“They said if you come you can’t drink. I thought, I can’t stop.” Exploring the journeys to support among women who experience co-occurring substance use and domestic abuse.

Fox, Sarah (2018) “They said if you come you can’t drink. I thought, I can’t stop.” Exploring the journeys to support among women who experience co-occurring substance use and domestic abuse. Doctoral thesis (PhD), Manchester Metropolitan University.

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Abstract

Although 30-40 percent of people in England seeking treatment for substance use are women, little research explores their experiences of support when domestic abuse is also present. There is also a gap in service provision for women with multiple and complex issues such as problematic substance use and domestic abuse. Ongoing austerity measures continue to impact health and social care services in the UK, which in turn, has an impact on the support options available to women. What women do to seek help, how they feel about the support they receive (or lack thereof), and information about the type of support available to them, is a missing conversation in both substance use and domestic abuse research and other related literature. As such, this research seeks to understand women’s journeys to support, when they experience co-occurring substance use and domestic abuse. The research aims to take an in-depth look at women’s motivations for support seeking, explore the barriers and/or enablers to accessing support, determine the wider influences on women's decision to seek help, and, identify the practice of substance use services and domestic abuse agencies in supporting women with dual needs. Influenced by feminist research theory and hermeneutic phenomenology, this thesis will present data from 12 interviews with women who have experienced co-occurring substance use and domestic abuse. Using interpretative phenomenological analysis (IPA) to analyse the interviews, a sample profile, 12 pen portraits and five superordinate themes will be presented. A discussion of the findings focuses on the complexity of support seeking among women with co-occurring’s substance use and domestic abuse. In particular, this research shows that the women in this study experienced multiple complex histories of abuse and substance use. The relationship between motivations and barriers of support seeking, the impact of systematic barriers and, a discussion of trauma informed approaches to support are also key themes discussed in this thesis. Overall, this research presents the journey to support, and the experiences of support, for women with histories of substance use and domestic abuse. This research creates a new knowledge, because it is the first-time women’s voices have been heard in terms of their own support journey. By listening to the voices of women, this research presents the lived realities of accessing support in a climate where support is reducing.