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Violence and multiple sclerosis: Towards an evidence-informed call to action in neurology
Cassie Nesbitt1, Anneke Van Der Walt1, Helmut Butzkueven1
1Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia; Department of Neurology, MSNI Multiple Sclerosis and Neuro-Immunology, Alfred Health, Melbourne, VIC, Australia.
Abstract:
Violence is a global health concern with profound physical, psychological and social consequences. People with multiple sclerosis (MS) may experience sustained risk due to the intersection of chronic illness, disability, gendered dynamics and structural inequality. MS-specific evidence remains limited and methodologically heterogeneous, precluding reliable conclusions regarding prevalence, outcomes or health system responses. Nonetheless, emerging findings, alongside broader disability literature, indicate that violence is relevant to MS care. This review situates MS within international evidence on disability, chronic illness and violence, synthesises what is known from MS focused literature and highlights key knowledge gaps. It translates the combined evidence to neurology by examining how services can recognise and respond to lived experience. Trauma-informed approaches, case-finding and sensitive inquiry, together with related global frameworks, are discussed as evidence-based models that could be adapted for MS care. People with MS who are victim-survivors remain underserved in research and health-system responses. Violence is pervasive across disability populations, and consistent signals in MS make the issue relevant to neurology. Building an evidence base is essential to establish prevalence, examine longitudinal outcomes and evaluate how recognition and response can be safely integrated and adapted for MS care.
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