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Seven days in medicine: 6-12 March 2024

BMJ 2024; 384 doi: (Published 14 March 2024) Cite this as: BMJ 2024;384:q604

Rapid Response:

Re: Seven days in medicine: 6-12 March 2024

Dear Editor,

Building a Collaborative Front Against Domestic Abuse: Integrating Digital Solutions for Comprehensive Support

The recent findings from a survey of psychiatrists [1] underscore a harsh reality: the primary drivers of poor mental health in women and girls are violence and abuse, relational issues often caused by coercive behaviour, familial pressures, and social isolation. These factors, whether direct or indirect, contribute to a cycle of violence and abuse, exacerbating mental health conditions. The findings emphasise a critical need for action from government, healthcare providers, and society as a whole.

I am compelled to shine a spotlight on an innovative solution to combat the pervasive issue of domestic abuse and its devastating impact on women and girls' mental health. In addition to advocating for increased awareness and support services, I propose integrating digital screening tools into healthcare settings to reach those who may be hesitant to disclose their experiences of abuse.

Violence and abuse, whether physical or psychological, can inflict long-term mental health illnesses. Yet, victims often suffer in silence, and clinicians may miss crucial signs, leaving cases undetected and unaddressed. This oversight perpetuates the cycle of abuse and denies victims critical support.

To effectively address these issues, we must empower survivors to seek support on their terms. Government and NHS services must recognise the varying readiness of individuals to seek help and provide accessible pathways to support tailored to patients' needs.

With the NHS long-term plan on digital technology [2], the introduction of digital screening tools offers a beacon of hope in this struggle. By integrating self-referral domestic abuse support services into routine screening processes, we can offer discreet and accessible avenues for individuals to seek support, reclaiming control of their healthcare journey.

Moreover, digital screening tools bridge gaps, reaching individuals who may be hesitant to discuss their experiences in person. Through technology, we dismantle barriers to disclosure, ensuring no victim goes unnoticed or unsupported.

Beyond identification, digital screening offers a cost-effective and scalable solution that can be seamlessly integrated into various healthcare settings. By prioritising mental health and well-being, we create a proactive system of care.

The time for action is now. We cannot wait until victims reach crisis points to intervene. Every victim deserves to know that support is available to help them escape the harm of an abuser.

I urge government officials, healthcare providers, and policymakers to recognise the potential of digital screening tools in addressing domestic abuse. Let us prioritise their implementation as part of a comprehensive approach to supporting survivors. This approach not only aids in secondary prevention but also contributes to primary prevention efforts against domestic violence and abuse. Together, we can break the cycle of violence and ensure every individual receives the care and support they deserve.


Dr Vasumathy Sivarajasingam
GP Partner, Hillview Surgery, West London

Honorary Clinical Research Fellow, Imperial College London
NWL Primary Care Clinical Lead – Ealing Borough: Green Agenda/Adult Mental Health/Patient Engagement

Twitter: @vasu27765631


1. Royal College of Psychiatrists. Violence and abuse are driving mental illness in women and girls, psychiatrists warn. Accessed 1 April 2024.
2. NHS Long Term Plan. Digital Transformation. Accessed 1 April 2024.

Competing interests: No competing interests

01 April 2024
Vasumathy Sivarajasingam
GP Partner
Hillview Surgery, West London