4), 477–501. https://doi.org/10.1177/1049732305274590

    Article  PubMed  Google Scholar 

  • Ford-Gilboe, M., Wuest, J., Varcoe, C., Davies, L., Merritt-Gray, M., Campbell, J., & Wilk, P. (2009). Modelling the effects of intimate partner violence and access to resources on women’s health in the early years after leaving an abusive partner. Social Science & Medicine, 68(6), 1021–1029. APA PsycInfo. https://doi.org/10.1016/j.socscimed.2009.01.003

  • Ford-Gilboe, M., Varcoe, C., Noh, M., Wuest, J., Hammerton, J., Alhalal, E., & Burnett, C. (2015). Patterns and predictors of service use among women who have separated from an abusive partner. Journal of Family Violence, 30(4), 419–431. https://doi.org/10.1007/s10896-015-9688-8

    Article  PubMed  PubMed Central  Google Scholar 

  • Gergen, M. (2008). Qualitative methods in feminist psychology. In W. Carla & W. Stainton Rogers (Eds.), The SAGE handbook of qualitative research in psychology (pp. 280–295). SAGE.

    Chapter  Google Scholar 

  • Gilligan, C. (1982). In a different voice: Psychological theory and women’s development. Harvard University Press.

    Google Scholar 

  • Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Aldine Pub. Co..

    Google Scholar 

  • Health Canada (2014). A statistical profile on the health of first nations in Canada: Vital statistics for Atlantic and Western Canada, 2003–2007. Statistics Canada. http://publications.gc.ca/collections/collection_2014/sc-hc/H34-193-3-2014-eng.pdf

  • Horwitz, A. G., McGuire, T., Busby, D. R., Eisenberg, D., Zheng, K., Pistorello, J., Albucher, R., Coryell, W., & King, C. A. (2020). Sociodemographic differences in barriers to mental health care among college students at elevated suicide risk. Journal of Affective Disorders, 271, 123–130. https://doi.org/10.1016/j.jad.2020.03.115

    Article  PubMed  PubMed Central  Google Scholar 

  • Huckshorn, K. A. (2008). Six core strategies for reducing seclusion and restraint use. National Association of State Mental Health Program Directors. https://www.nasmhpd.org/sites/default/files/Consolidated%20Six%20Core%20Strategies%20Document.pdf

  • Islam, M. J., Broidy, L., Mazerolle, P., Baird, K., Mazumder, N., & Zobair, K. M. (2019). Do maternal depression and self-esteem moderate and mediate the association between intimate partner violence after childbirth and postpartum suicidal ideation? Archives of Suicide Research. https://doi.org/10.1080/13811118.2019.1655507

  • Jaggar, A. M. (2000). Feminist Ethics. In The Blackwell guide to ethical theory. Blackwell. https://search.proquest.com/docview/42952205

  • Kaslow, N. J., Leiner, A. S., Reviere, S., Jackson, E., Bethea, K., Bhaju, J., Rhodes, … Thompson, M. P. (2010). Suicidal, abused African American women’s response to a culturally informed intervention. Journal of Consulting and Clinical Psychology, 78(4), 449–458. (Supplemental). https://doi.org/10.1037/a0019692

  • Lyons, B. H., Walters, M. L., Jack, S. P. D., Petrosky, E., Blair, J. M., & Ivey-Stephenson, A. Z. (2019). Suicides among lesbian and gay male individuals: Findings from the national violent death reporting system. American Journal of Preventive Medicine, 56(4), 512–521. https://doi.org/10.1016/j.amepre.2018.11.012

    Article  PubMed  PubMed Central  Google Scholar 

  • McManus, S., Bebbington, P. E., Tanczer, L., Scott, S., & Howard, L. M. (2021). Receiving threatening or obscene messages from a partner and mental health, self-harm and suicidality: Results from the adult psychiatric morbidity survey. Social Psychiatry and Psychiatric Epidemiology: The International Journal for Research in Social and Genetic Epidemiology and Mental Health Services. https://doi.org/10.1007/s00127-021-02113-w

  • Mladen, S. N., Williams, A. B., Griffin, S. C., Perrin, P. B., & Rybarczyk, B. D. (2021). Models of trauma exposure, depression, and suicidality in safety-net primary care. Journal of Traumatic Stress. https://doi.org/10.1002/jts.22658

  • Moffitt, P., & Vollman, A. (2004). Photovoice: Picturing the health of aboriginal women in a remote northern community. The Canadian Journal of Nursing Research = Revue Canadienne de Recherche En Sciences Infirmières, 36(4), 189–201.

    PubMed  Google Scholar 

  • Morrow, S. L. (2006). Honor and respect: Feminist collaborative research with sexually abused women. In C. T. Fischer (Ed.), Qualitative research methods for psychologists: Introduction trough empirical studies (1st ed., pp. 143–172). London: Elsevier.

