Responding to Intimate Partner Violence Disclosures in Psychiatry

Intimate partner violence (IPV) was underrecognized in male patients and LGBTQ+ patients, higlighted Sydney Taylor, MD, because depictions typically centered on a male perpetrator and female victim. A study of police data this year found that 1 in 5 police calls about IPV came from men, who reported the same subjective victimization as women. All reported abuse warranted serious consideration, Taylor said, with mandated reporting, safety planning, and screening initiated as indicated.¹

A thorough history supplemented by collateral from a trusted loved one also clarified the home environment and relationships. Taylor said, "Let's say that you have a patient who has schizophrenia, and let's say that they are based in reality, so they're not decompensated, and they're reporting abuse there. So, I think that's even more of an indication that they might be experiencing it."

Suicidality and IPV overlapped substantially, Taylor noted.² Patients presenting with depression or suicidal thoughts warranted a social history that went beyond whether support existed to what home life and relationships looked like.

In a 30-minute outpatient visit, clinicians should confirm home safety, screen for suicidality and homicidality, and assess imminent risk, taking extra time when possible. Patients who disclosed perpetrating IPV also warranted a request to speak with the victim. Homicidal ideation toward the victim could justify breaching confidentiality under duty to warn or duty to a third party, which also varied by state. Transfer to the emergency department allowed more time to evaluate, and observation could be used when a patient could not verify safety so that a safety plan could be secured.

Taylor said, "Whether you're outpatient or in some sort of a crisis evaluation like in the emergency department, just make sure that you assess imminent danger, you consider mandated reporting based on your state, and you really support the patient where they are, whether they're the victim or the perpetrator."

Dr Taylor is a second-year psychiatry resident at the Carolinas Medical Center Psychiatry Residency Program.

References

1. Taylor S, Rachal J, Soliman L. Breaking the cycle of intimate partner violence: a brief guide for psychiatric clinicians. Psychiatric Times. September 22, 2026. https://www.psychiatrictimes.com/view/breaking-the-cycle-of-intimate-partner-violence-a-brief-guide-for-psychiatric-clinicians

2. Carlisle S, Whyte R, Saunders K, et al. Perpetration of intimate partner violence and suicide attempt, suicidal ideation, and non-suicidal self-harm: a cross-sectional secondary analysis using the Adult Psychiatric Morbidity Survey. Epidemiol Psychiatr Sci. 2026;35:e16.