RANZCP homepage
Contact
Log in Log in
  • Become a psychiatrist
    • Psychiatry training
      • About the Fellowship Program
      • Entry requirements
      • How to apply
      • Time, fees and costs
    • Assessment of international specialists
      • Specialist assessment
      • Area of Need
      • Vocational registration (New Zealand)
      • Specialist specified training
      • Get to know the Australian healthcare system
    • The Psychiatry Interest Forum (PIF)
      • Join PIF
      • Opportunities for PIF members
      • Aboriginal and Torres Strait Islander PIF members
      • Māori and Pasifika PIF members
      • Posters, printables and videos
    • What a psychiatrist does
      • Specialist areas in psychiatry
      • A day in the life
      • Information for high school students
  • Training, exams & assessments
    • Fellowship Program
      • Program overview
      • Stage 1
      • Stage 2
      • Stage 3
      • Formal education courses
      • Reading list
      • Fellowship competencies
      • Training programs and zones
    • Advanced Training
      • About Advanced Training
      • Addiction psychiatry
      • Adult psychiatry
      • Child & adolescent psychiatry
      • Consultation–liaison psychiatry
      • Forensic psychiatry
      • Psychiatry of old age
      • Psychotherapies
      • See all Advanced training
    • SIMG placements
      • Partial comparability
      • Substantial comparability
      • Extensions, breaks and reviews of comparability
      • Fees for SIMG
    • Exams & assessments
      • Results
      • Timetables
      • Applying for exams and assessments
      • Exams
      • Psychotherapy Written Case
      • Scholarly Project
      • Self-paced online learning
      • Rotation assessments
      • List of EPAs
    • Fees
    • For assessors and supervisors
    • Certificate of Psychiatry
    • Help centre & support
    • Go to InTrain
  • Clinical guidelines & publications
    • Journals
      • Australian and NZ Journal of Psychiatry
      • Australasian Psychiatry
      • MEDLINE Ultimate
      • British Journal of Psychiatry
      • DynaMed
      • Explore all journals
    • Publication library
      • Clinical guidelines
      • Codes of ethics & conduct
      • Position statements
      • Reports
      • Submissions
      • Explore all documents
    • Explore by topic
      • ADHD
      • Electroconvulsive therapy
      • Ketamine
      • LGBTIQ+
      • Psychedelics
      • See all topics
  • CPD program & membership
    • CPD program
      • CPD overview
      • Program guide and requirements
      • Key dates
      • Templates and CPD activities
      • Peer review groups
      • Practice Peer Review
      • Join the CPD program
      • CPD policies
    • MyCPD
    • Support, breaks & deferrals
      • Leave and return to practice
      • Deferral or exemption of CPD
      • CPD while living and working overseas
      • Reinstatement of membership
      • Retirement
      • Refresher and remediation
      • Mentoring
      • Wellbeing support
    • Types of membership
      • Fellowship
      • Affiliate membership
      • Associate (trainee) membership
      • CPD only membership
      • International Corresponding Membership
      • Honorary Fellowship
      • Membership for junior doctors and med students
    • Membership services & benefits
      • Member benefits
      • Discounts and partner programs
      • Fees and payments
      • Expense reimbursements
  • Events & learning
    • Upcoming events
      • Conferences
      • Webinars
      • Courses
      • See all upcoming events
    • Catch up & learning
      • Past conference talks
      • Webinar recordings
      • Podcasts
      • Explore all catch-up
    • Series
      • rTMS courses
      • ECT courses
      • Psych Matters podcast
    • Go to Learnit
    • Congress 2025
  • Grants, awards & giving
    • Awards & member recognition
      • RANZCP awards
      • Faculty and section awards
      • Branch awards
      • Membership milestones
      • Honour board
    • Grants
      • Event grants & scholarships
      • Research grants
      • Trainee grants
    • RANZCP Foundation
      • Donate
      • Your impact
      • About the Foundation
      • Our patrons
      • Foundation Partners
  • News & analysis
  • College & committees
    • About
      • What the College does
      • Board
      • Our members
      • Executive team
      • Annual reports, AGM and evaluations
      • Governance
      • Accreditation of the College
      • Our history
      • Current projects
    • Public & partners
      • Find a psychiatrist
      • Media centre
      • Feedback and complaints
      • Advertising and endorsements
      • Consultation Hub
      • For health services with STP posts
      • Career opportunities
    • Key focus areas
      • Aboriginal & Torres Strait Islander mental health
      • Māori mental health
      • Lake Alice apology and actions
      • Gender equity
      • Rural psychiatry
      • NSW workforce crisis
    • Committees & groups
      • Committees
      • Faculties
      • Sections
      • Networks
      • Working & advisory groups
      • Committee openings
      • Board elections
    • Tu Te Akaaka Roa NZ National Office
    • Australian branches
      • Australian Capital Territory
      • New South Wales
      • Northern Territory
      • Queensland
      • South Australia
      • Tasmania
      • Victoria
      • Western Australia
  • Contact
Back to results

Family and domestic violence

Last updated: Jun 2024

A coroner’s inquest in Victoria (2021-22) triggered a recommendation that all psychiatrists undertake at least four hours of education, every two years in mental health aspects of family violence (FV)/Intimate partner violence (IPV). 

