Individuals experiencing domestic abuse (DA) struggle to disclose victimization, but as frequent users of mental health services, this is a pivotal setting for identification and addressing DA. This systematic review of 20 studies investigates DA identification, screening, and responses within mental health settings. Three databases were searched using these inclusion criteria: adults aged 18 and older accessing mental health services, samples comprising mental health professionals (or combination). No geographical restrictions were applied. All studies were peer-reviewed and published in English between January 2000 and December 2023. Studies had to incorporate screening for DA between (ex-)partners and/or response to disclosure within mental health settings. The findings revealed considerable variation in DA screening methods from direct screening tools to retrospective analyses of patient files. Professionals report barriers in identifying DA, including uncertainty about their role, time constraints, and the importance of building trust with service users. Nonetheless, many highlight the importance of routinely asking about DA. A small number of interventions have been effective in enhancing professionals’ readiness to address DA, but it remains unclear what format of training is most effective. Service users report feelings of shame and fear of not being believed when disclosing DA, but are aided by therapeutic engagement and enhanced professional awareness. There is a lack of diverse inclusion in the research. In summary, there is considerable scope to develop good practice to support mental health professionals’ ability to identify and respond to DA across assessment tool and training, but also in understanding what facilitates service users to disclose.

中文翻译：

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打破沉默：解决心理健康环境中的家庭虐待问题——识别、筛查和应对


遭受家庭虐待 （DA） 的个人很难披露受害情况，但作为心理健康服务的频繁使用者，这是识别和解决 DA 的关键环境。本系统评价对 20 项研究进行了调查，调查了心理健康环境中的 DA 识别、筛查和反应。使用这些纳入标准检索了三个数据库：18 岁及以上获得心理健康服务的成年人，由心理健康专业人员（或组合）组成的样本。没有应用地理限制。所有研究均经过同行评审，并在 2000 年 1 月至 2023 年 12 月期间以英文发表。研究必须纳入（前）伴侣之间的 DA 筛查和/或对心理健康环境中披露的反应。研究结果揭示了 DA 筛查方法的巨大差异，从直接筛查工具到患者档案的回顾性分析。专业人士报告了识别 DA 的障碍，包括他们的角色、时间限制以及与服务用户建立信任的重要性的不确定性。尽管如此，许多人强调了定期询问 DA 的重要性。少数干预措施在提高专业人员应对 DA 的准备程度方面是有效的，但目前尚不清楚哪种培训形式最有效。服务使用者报告说，在披露 DA 时，他们感到羞耻和害怕不被相信，但治疗参与和增强的专业意识有助于他们。研究中缺乏多元化的包容性。总之，在支持心理健康专业人员通过评估工具和培训识别和响应 DA 的能力方面，以及了解什么有助于服务使用者披露方面，还有相当大的空间来发展良好实践。