Nadia Mantovani | St George's, University of London (original) (raw)

Papers by Nadia Mantovani

Trauma, Violence, & Abuse, 2023

The aim of this systematic review was to assess the magnitude of the association between types of... more The aim of this systematic review was to assess the magnitude of the association between types of intimate partner violence (IPV) and mental health outcomes and shed light on the large variation in IPV prevalence rates between low-to middleincome countries and high-income countries. The study is a systematic review and meta-analysis. The following databases were searched for this study: Cochrane, MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and the Applied Social Sciences Index and Abstracts. The inclusion criteria for this study are as follows: quantitative studies published from 2012 to 2020 on IPV exposure in women aged 16+, using validated measures. Random effects metaanalyses and subgroup analysis exploring heterogeneity across population groups in different economic contexts are used in this study. In all, 201 studies were included with 250,599 women, primarily from high-income countries. Higher prevalence rates were reported for women's lifetime IPV than past year IPV. Lifetime psychological violence was the most prevalent form of IPV. Women in the community reported the highest prevalence for physical, psychological, and sexual violence in the past year compared to clinical groups. Perinatal women were most likely to have experienced lifetime physical IPV. Prevalence rates differed significantly (p = .037 to <.001) for "any IPV" and all subtypes by income country level. Meta-analysis suggested increased odds for all mental health outcomes associated with IPV including depression (odds ratio [OR] = 2.04-3.14), posttraumatic stress disorder (PTSD) (OR = 2.15-2.66), and suicidality (OR = 2.17-5.52). Clinical and community populations were exposed to high prevalence of IPV and increased likelihood of depression, PTSD, and suicidality. Future research should seek to understand women's perspectives on service/support responses to IPV to address their mental health needs. Work with IPV survivors should be carried out to develop bespoke services to reduce IPV in groups most at risk such as pregnant and/or help-seeking women.

Health & Social Care in the Community, 2023

A range of professionals and services are often involved in supporting parents with mental health... more A range of professionals and services are often involved in supporting parents with mental health needs where there are child
protection concerns. However, they do not always meet the needs of this population who tend to experience inadequate support
and mistrust of services. Tis review aimed to synthesize parent and practitioner experiences of support for parents with both
mental health needs and children’s social services involvement. We performed electronic searches of the following databases:
PsycINFO, CINAHL, HMIC, MEDLINE, Embase, Social Policy and Practice, Social Services Abstracts, Social Science Citation
Index, OpenGrey, Social Care Online, and ProQuest. Following searching and screening, 41 studies were identifed including 359
parents and 1370 practitioners. We worked with a Lived Experience Advisory Group to develop the following themes: (1)
a downward spiral of service intervention; (2) working with parents, not against them; (3) support wanted versus support
provided; and (4) constrained by service rigidity. We found that families were often parenting amidst trauma and adversity.
However, service involvement could trigger a “downward spiral” of stressful processes over which parents felt they lacked control.
Instead of improving their situations, support sometimes added to families’ difculties, worsening parents’ mental health and
making them feel marginalised, criticised, and retraumatised. Tere were, however, also examples of positive practice, where
practitioners and parents developed trusting, open, and mutually respectful relationships. Practitioners often felt that they were
limited in their ability to ofer collaborative, holistic care because services were fragmented, underfunded, crisis driven, and
infexible. Difculties mentioned most often by parents, such as fnancial issues, tended not to be a focus of available interventions.
We conclude that the key issues identifed must be targeted to improve support.

Journal of Clinical Medicine, 2021

In this study, we explore the role that isolation and loneliness play in the narratives of women ... more In this study, we explore the role that isolation and loneliness play in the narratives of women diagnosed with perinatal depression. Isolation and loneliness are increasingly seen as risk factors for depression, including in the perinatal period, but little is known about whether, and in what ways, women themselves associate isolation or loneliness with perinatal distress. Based on the thematic analysis of semi-structured interviews with fourteen mothers in England, we found that women often connected feelings of depression during and after pregnancy to feeling dislocated from their previous identities and relationships. Women felt lost, confined to their homes, and often unsupported by their partners and families. However, fears of being judged to be inadequate mothers made it difficult for women to make authentic connections with others or to express negative feelings, increasing isolation and depression. We drew on the intersectionality theory to illustrate how the intersect bet...

a b s t r a c t Objective: this paper addresses the experiences of a group of young black teenage... more a b s t r a c t Objective: this paper addresses the experiences of a group of young black teenage mothers looked after by the State, most of whom were also either migrants or asylum seekers. The paper explores the experience of discovery of pregnancy, attempts to seek professional help and the eventual decision to continue with the pregnancy. Design: an interpretative study with in-depth interviews. Settings: interviews were carried out in the participants ' homes and focussed on their experiences of pregnancy decision-making. Participants: 15 young women (aged 16–19), from black minority ethnic groups, with a history of care (past or present), currently pregnant or mothers of a child no older than two years of age. Findings: all the pregnancies were unexpected: eight of the informants conceived as a result of rape and seven while in a relationship. All the young women chose motherhood over abortion despite their complex social and pregnancy background. Conclusions: the importa...

