Early on in my journey of waking up to abuse, I tried labeling it by many names—bullying, deception, attachment disorder, contempt, pathological lying, intimidation. I also tried labeling its effects—confusion, fear, submission, trauma, loneliness, misunderstandings, and betrayal.
It took me a while to understand that these attempts at labeling only skirted around the real issue. They were symptoms of a much deeper harm. So as I dug deeper, I was left with terms that sounded like mental health diagnoses, but I certainly wasn’t a mental health expert.
Terms like abuse, narcissism, dissociation, PTSD, anxiety, depression.
Issues of mental health deeply intertwine with the abuse dynamic. In conversations about abuse, whether within legal cases or in news articles reporting instances of abuse or legal cases where abuse is the focus or part of the evidence, we still focus so much on whether or not there are visible wounds—cuts, bruises, or outright violence.
But abuse runs so much deeper. If you’ve been following my Substack, you likely know that already. Abuse and its effects dig into your heart and mind and soul, leaving invisible scars that can last a lifetime.
And when survivors bring their cases to court, these mental scars are often misunderstood, misrepresented, or totally ignored.
The Intersection of Mental Health and Abuse
There are two main forks at the intersection of mental health and abuse:
One, how mental health impacts survivors in their healing and in their fight for justice.
Two, how mental health can play a role in perpetrators’ behaviors, and how it’s often used unjustly to excuse or diminish the abuse.
It’s an uncomfortable topic because we know mental health struggles affect both those who cause harm and those who suffer from it. However, this doesn’t make the pursuit of justice any less urgent or vital.
The Double Burden on Survivors
When it comes to survivors, there is a double burden on them related to mental health and abuse. For survivors of abuse—whether that is sexual assault, domestic violence, or emotional manipulation, or other kinds of abuse—we must acknowledge the profound mental health consequences they endure. The trauma of abuse doesn’t end when the abuse or the assault stops. It lingers, for years, even decades, manifesting as PTSD, anxiety, depression, dissociation, or even an overwhelming sense of shame or self-blame.
As someone who has personally walked through this fire, I know full well that you can feel like you’re drowning in it, even when the actual abuse is over. Each day can feel like a battle to stay afloat, a battle to convince yourself that you are worthy of love and healing, that you deserve justice.
Yet, when survivors report their abuse or bring their cases to court, issues related to mental health are often weaponized against them. Symptoms of PTSD, emotional flashbacks, or moments of dissociation are portrayed as signs of instability or untrustworthiness. Survivors are often told that their trauma disqualifies them from being reliable witnesses to their own experiences. Or, they are often forced into mental health exams by one-time evaluators who have no context for the dynamics of abuse that occurred in the relationship.
My own divorce was settled right before we argued their motion for both me and my children to submit to psychological exams. This motion was despite there already being on the record testimony by a psychologist (who the court had deemed an expert) of physical and psychological abuse, as well as an affidavit by another. Also, despite clear evidence of the harmful impact in the form of learned behaviors and efforts to evaluate and deal with those behaviors in treatment and in court.
I’ve known other parents who struggled with the idea of forcing their children to endure psychological exams by strangers, versus going ahead and settling their divorce from an abusive spouse. Especially with children, who are unlikely to open up about the truth of abuse or its impact to anyone, much less to a one-time examiner peppering them with questions. The same is true for when DCS case workers step in and singularly ask flat questions about whether their parent or someone else they trust (and often love) such as a pastor, youth leader, teacher, or relative is abusing them.
There is a terrible irony here: the system seems to say, “If you’re too well, you can’t have been hurt; but if you’re too hurt, you can’t be trusted.” It’s an impossible bind that many survivors find themselves in.
In this way, the legal system itself can become an extension of the abuse—a place where survivors are re-traumatized. Defense attorneys might dig into a survivor’s mental health history, turning it into ammunition against their credibility. They argue, “You can’t trust what they’re saying because they’re mentally ill,” while ignoring the fact that these mental health conditions are often direct results of abuse that they endured.
The courts, as well as bystanders like friends, family, or even religious leaders, often treat mental health struggles as weakening the survivor’s case when, in reality, those struggles are evidence of the harm inflicted. The trauma response isn’t a sign of weakness, but a natural reaction to enduring abuse.
The trauma response isn’t a sign of weakness, but a natural reaction to enduring abuse.
There is a terrible irony here: the system seems to say, “If you’re too well, you can’t have been hurt; but if you’re too hurt, you can’t be trusted.” It’s an impossible bind that many survivors find themselves in.
