Mental health services for marginalised women
By Geraldine Esdaille,
As a 2019 Churchill Fellow, my Fellowship took me to Australia, Aotearoa New Zealand, Canada, and the United States, where I investigated fatality review systems.
These systems are designed to help understand the circumstances of intimate partner homicides – and in some cases, deaths by suicide or other forms of family homicide – and to generate learning that can inform improvements to practice, policy, and systems.
I became interested in fatality reviews after a similar system was introduced in England and Wales in 2011 (originally known as ‘Domestic Homicide Reviews’ and now being renamed ‘Domestic Abuse Related Death Reviews’). As a practitioner, I had been involved in these reviews – first commissioning and later leading them. At the time of my Fellowship, I was also completing a PhD at Sussex University, looking at what people understood as the purpose of these reviews, how they undertook them, and the kind of changes they produced.
My Fellowship was a unique opportunity to see first-hand how reviews were being conducted in different countries. But, perhaps most importantly, it gave me the chance to connect with practitioners, policymakers, and researchers around the world. Some of the people I met have since become colleagues with whom I have remained in touch, allowing me to be part of an ongoing global conversation about review systems.
Since returning, I have continued to work on reviews and am now an Assistant Professor at Durham University. Last month, my first book – ‘The Potential and Peril of Reviewing Domestic Abuse-Related Deaths’ – was published.
While the book is based primarily on my PhD research, one of the final chapters considers ‘what’s next’. Drawing on insights from my Fellowship (including my Fellowship report), it explores what England and Wales might learn from how other countries approach fatality review. What’s striking about fatality review globally is that, while the goal is often similar – to build a picture of someone’s life and contact with services, identify learning and any gaps in responses, and make recommendations to address these – these review systems vary considerably depending on the local context.
In England and Wales for example, the review system is highly centralised and overseen by the Home Office. In contrast, most other review systems operate at the level of state, territory or province and, ironically perhaps, this variety has often led to more sustained discussions about how best to improve practice and share learning effectively.
"My Fellowship gave me the chance to connect with practitioners, policymakers, and researchers around the world."
One shared challenge across all systems is how to evidence impact – that is, how to show that the learning and recommendations reviews produce lead to meaningful change. While no one country has cracked the issue yet, there are promising approaches. Some systems publish regular reports to raise awareness and have also developed ways to monitor the implementation of recommendations. These remain areas where England and Wales have more work to do, although the development of an oversight mechanism overseen by the Domestic Abuse Commissioner is an important step in the right direction.
My work on reviews is continuing. I’m currently involved in projects looking at how reviews are commissioned, and how well they capture data that can help us understand the sex- or gender-related motives and indicators in femicides.
If you’re interested in finding out more about the book or my ongoing work, I’d love to welcome you to the upcoming book launch on 22 April.
The views and opinions expressed by any Fellow are those of the Fellow and not of the Churchill Fellowship or its partners, which have no responsibility or liability for any part of them.
By Geraldine Esdaille,
By Saeida Rouass,
By Mandy Bell,