The aim of the study was to explore what mental health service users and professionals believed were barriers and facilitators of disclosures of domestic violence. The sample included 18 mental health service users and 20 mental health professionals. The 18 service users had all experienced domestic violence. 16 of them were female and 2 were male, their ethnic background reflected that of the population as identified in the 2001 census, and a number of diagnoses were identified, as intended by the purposive sampling. As the research question was specific to mental health service users and professionals, the sample was appropriate in that regard.
The data were collected by a cross sectional semi-structured individual interview study, which was appropriate for the subject matter. A focus group could have proved intimidating for the service users and could have restricted how open the mental health professionals were (Hawthorne effect); one of the professionals was a team manager, which may have made a number of the professionals uncomfortable in questioning whether domestic violence was part of their role. An individual interview would make the participants more comfortable and open.
The data were analysed thematically, beginning with identification of patterns that were coded by two raters. From the description of the analysis, it seems that the analysis was reapplied as the coding developed. The thematic analysis allowed common themes to be identified within and between the groups. The authors explain their method and analysis in detail.
As described in the paper, the study was carried out in a very socioeconomically deprived setting with a high proportion of ethnic minority groups, which may result in a lack of transferability. This is particularly important with the theme of culture that was brought up by both mental health service users and professionals. However, the discussion of the clinical implications of the study is quite general; disclosure of domestic violence is facilitated by a good service user-professional relationship and would be further facilitated by domestic violence training of professionals. Despite the deprivation within this particular setting, it is unlikely that this would not have beneficial effects elsewhere.
The study does not discuss ethical issues, but does discuss exclusion of service users, based on the opinion of a clinician that they are too unwell. Service users were given £20 for their time and expenses, which may have coerced them into attending.
I think that, overall, the methods and analysis that the researchers undertook are described in detail in the paper.
I struggled with deciding whether thematic analysis is appropriate - what alternatives are there? And when is thematic analysis appropriate or not?