When studying the natural distribution of the species, it is necessary to have sufficient records... more When studying the natural distribution of the species, it is necessary to have sufficient records with valid coordinates, but for some of these species, such records available to the public are limited. To overcome the poor number of records for some species, ecological niche modeling is used, which allows to predict the natural range of each species. This technique creates an ecological niche from the environmental characteristics of each site where a species has been observed and identifies other areas with similar environmental conditions as areas where the species can potentially occur. The advantage of this method is that it can be consistently applied to a large number of species.

Telah dilakukan penelitian uji penolakan distilat minyak atsiri pandan wangi (P.amaryllifolis Rox... more Telah dilakukan penelitian uji penolakan distilat minyak atsiri pandan wangi (P.amaryllifolis Roxb.) terhadap hama kutu beras (Sitophilus oryzae L). Penelitian ini menggunakan rancangan acak lengkap sebagai rancangan penelitian. Uji penolakan menunjukkan fraksi A (41-50 0 C) signifikan menolak hama kutu beras. Fraksi ini memberikan persen penolakan sebesar 32,22; 29,44; dan 13,30 % untuk tiap konsentrasinya (10, 15, dan 20%). Hari pertama hingga hari ketiga merupakan hari efektif fraksi ini menolak hama kutu beras, sedangkan pada hari berikutnya persen penolakan berkurang tajam.

This paper seeks to explore the moral accounts of young people’s own interpretation of their choi... more This paper seeks to explore the moral accounts of young people’s own interpretation of their choice of parenthood, the new meanings in their lives brought about by the responsibility of parenthood, and the transformative experience that this responsibility generated. Drawing on a study of young parents in South West London this paper considers how the participants’ moral understanding is fundamentally shaped by the social construction of the 'good' parent. This study employs an interpretative methodology with in-depth interviews and focused on their choice to become a parent at a young age. Fifteen young people were interviewed aged 16-19; of these six were young mothers, five young fathers, and four currently pregnant. A narrative method to analyse the data was employed because moral sense-making and self-interpretation take a narrative form. In the worlds in which these young parents live they negotiated their own narratives of the child and adult divide; and they position...

International Journal of Mental Health Nursing, 2021

The long-term effects of childhood abuse have been well studied though the effects of abuse of sp... more The long-term effects of childhood abuse have been well studied though the effects of abuse of specific types in adult psychiatric service users are less known. This study aimed to assess the association between childhood abuse and the development of harmful social and behavioural outcomes among adult psychiatric service users. Adult psychiatric service users were accessed from secondary mental health services in South London. A retrospective analysis was conducted of a randomly selected sample of 342 mental health records. Chi-square tests and logistic regression models were used to examine associations between childhood abusesexual abuse, physical abuse and psychological/emotional abuseand health and behavioural outcomes. This study identified that 109 (31.8%) psychiatric service users had some history of childhood abuse and more often presented with high-risk or severe behaviours. Sexual abuse in childhood was linked with social isolation related to loss of friends (odds ratio (OR) = 2.68, P < 0.01), risky behaviours such as binge drinking (OR = 2.15, P < 0.05) and self-harming (OR = 2.86, P < 0.01), while childhood physical abuse was associated with drug abuse in adulthood (OR = 1.88, P < 0.05). Revictimization (adult domestic violence) also impacted on service users' quality of life in terms of loss of housing (OR = 2.21, P < 0.05) and loss of friends/family contact (OR = 2.73, P < 0.01). These findings suggest childhood abuse may play an important role in shaping risk and vulnerability for mental health problems across a lifespan. In acute mental health services, the incorporation of a trauma-informed nursing care model is necessary to generate a shift in culture in the delivery of care.

Current Opinion in Environmental Sustainability, 2021

Responding to climate change requires radical transformations in social, political, economic and ... more Responding to climate change requires radical transformations in social, political, economic and social-ecological systems. Recent research has argued that individuals can drive transformations at scale through changes in beliefs and values that affect political activity. We draw from sociological and psychological perspectives on mental health outcomes among survivors of violence and abuse, taking a gendered approach, to show how potential for individual transformation is differentially constructed through personal life trajectories and intersectional social relations. We also argue that being resilient and transforming is stressful and involves significant personal costs. In integrating this psychological perspective, we suggest a more equitable way to define the individual's role in, and their responsibility for, sustainable, societal-scale shifts for climate change.

Epidemiology and Psychiatric Sciences, 2019

To experience sexual violence and abuse is to experience silence. This commentary explores some o... more To experience sexual violence and abuse is to experience silence. This commentary explores some of the ways in which psychiatry reinforces the silencing of sexual violence survivors. We argue that current psychiatric responses to sexual violence typically constitute iatrogenic harm including through: a failure to provide services that meet survivors’ needs, a failure to believe or validate disclosures; experiences of medicalisation and diagnoses which can delegitimise people's own knowledge and meaning; ‘power over’ relational approaches which can prevent compassionate responses and result in staff having to develop their own coping strategies; and poorly addressed and reported experiences of sexual violence within psychiatric settings. We argue that these multiple forms of silencing have arisen in part because of biomedical dominance, a lack of support and training in sexual violence for staff, inconsistent access to structured, reflective supervision, and the difficulties of f...

