Pooled analysis of the association between mental health and violence against women: evidence from five settings in the Global South

Leane Ramsoomar; Andrew Gibbs; Esnat D Chirwa; Mercilene T Machisa; Deda Ogum Alangea; Adolphina Addoley Addo-Lartey; Kristin Dunkle; Rachel Jewkes

doi:10.1136/bmjopen-2022-063730

Pooled analysis of the association between mental health and violence against women: evidence from five settings in the Global South

BMJ Open. 2023 Mar 15;13(3):e063730. doi: 10.1136/bmjopen-2022-063730.

Authors

Leane Ramsoomar^{1

2}, Andrew Gibbs^{3

4}, Esnat D Chirwa^{3

5}, Mercilene T Machisa^{3

5}, Deda Ogum Alangea⁶, Adolphina Addoley Addo-Lartey⁶, Kristin Dunkle³, Rachel Jewkes^{3

2}

Affiliations

¹ Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa leane.ramsoomar@mrc.ac.za.
² School of Health Systems and Public Health, University of the Pretoria, Gauteng, South Africa.
³ Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa.
⁴ Department of Psychology, University of Exeter, Exeter, Devon, UK.
⁵ School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
⁶ Department of Population, Family & Reproductive Health, University of Ghana School of Public Health, Legon, Accra, Ghana.

Abstract

Objectives: To describe associations between men's poor mental health (depressive and post-traumatic stress symptomatology) and their perpetration of intimate partner violence (IPV) and non-partner sexual violence (NPSV), and women's mental health and their experiences of IPV and NPSV in five settings in the Global South.

Design: A pooled analysis of data from baseline interviews with men and women participating in five violence against women and girls prevention intervention evaluations.

Setting: Three sub-Saharan African countries (South Africa, Ghana and Rwanda), and one Middle Eastern country, the occupied Palestinian territories.

Participants: 7021 men and 4525 women 18+ years old from a mix of self-selecting and randomly selected household surveys.

Main outcome measures: All studies measured depression symptomatology using the Centre for Epidemiological Studies-Depression, and the Harvard Trauma Scale for post-traumatic stress disorder (PTSD) symptoms among men and women. IPV and NPSV were measured using items from modified WHO women's health and domestic violence and a UN multicountry study to assess perpetration among men, and experience among women.

Findings: Overall men's poor mental health was associated with increased odds of perpetrating physical IPV and NPSV. Specifically, men who had more depressive symptoms had increased odds of reporting IPV (adjusted OR (aOR)=2.13; 95%CI 1.58 to 2.87) and NPSV (aOR=1.62; 95% CI 0.97 to 2.71) perpetration compared with those with fewer symptoms. Men reporting PTSD had higher odds of reporting IPV (aOR=1.87; 95% CI 1.44 to 2.43) and NPSV (aOR=2.13; 95% CI 1.49 to 3.05) perpetration compared with those without PTSD. Women who had experienced IPV (aOR=2.53; 95% CI 2.18 to 2.94) and NPSV (aOR=2.65; 95% CI 2.02 to 3.46) had increased odds of experiencing depressive symptoms compared with those who had not.

Conclusions: Interventions aimed at preventing IPV and NPSV perpetration and experience must account for the mental health of men as a risk factor, and women's experience.

Keywords: Anxiety disorders; Depression & mood disorders; MENTAL HEALTH; PUBLIC HEALTH; Public health; Substance misuse.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Domestic Violence*
Female
Humans
Intimate Partner Violence*
Male
Mental Health
Risk Factors
Stress Disorders, Post-Traumatic* / epidemiology
Stress Disorders, Post-Traumatic* / psychology