Northamptonshire Healthcare NHS Foundation Trust and the University of Leicester launch a best‑practice model for domestic abuse support in mental health services

Domestic abuse affects millions of people every year, leaving lasting impacts on a person’s physical and mental health. Survivors of domestic abuse often experience depression, anxiety, post-traumatic stress disorder (PTSD), and other serious mental health conditions. Yet, despite these links, and that domestic abuse costs health services £2.3 billion annually, it often goes unnoticed in mental health settings*. The DREAMS project developed a framework to help mental health professionals identify and respond effectively to domestic abuse.

The Detecting and Responding Effectively to Domestic Abuse in Mental Health Settings – or DREAMS – research project is a collaboration between Northamptonshire Healthcare NHS Foundation Trust (NHFT) and the University of Leicester. It aims to understand healthcare professionals’ knowledge of, and barriers to, identifying domestic abuse. The project is led by Dr Kate Walker (NHFT) and Dr Emma Sleath (University of Leicester).  

The DREAMS research project began in 2023, when questionnaires, interviews and focus groups were undertaken with mental healthcare professionals in Northamptonshire and Leicestershire, as well as with survivors of domestic abuse, to:  

• understand what mental health professionals know about domestic abuse and how they respond
• explore the experiences of both professionals and survivors, including barriers to asking about, and disclosing abuse
• develop a practical framework to help staff identify and respond effectively 

The research showed that opportunities to identify domestic abuse are often missed because staff don't initiate conversations, which is often due to insufficient training and confidence. Survivors emphasised the need for emotionally safe environments and trusted relationships to enable disclosure.

The DREAMS project team developed an Identification and Response Framework giving mental health professionals evidence-based guidance to confidently recognise, ask about, and respond to domestic abuse. Co-produced with staff and survivors, the framework focuses on three core elements: equipping professionals with proper knowledge and training; providing trauma-informed tools for safe enquiry; and offering survivor-centred response approaches.

By embedding these actions into everyday mental health practice, the framework aims to reduce missed opportunities, improve safety and wellbeing, and ensure timely, appropriate support for those affected by domestic abuse.

Co-lead of the project and Research Associate at NHFT, Dr Kate Walker, said: 
“Every person experiencing domestic abuse deserves to be seen, heard and supported. This framework can help ensure that when individuals reach out to mental health services, the system is ready to respond with compassion, safety and the right help at the right time.”

“This project has shown the power of bringing people together: survivors, professionals, researchers and our partners at the University of Leicester. By combining lived experience with clinical insight and academic expertise, we have created a framework that has the potential to truly improve how domestic abuse is recognised and responded to in mental health care.”

Co-lead of the project and Associate Professor of Criminology at the University of Leicester, Dr Emma Sleath, commented:

“The recently published Fit for the Future: 10-Year Health Plan for England recognises that experiences such as domestic abuse can deepen existing health inequalities. Our framework offers a vital opportunity to intervene in these experiences of violence in a survivor-centred, trauma-informed way, with the ultimate aim of improving safety and supporting better outcomes for those affected.”  

Elena, who contributed their lived experience to the DREAMS research project, said:

“The DREAMS project created unique opportunities for me to meet like-minded people who feel passionate about combating domestic abuse in all levels of our society. The most valuable aspect of the DREAMS project for me was learning the comprehensive picture of all the challenges that face not only victims disclosing domestic abuse, but professionals dealing with these disclosures.”

With the framework developed, the next step is testing it in NHS mental health settings. A pilot and feasibility study will assess how easily the framework can be implemented, staff and service user experiences, and what outcomes it can influence. Findings will refine the training, tools and responses for practical, scalable use in routine care. The team will apply for National Institute for Health and Care Research (NIHR) funding to progress toward a full randomised controlled trial, generating robust evidence to shape national policy and embed safe, effective domestic abuse identification and response into NHS mental health practice.

The project is a collaboration between the University of Leicester and Northamptonshire Healthcare NHS Foundation Trust, with a significant contribution from Leicestershire Partnership NHS Trust’s (LPT) Research team, who supported with recruitment of participants for the study.

The University of Leicester has provided academic leadership and research expertise, working with clinical teams to ensure the framework is evidence-based and practical. This partnership combines high-quality academic input with frontline experience, making the framework effective for both staff and service users.

NHFT provides over 240 services across Northamptonshire, including mental health in-patient and community care. The Trust has a strong Research and Innovation programme with research delivery, governance, and development teams.

NHFT and LPT have a Group arrangement and are known as Leicestershire Partnership and Northamptonshire Healthcare Associate University Group.

Watch a short summary video of the DREAMS research project here. 

* For more information visit the University of Leicester website and click on the DREAMS drop-down 

This project is funded by the National Institute for Health and Care Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number NIHR204884). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

For more information about DREAMS or Research and Innovation at NHFT visit www.nhft.nhs.uk/research or email research&innovation@nhft.nhs.uk