Domestic violence and mental health: A case report

Abstract

Background: A 42-year-old mother of three was admitted to the psychiatry ward of the National Hospital of Sri Lanka (NHSL) on January 25, 2025, presenting with dissociative symptoms and severe depression. Her condition is attributed to longstanding intimate partner violence (IPV). Her husband, with a history of morbid jealousy, alcohol and substance abuse, has been physically abusive since early in the marriage. The patient has had multiple hospital admissions, including treatment for a head injury in 2010, seizure episodes, and a suicide attempt in 2024 via Amitriptyline and Metformin overdose. Case study: A comprehensive medico-legal and psychiatric evaluation was conducted. Social support services were engaged to ensure the patient's safety and initiate legal protection. Referrals were made to Women in Need, the Children and Women Bureau, and "Mitura Piyasa." An interim/restraining order was requested under the Domestic Violence Act No. 34 of 2005. The patient and her eldest daughter were educated on available emergency resources, including the national 1938 hotline. A family intervention session was held involving the abusive partner. Results: The patient exhibited ongoing suicidal ideation and poor treatment compliance. The family intervention led to the husband agreeing to seek treatment. However, due to her vulnerability and history of poor follow-up, legal action and continuous monitoring were emphasized. Despite previous medico-legal and social interventions, the risk to her safety persists. Conclusion: This case highlights the grave and enduring impact of domestic violence on women's mental health. It underscores the importance of early legal intervention, sustained psychiatric care, and robust multidisciplinary collaboration. Immediate legal protection, strict enforcement of the Domestic Violence Act, continuous psychiatric monitoring, and community-based support are critical to ensuring long-term safety and recovery.