1. Jennifer Holly Stella Project Mental Health Initiative Coordinator “Treat me like a human being, like someone who matters”

2. Working with people affected by domestic and sexual violence and problematic substance use www.avaproject.org.uk www.twitter.com/AVAProject  30,000 women will experience domestic violence and two of them will be murdered  15,000 will be sexually assaulted  2,000 will be raped  Around 75 women will be trafficked into the UK  Around 56 women will be forced into a marriage  Still more will experience sexual harassment, some will have their genitals mutilated and so on and so on and so on….

3. Working with people affected by domestic and sexual violence and problematic substance use www.avaproject.org.uk www.twitter.com/AVAProject Vulnerability DOMESTIC VIOLENCE SUBSTANCE USE MENTAL HEALTH Further abuse Survivors Perpetrators SEXUAL VIOLENCE

4. Working with people affected by domestic and sexual violence and problematic substance use www.avaproject.org.uk www.twitter.com/AVAProject VAWG survivors’ mental health 2011 study of 4451 women aged 16-85, based on the Australian National Mental Health & Well-being Survey No GBV Participants exposed to 1 form of GBV Participants exposed to 3-4 forms of GBV Any mental disorder 28.0%57.3%89.4% Substance use disorders 8.5%23%47.1% Mood disorders 12.4%30.7%52.5% Anxiety disorder 16.9%38.5%77.3% PTSD 4.6%15.2%56.2% Suicide attempts 1.6%6.6%34.7% Rees et al 2011. “Lifetime Prevalence of Gender-Based Violence in Women and the Relationship With Mental Disorders and Psychosocial Function.” Journal of American Medical Association, Vol. 306, No. 5, pp. 513-521.

5. Working with people affected by domestic and sexual violence and problematic substance use www.avaproject.org.uk www.twitter.com/AVAProject A curious conversation

6. Working with people affected by domestic and sexual violence and problematic substance use www.avaproject.org.uk www.twitter.com/AVAProject Respect and compassion “The basic essence of it is that you are worth treating. By the time I got to that point it was like I can’t live with drink, I can’t live without drink, I’ve completely screwed up my whole life, my children’s life, I’m a horrible mother, nobody loves me, everyone I go out with want to beat the shit out of me, so where does that leave me? I’m nothing.”

7. Working with people affected by domestic and sexual violence and problematic substance use www.avaproject.org.uk www.twitter.com/AVAProject Acknowledgement “My receptionist asked me, after reading my notes on screen, ‘why are you trying to kill yourself? There are worse things than child sexual abuse’. She was not only belittling my notes she was belittling me.”

8. Working with people affected by domestic and sexual violence and problematic substance use www.avaproject.org.uk www.twitter.com/AVAProject Consistency “You can’t ring and make an appointment; you’re given whatever doctor is on duty – never get the same doctor twice.” “Different doctors change and up your prescriptions. I felt like a guinea pig. I took myself off the medication because I couldn’t trust the doctor.”

9. Working with people affected by domestic and sexual violence and problematic substance use www.avaproject.org.uk www.twitter.com/AVAProject Choice “Services make assumptions about what is needed; they don’t actually ask women what they need. Then if it doesn’t work the women are blamed for being difficult or anti social.”

10. Working with people affected by domestic and sexual violence and problematic substance use www.avaproject.org.uk www.twitter.com/AVAProject Appropriate services “ I have found that some counsellors don’t really have any understanding of Asian women’s issues, which sometimes means you don’t want to talk because you feel they don’t really understand you. But in certain areas they are more clued up, which is why it’s important that refuge services for BME women have counselling attached to them.”

11. Working with people affected by domestic and sexual violence and problematic substance use www.avaproject.org.uk www.twitter.com/AVAProject A chance to recover “You should have as much counselling as you need, not just the six sessions I’ve been told I can have on the NHS. They think that my childhood abuse can be treated in one session, my depression in the next, the fact that I have a child who is going to die in the next. No one goes because they fancy a chat. They go until they don’t need to go anymore.”

12. Working with people affected by domestic and sexual violence and problematic substance use www.avaproject.org.uk www.twitter.com/AVAProject The simple things “The mental health nurse I saw was a really compassionate person, she was always there for me which made me able to disclose and just offload on to her. Along with listening it was little things she did like she would come and see me in reception, ask if I wanted a coffee, she would always come out and let me know if she was running late. Once I was really upset, I went in without an appointment and she saw me straight away.”

13. Working with people affected by domestic and sexual violence and problematic substance use www.avaproject.org.uk www.twitter.com/AVAProject