    Chapter  Google Scholar 

  • Moulding, N., Franzway, S., Wendt, S., Zufferey, C., & Chung, D. (2021). Rethinking Women’s mental health after intimate partner violence. Violence Against Women, 27(8), 1064–1090. https://doi.org/10.1177/1077801220921937

    Article  PubMed  Google Scholar 

  • Muyan, M., & Chang, E. C. (2019). Hope as a mediator of the link between intimate partner violence and suicidal risk in Turkish women: Further evidence for the role of hope agency. Journal of Interpersonal Violence, 34(21–22), 4620–4637. https://doi.org/10.1177/0886260516675465

    Article  PubMed  Google Scholar 

  • Piatkowska, S. J. (2020). Poverty, inequality, and suicide rates: A cross-national assessment of the Durkheim theory and the stream analogy of lethal violence. The Sociological Quarterly, 61(4), 787–812. https://doi.org/10.1080/00380253.2020.1715308

    Article  Google Scholar 

  • Pickover, A. M., Bhimji, J., Sun, S., Evans, A., Allbaugh, L. J., Dunn, S. E., & Kaslow, N. J. (2021). Neighborhood disorder, social support, and outcomes among violence-exposed African American women. Journal of Interpersonal Violence, 36(7–8), NP3716–NP3737. https://doi.org/10.1177/0886260518779599

    Article  PubMed  Google Scholar 

  • Ponic, P., Varcoe, C., & Smutylo, T. (2016). Trauma-(and violence-) informed approaches to supporting victims of violence: Policy and practice considerations. Victims of Crime Research Digest, 9, 3–15.

    Google Scholar 

  • Potter, L. C., Morris, R., Hegarty, K., García-Moreno, C., & Feder, G. (2021). Categories and health impacts of intimate partner violence in the World Health Organization multi-country study on women’s health and domestic violence. International Journal of Epidemiology, 50(2), 652–662. https://doi.org/10.1093/ije/dyaa220

    Article  PubMed  Google Scholar 

  • Richards, J. E., Whiteside, U., Ludman, E. J., Pabiniak, C., Kirlin, B., Hidalgo, R., & Simon, G. (2019). Understanding why patients may not report suicidal ideation at a health care visit prior to a suicide attempt: A qualitative study. Psychiatric Services, 70(1), 40–45. https://doi.org/10.1176/appi.ps.201800342

    Article  PubMed  Google Scholar 

  • Roelands, M., Vanoverloop, J., Maron, L., & Bilsen, J. (2018). Socioeconomic risk factors for hospital admittance due to a suicide attempt in Belgium: A population-based study using administrative data. Social Psychiatry and Psychiatric Epidemiology: The International Journal for Research in Social and Genetic Epidemiology and Mental Health Services, 53(1), 53–61. https://doi.org/10.1007/s00127-017-1458-x

    Article  Google Scholar 

  • Samlan, H., Shetty, A., & McWhirter, E. H. (2020). Gender and racial-ethnic differences in treatment barriers among college students with suicidal ideation. Journal of College Student Psychotherapy. https://doi.org/10.1080/87568225.2020.1734133

    Article  Google Scholar 

  • Scherer, B. (2020). I am a suicide waiting to happen: Reframing self-completed murder and death. In M. E. Button & I. Marsh (Eds.), Suicide and social justice: New perspectives on the politics of suicide and suicide prevention. (2020-09865-008; pp. 141–153). Routledge/Taylor & Francis Group. https://login.proxy.hil.unb.ca/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2020-09865-008&site=ehost-live&scope=site

  • Shiner, B., Peltzman, T., Cornelius, S. L., Gui, J., Forehand, J., & Watts, B. V. (2021). Recent trends in the rural–urban suicide disparity among veterans using VA health care. Journal of Behavioral Medicine, 44(4), 492–506. https://doi.org/10.1007/s10865-020-00176-9

    Article  PubMed  Google Scholar 

  • Shlachter, J. (2017). Gender Role Conformity in College Women: Psychological Consequences of Feminity. Graduate School of Professional Psychology: Doctoral Papers and Masters Projects. https://digitalcommons.du.edu/capstone_masters/226

  • Smye, V., Varcoe, C., Browne, A. J., Dion Stout, M., Josewski, V., Ford-Gilboe, M., & Keith, B. (2021). Violence at the intersections of Women’s lives in an urban context: Indigenous Women’s experiences of leaving and/or staying with an abusive partner. Violence Against Women, 27(10), 1586–1607. https://doi.org/10.1177/1077801220947183

    Article  PubMed  Google Scholar 

  • Statistics Canada (2018). Mental health characteristics and suicidal thoughts: Table 13-10-0098-01. https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310009801

  • Statistics Canada, G (2020). Police-reported hate crime in Canada, 2018. 85, 31.