In Australia, in 2022, 1 in 4 women and 1 in 8 men experienced violence by an intimate partner or family member or a current or previous partner. In New Zealand 1 in 3 (35%) ever-partnered women report having experienced physical and/or sexual IPV in their lifetime. When psychological/emotional abuse is included, 55% report having experienced IPV in their lifetime. (NZ Clearing House 2017).

1 in 6 women witnessed parental violence during childhood (16%), 1in 9 men witnessed parental violence during childhood (11%). Children who witness FV are vulnerable to increased risk of internalising and externalising mental health issues, learning difficulties, and behavioural problems. (Campo M.2015).  On average, 1 woman a week is murdered by her current/former partner. [Australian Bureau of Statistics (2021-22)]. 

Family domestic violence (FV) Is a socially determined crime. Abuse of power and control is considered central to the perpetration of violence. Coercive control over time is an essential pattern of FV. 

Coercive control is a red flag for future intimate partner homicide. The NSW Domestic Violence Death Review Team report (2019-2021) found that intimate partner homicide in NSW is typically preceded by coercive control often without any recorded physical violence. The NSW Government has legislated to criminalise coercive control. It is a pattern of abuse that has the cumulative effect of denying victim-survivors their decision-making capacity. They are watched, judged, lose autonomy, and subjected to isolation from support networks and independence. (Stark 2007) 

FV is associated with serious mental and physical health consequences and puts an enormous financial burden on the country, with KPMG estimating it at approximately $22 Billion annually.

The role of psychiatry in family violence

The role of psychiatry in FV is increasingly being highlighted. There are however barriers to women and men disclosing FV in psychiatric practice. (Rose et al 2011) Strong associations between FV and post-traumatic stress disorder, panic attacks, depressive illness, chronic substance use, risky sexual behaviours, eating disorders, and suicidality are found. Women are three times more likely to be affected. (Howard, Trevillion et al. 2010); Trevillion K, et al 2012)

Pre-existing mental illness and disability are associated with a higher risk of being victimised by carers and intimate partners. Serious mental illness such as psychotic disorders is associated with two to eight times greater experience of domestic violence. The experience of domestic violence in turn exacerbates pre-existing mental illness, suicide attempts, and substance abuse. (Khalifeh, Moran et al. 2015)  

The role of mental illness in perpetrators is being increasingly accepted as an important contributor to domestic violence. A recent big data study of reports on 492,393 police callouts to FV events shows an extensive association of mental illness in FV in alleged perpetrators. In 15.51% of events, mental illness was mentioned, and almost three-quarters concerned the alleged perpetrator. “Mood disorders” (e.g. bipolar disorder, depression) had the highest number of mentions, followed by “attention deficit hyperactivity disorders,” and “conduct disorders”. (Karystianis, Simpson et al. 2020)

Case example

On 21 August Mr X attended his psychiatrist. He was severely depressed but reported that he was not a risk to himself. Dr Z queried whether Mr X may have been experiencing thoughts of self-harm that he did not wish to disclose. There was no further disclosure of self-harm.

During this appointment, Mr X also disclosed that Ms Y, his intimate partner didn’t ‘want’ him anymore and that this meant that he ‘had nothing to live for’. Mr X also spoke of concerns regarding his ability to maintain employment, his dire financial situation, and his lack of sleep.

His partner Ms Y, who had told him to vacate her house, attended the consultation with him. Dr Z had earlier warned her of the risk of being financially manipulated by Mr X. 

Later the same day Ms Y’s children contacted emergency services. Police and paramedics confirmed that both Mr X and Ms Y were deceased and appeared to have suffered fatal gunshot injuries. It was murder-suicide perpetrated by Mr X.

His past history of serious domestic violence and intervention orders protecting his ex-wife was revealed at the coroner’s inquest. It was known to Dr Z. 