Trauma, Violence, & Abuse, 2023

Health & Social Care in the Community, 2023

Journal of Clinical Medicine, 2021

International Journal of Mental Health Nursing, 2021

Current Opinion in Environmental Sustainability, 2021

Epidemiology and Psychiatric Sciences, 2019

Report

Given the increasing awareness of domestic violence or abuse (DVA) and its prevalence and impact ... more Given the increasing awareness of domestic violence or abuse (DVA) and its prevalence and impact within the general population and amongst users of psychiatric services this study looked at the extent to which domestic violence was related to the mental health needs of a secondary psychiatric service user population in Wandsworth, and how service response to DVA in secondary mental health services in the Borough could be improved. This included considering the potential for more systematic screening for DVA, and developing a new service response based on a peer-mentoring model, as a way to address the long-terms mental health effect of DVA. Psychiatric services users have often contested the dominance of biomedical explanations for mental distress which too often has marginalised more holistic and social explanations and interventions. This has contributed to mental health professionals’ failure to identify and acknowledge abuse, and a failure to ask the question ‘what happened to you?’ (rather than the more standard and individually pathologising ‘what is wrong with you?’).
This study explored how focused efforts to enquire about experiences of DVA and other abuse may need a stronger emphasis if we are to improve service responses and people’s experiences of mental health support from professionals. To investigate this, we adopted a mixed methods study to: a) establish the extent of domestic violence in secondary mental health services in Wandsworth through examining service users’ files for recorded incidents of violence or abuse, aimed at informing the subsequent qualitative component of the study, and b) elicit the views of a range of stakeholders about adopting routine enquiry into domestic violence in secondary mental health services, together with their views on responding to domestic violence in this population with a peer-mentoring service, as way to address the long-terms effect of DVA.
We examined the lifetime exposure to and patterns of violence or abuse (DVA) in a randomly selected sample of services users (N=342) admitted to secondary mental health services, the health and social outcomes of those service users exposed to violence or abuse, and its potential for intergenerational patterns of violence or abuse. The inspection of the patients’ files in the selected sample revealed a high number of service users with recorded incidents of domestic violence or abuse; n=167 (49%) had been exposed to patterns of violence or abuse either as a single or multiple incident in their lifetime. It should be noted, however, that the electronic records did not have a standard question (or a validated tool) to capture information about current or past abuse, and that practitioners did not ask about this routinely. Therefore, there is the possibility of under-recording which is corroborated by research evidence in psychiatric settings highlighting the underreporting and under-disclosing of DVA within health services.

within this she has covered topics such as health related stigma, the sociology of early reproduc... more within this she has covered topics such as health related stigma, the sociology of early reproduction, the experience of care and after care of minority young people, and drug misuse. She has an interest on the social aspect of mental health and particularly the impact of migration on the mental health of minority groups. Her recent work proposes peermentoring-based interventions to promote positive outcomes in mental health settings among victims of domestic violence.

Infographic, 2023

In the realm of mental health, the quest to understand and explore the impacts of violence transc... more In the realm of mental health, the quest to understand and explore the impacts of violence transcends traditional boundaries. It delves deeper, reaching into social dynamics, relationships, and overall well-being. This pursuit is not confined to diagnostic labels; it extends to the broader repercussions that violence can have on individuals and communities. This is a journey marked by empathy, research, and a commitment to listening to the voices of wisdom—those who have endured the harrowing experiences of violence.
A large systematic review, authored by Mantovani and colleagues in 2023, offered a comprehensive examination of the mental health toll exacted by intimate partner violence among women. The findings of the review laid bare the grim statistics, but it also revealed a significant gap. The Survivor Panel, comprised of individuals who have walked the challenging path of surviving violence, sensed a void in the available data. The review, though informative, could not capture the nuances that mattered most to the survivors. This discrepancy ignited a call to action—a call for a paradigm shift in the way we approach research and practice in the field of mental health.
Survivors’ perspectives highlight core issues that demand immediate attention. The way forward necessitates a significant shift. Clinicians and researchers must rise to the occasion by understanding trauma-specific experiences, such as somatization, dissociation, and flashbacks, and supporting survivors in their journey towards identity reconstruction and healing. Recognizing the intersection of identities, the impact of systemic and structural oppression, and the need for culturally responsive treatment are paramount in addressing trauma comprehensively.
Moreover, to reflect the survivor's perspective and their unique path to recovery, new psychosocial outcome measures must be created. These measures should extend beyond assessing mental health symptoms and instead capture the broader scope of trauma's effects, rooted in the survivor's strengths and recovery goals.
In this endeavour, mental health professionals are encouraged to look beyond the conventional and embark on a journey of empathy and enlightenment, seeking to truly understand and explore the profound impacts of violence. It's a journey that respects the wisdom of survivors and strives to make a positive difference in their lives.