“Devon Partnership NHS Trust staff had not received detailed training on domestic abuse…”

The coroner’s concerns

(1) Devon Partnership NHS Trust staff had not received detailed training on domestic abuse and its significance for patients and service users experiencing domestic abuse. (2 ) Although there appeared to be evidence that training in relation to domestic abuse was being developed or planned, it did not appear to be sufficiently comprehensive, readily accessible to all staff, or focused on the particular challenges of identifying domestic abuse in patients with mental ill health. Nor did it adequately address the established links between domestic abuse, homicide and suicide. (3 ) Recent Domestic Homicide Reviews undertaken in Devon had identified shortcomings in professionals' understanding and recognition of domestic abuse, and had highlighted the importance of improved training and awareness across agencies. 2 6 (4 ) There remains a need for training to assist professionals in identifying the effects that domestic abuse may have on patients and service users with mental health conditions, including how domestic abuse may present, the barriers to disclosure, and the increased risks of self-harm and suicide associated with such experiences .

An extract. Read the full report, including the circumstances of the death, on the Courts and Tribunals Judiciary website.

Source

judiciary.uk, Prevention of Future Deaths reports, 2026-0369

Added to Minute Book

7 Oct 2026

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Contains public sector information licensed under the Open Government Licence v3.0. Source: Courts and Tribunals Judiciary, judiciary.uk. Open Government Licence v3.0