  • Swartz, S. (2013). Feminism and psychiatric diagnosis: Reflections of a feminist practitioner. Feminism & Psychology, 23(1), 41–48. https://doi.org/10.1177/0959353512467965

    Article  Google Scholar 

  • Taha, F., Zhang, H., Snead, K., Jones, A. D., Blackmon, B., Bryant, R. J., … Kaslow, N. J. (2015). Effects of a culturally informed intervention on abused, suicidal African American women. Cultural Diversity and Ethnic Minority Psychology, 21(4), 560–570. https://doi.org/10.1037/cdp0000018

  • Taylor, P. (2022). A Relational approach to violence research: A feminist study on women’s help-seeking for suicidality in the wake of intimate partner violence. In C. Holtmann, S. O’Donnell, & L. Neilson (Eds.), Ending gender based violence: Harnessing research for social change. (1st ed.). Muriel McQueen Fergusson Centre for Family Violence Research (MMFC) (In Press).

  • Thomas, K., Browne, A. J., Jiao, S., Dooner, C., Wright, P., Slemon, A., Diederich, J., Wathen, C. N., Bungay, V., Wilson, E., & Varcoe, C. (2021). Media framing of emergency departments: A call to action for nurses and other health care providers. BMC Nursing, 20(1), 118. https://doi.org/10.1186/s12912-021-00606-2

    Article  PubMed  PubMed Central  Google Scholar 

  • Tseris, E. J. (2013). Trauma theory without feminism? Evaluating contemporary understandings of traumatized women. Affilia: Journal of Women & Social Work, 28(2), 153–164. https://doi.org/10.1177/0886109913485707

    Article  Google Scholar 

  • Varcoe, C., Ford-Gilboe, M., Browne, A. J., Perrin, N., Bungay, V., McKenzie, H., … Dion Stout, M. (2021). The efficacy of a health promotion intervention for indigenous women: Reclaiming our spirits. Journal of Interpersonal Violence, 36(13–14), NP7086–NP7116. https://doi.org/10.1177/0886260518820818

  • Walsh, L., Luthy, E., Feng, X., Yilmazer, T., Ford, J., Kelleher, K., … Slesnick, N. (2021). Predictors of treatment engagement among suicidal youth experiencing homelessness. Community Mental Health Journal. https://doi.org/10.1007/s10597-021-00850-5

  • Wand, T., Glover, S., & Paul, D. (2021). What should be the future focus of mental health nursing? Exploring the perspectives of mental health nurses, consumers, and allied health staff. International Journal of Mental Health Nursing. https://doi.org/10.1111/inm.12947

  • Wang, C., & Burris, M. A. (1997). Photovoice: Concept, methodology, and use for participatory needs assessment. Health Education & Behavior: The Official Publication of the Society for Public Health Education, 24(3), 369–387.

    Article  CAS  Google Scholar 

  • Wang, C. C., Morrel-Samuels, S., Hutchison, P. M., Bell, L., & Pestronk, R. M. (2004). Field action report—Flint photovoice: Community building among youths, adults, and policymakers. American Journal of Public Health, 94(6), 911.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wilson, J. L., Uthman, C., Nichols-Hadeed, C., Kruchten, R., Thompson Stone, J., & Cerulli, C. (2021). Mental health therapists’ perceived barriers to addressing intimate partner violence and suicide. Families, Systems & Health. https://doi.org/10.1037/fsh0000581

  • Wood, S. N., Glass, N., & Decker, M. R. (2021). An integrative review of safety strategies for women experiencing intimate partner violence in low- and middle-income countries. Trauma, Violence, & Abuse, 22(1), 68–82. https://doi.org/10.1177/1524838018823270

    Article  Google Scholar 

  • World Health Organization (2021). Violence against women prevalence estimates, 2018. Global, regional and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for non-partner sexual violence against women. https://who.canto.global/pdfviewer/viewer/viewer.html?share=share%2Calbum%2CKDE1H&column=document&id=tfgc8uqvuh0b1157tevomtch1j&suffix=pdf

  • Wuest, J. (2012). Grounded theory: The method. In P. L. Munhall (Ed.), Nursing research: A qualitative perspective (5th ed.). Jones & Bartlett Learning.

    Google Scholar 

  • Wuest, J., & Merritt-Gray, M. (2001). Beyond survival: Reclaiming self after leaving an abusive male partner. Canadian Journal of Nursing Research, 32(4), 79–94.

    CAS  Google Scholar 

  • Wuest, J., Merritt-Gray, M., & Ford-Gilboe, M. (2004). Regenerating family: Strengthening the emotional health of mothers and children in the context of intimate partner violence. Advances in Nursing Science, 27(4), 257–274. https://doi.org/10.1097/00012272-200410000-00003

    Article  PubMed  Google Scholar 

  • Yoon, S., Cummings, S., Nugent, W. R., & Forrest-Bank, S. (2020). Protective factors against suicidal ideation among community-dwelling older adults with experience of spousal physical abuse: Focusing on direct and indirect protections. Aging & Mental Health, 24(11), 1854–1863. https://doi.org/10.1080/13607863.2019.1636208

    Article  Google Scholar 

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Acknowledgements

Dr. Judith Wuest who taught me grounded theory and how to write.

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Taylor, P. Enduring and Distancing: a Grounded Theory and Photovoice Study about Women’s Help-Seeking for Suicidality in the Wake of Intimate Partner Violence. J Fam Viol 38, 1365–1375 (2023). https://doi.org/10.1007/s10896-022-00445-y

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