The assessment of self-harm as a window of opportunity for addressing domestic abuse: invited editorial on Knipe et al.

Domestic abuse harms children and families. Self-harm is associated with exposure to and perpetration of domestic abuse, but research on health service responses to self-harm in the context of domestic abuse is limited. We discuss recent work examining the response of mental health professionals to domestic abuse in the emergency department by Knipe and colleagues. Thematic analysis of interviews with 15 mental health professionals working in consultation and liaison settings helped to construct themes including a fear of deeper exploration and tensions between identification and response ('between knowing and acting'). The paper raises important issues for quality improvement in responses to self-harm in liaison settings, including balancing time and resources across different management needs (including domestic abuse response) and professional perceptions of their own actions in clinical settings, such as acknowledging harmful behaviour. The paper demonstrates opportunities for strengthening responses to domestic abuse in professional training.