Ms Y’s children reported evidence of dominating and controlling behaviours towards Ms Y at the coroner’s inquest. Victoria Police stated that in November 2014, they received information that Mr X was illegally in the possession of 8 firearms and conducted a search of his residence. They found 6 out of 8 guns but were not able to find two missing firearms, and the trail went cold. It appears he hid the two guns, that he used later.  The full details of the case (reference COR 2017 4175) are published Findings | Coroners Court of Victoria

Enhancing the safety of our patients 

As psychiatrists, we assess risk in every patient. The information gathering and assessment of the risks need to be completed in three domains: 

  • risk to oneself
  • risk to others
  • risk from others

and included in the final formulation. 

Information may be shared with other key service providers overriding privacy concerns in Victora according to MARAMS framework legislation. 

Practice tips

Separation is the most dangerous time for the victim. The separating or divorced women have five times the risk of intimate femicide compared to other women.  (Brownridge 2006), (Karystianis, Simpson et al. 2020). The role of past history of domestic violence, and owning a gun are significant factors in perpetration. (Cherie Toivonen and Corina Backhouse, 2018). It is essential to make a Safety Plan with the separating survivor.  

Combined consultations with the abusive partner should be avoided. It provides opportunities to the perpetrator for further coercive control and violence.   

Further learning

A duty to care: Mental health service responses to family violence. Including diverse populations experiencing family violence. A webinar, presented by Family Violence Psychiatry Network RANZCP, and Safer Families Program by University of Melbourne, Department of General Practice.

There are a number of webinars and podcasts on family violence and mental health are available on the RANZCP education portal.

References

Adj. Professor Manjula O’Connor - Member, Committee of Continuing Professional Development and Chair, Family Violence Psychiatry Network

Australian Bureau of Statistics (2021-22), Personal Safety, Australia, ABS Website, accessed 24 April 2023.

Brownridge, D. A. (2006). "Violence against women post-separation." Aggression and violent behaviour 11(5): 514-530.

Campo M. Children's exposure to domestic and family violence: Key issues and responses (CFCA Paper No. 36). Melbourne, VIC: Australian Institute of Family Studies; 2015:1-24

Cherie Toivonen and Corina Backhouse (2018.) Australia’s National Research Organisation for Women’s Safety, for the Commonwealth Department of Social Services ANROWS

Howard, L. M., et al. (2010). "Domestic violence and severe psychiatric disorders: prevalence and interventions." Psychol Med 40(6): 881-893.

Karystianis, G., et al. (2020). "Prevalence of Mental Illnesses in Domestic Violence Police Records: Text Mining Study." J Med Internet Res 22(12): e23725.

Khalifeh, H., et al. (2015). "Domestic and sexual violence against patients with severe mental illness." Psychol Med 45(4): 875-886.

New Zealand Family Violence Clearing House. 2017. 

NSW Domestic Violence Death Review Team. Report 2019-2021.

RANZCP position statement Family violence and mental health, May 2021.Position statement 102)   

Rose, D., Trevillion, K., Woodall, A., Morgan, C., Feder, G., & Howard, L. (2011). Barriers and facilitators of disclosures of domestic violence by mental health service users: qualitative study. 

The British journal of psychiatry: the journal of mental science, 198(3), 189–194. 

Stark. Evan. 2007. Coercive Control. Oxford University Press.

Trevillion K, Oram S, Feder G, Howard LM. Experiences of domestic violence and mental disorders: a systematic review and meta-analysis.

Your health in mind

For the public

Expert mental health information for everyone
  • Find a psychiatrist
  • Feedback about psychiatrists

About the College

  • Offices and branches
  • Media centre
  • About us
  • For health services with STP posts

Jobs

  • Career opportunities at the College
  • Psychiatry Jobs Hub
  • Committee openings

RANZCP Head Office

309 La Trobe Street

Melbourne VIC 3000

Australia

T: 1800 337 448 (Australia) T: 0800 443 827 (New Zealand) E: ranzcp@ranzcp.org

Contact

  • Contact the College
  • Advertising options
  • Consultation Hub
  • Help centre

We acknowledge Aboriginal and Torres Strait Islander Peoples as the First Nations and the Traditional Owners and Custodians of the lands and waters now known as Australia, and Māori as tangata whenua in Aotearoa, also known as New Zealand. We recognise those with lived and living experience of a mental health condition, including community members and all RANZCP members. We affirm their ongoing contribution to the improvement of mental healthcare for all people.

Our commitment to Aboriginal and Torres Strait Islander mental health Our commitment to Māori mental health
Please be aware that this website and associated resources may contain the names or images of Aboriginal and/or Torres Strait Islander peoples who are now deceased.
© The Royal Australian and New Zealand College of Psychiatrists
  • Privacy policy
  • Terms of use
  • Accessibility statement