The Influence of Substance Use, Mental Health Symptoms, and Intimate Partner Violence (IPV) Severity on Treatment

Alexis R Alfano1, Melissa R Schick2, Tami P Sullivan2

  • 1Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD, USA.

Women who experience intimate partner violence (IPV; versus those who have not) are less likely to engage in treatment and more likely to encounter barriers to treatment. There is inadequate research regarding the effects of substance use, mental health symptoms, and IPV severity on mental health and substance use treatment utilization and barriers to treatment utilization among women who experience IPV. The goal of the present study was to describe substance use and mental health treatment utilization and to examine the extent to which substance use disorder (SUD), mental health symptoms, and IPV severity influence treatment utilization and barriers to treatment utilization among women experiencing IPV. Participants were 275 adult women experiencing IPV and who used any amount of alcohol or drugs in the past three months recruited from the community. A total of 54.5% of women engaged in treatment for substance use and/or mental health in the past 30 days. Receiving substance use treatment was associated with greater odds of having a SUD (OR = 2.30, p = .01). Receiving mental health treatment was associated with greater post-traumatic stress disorder (PTSD; b = 5.04, p = .002) and depressive symptom severity (b = 6.45, p < .001). Receiving combined substance use and mental health treatment was associated with more severe PTSD symptoms (b = 5.32, p = .03) and IPV-related injury (b = 5.14, p = .04). PTSD symptom severity was correlated with confidentiality concerns (r = .40, p = .02), and depressive symptom severity was correlated with attitudinal barriers (r = .40, p = .02). Psychological IPV severity was associated with attitudinal (r = .45, p = .01) and partner-related barriers (r = .35, p = .04). Utilizing treatment is associated with greater mental health severity, suggesting that either greater mental health symptom severity is associated with women seeking treatment and/or that treatment is not effectively reducing symptoms. Results highlight the importance of assessing psychological IPV and mental health symptoms to understand for whom barriers to treatment utilization are most relevant.

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