The Mental Health of Perpetrators: Accountability vs. Excuses
The other side of mental health and abuse relates to the perpetrator’s mental health. I want to tread carefully here because this topic gets complicated. There is no doubt that some perpetrators struggle with mental health issues themselves. Many have also suffered abuse or learned abusive behaviors from their own childhood experiences. But this is where we must draw a line—mental health struggles cannot become an excuse for abusive behavior.
Too often, in both the courtroom and society at large, we see narratives like, “He didn’t mean to do it; he’s mentally ill” or has a substance disorder or is an alcoholic, or “He learned these behaviors from his traumatic past.”
Mental illness is real, and it can affect behavior. However, mental illness should not be used as a blanket excuse for harm.
A perpetrator’s childhood abuse, or mental health struggles, or substance use disorder can sometimes partially explain abusive behaviors, but never excuses them.
It’s unjust to give more weight to a perpetrator’s alleged mental illness than to the harm they’ve caused the survivor. The legal system often reflects this imbalance, offering lighter sentences, reduced charges, or alternative forms of rehabilitation for those who agree to seek counseling.
While I firmly believe in rehabilitation, I also believe in accountability. True justice requires that we don’t sidestep the consequences of abusive actions, even if the abuser has struggled with their own mental health. Compassion for mental health issues should never mean overlooking the responsibility for harm done.
A perpetrator’s childhood abuse, or mental health struggles, or substance use disorder can sometimes partially explain abusive behaviors, but never excuses them.
The Role of Faith: Justice, Mercy, and Accountability
As a person of faith, I constantly find myself returning to the balance of justice, mercy, and accountability. Scripture reminds us in Micah 6:8 to “seek justice, love mercy, and walk humbly with your God.” But what does that look like when abuse, trauma, and mental health are involved?
For survivors, justice means being seen and heard, without their trauma being used against them. The Bible is full of stories where God sees the suffering of the vulnerable and oppressed. Hagar, fleeing her abusive situation, called God “El Roi,” the God who sees, in Genesis 16:13. We need systems that see survivors—where their mental health struggles are understood as possible evidence of harm, not as signs of weakness.
For perpetrators, justice means accountability, but this doesn’t mean abandoning mercy. I believe in redemption and the possibility for people to change, even though change for most abusers is unlikely and if it does occur, often takes decades of intentional work. But even when God offers forgiveness, there are still consequences for harmful actions. King David, despite being a man after God’s own heart, faced severe consequences for his abuse of power over Bathsheba, as Nathan described when he confronted David in 2 Samuel 12.
True repentance includes acknowledging the harm caused and accepting the consequences, not avoiding them. Healing must involve accountability.
Moving Toward Advocacy and Systemic Change
So where do we go from here? How do we untangle this web of mental health, abuse, and justice?
We must advocate for survivors, ensuring they are supported and that their trauma isn’t used against them. This means rethinking how mental health records are used in abuse cases and providing more comprehensive mental health support both before and after court proceedings.
We also desperately need trauma-informed legal practices. Judges, attorneys, and juries must be educated on what abuse can look like and how trauma can affect survivors’ behavior, memory, and demeanor. Too often, survivors are expected to act “normal” or behave in ways that simply aren’t realistic for someone who has lived through trauma.
Ending the Stigma: Mental Health as Part of the Conversation
A significant part of this advocacy involves dismantling the stigma surrounding mental health—both for survivors and perpetrators.
For survivors, we must continue to destigmatize trauma responses. Survivors should never feel ashamed or weak for struggling with PTSD, anxiety, or depression after abuse. These are normal, human reactions to extraordinary harm, and they deserve empathy, not suspicion.
For perpetrators, we must also address the stigma around mental health, but in a way that ensures accountability. Yes, many abusers have their own histories of trauma and mental illness, but this does not absolve them of responsibility. It should, however, inform how we approach rehabilitation and prevention of future harm.
Survivors should never feel ashamed or weak for struggling with PTSD, anxiety, or depression after abuse. These are normal, human reactions to extraordinary harm, and they deserve empathy, not suspicion.
Practical Steps for Advocacy
What are some practical steps we can take to support justice with regards to abuse and mental health?
Support trauma-informed legal reform. Advocate for changes that prioritize understanding trauma and prevent mental health records from being misused in court.1
Provide mental health support for survivors. Legal representation isn’t enough—survivors need access to mental health care that helps them heal from their trauma.2
Hold perpetrators accountable while offering paths to healing. Justice should involve both accountability and opportunities for rehabilitation where wanted.3
Challenge the stigma around mental health. Talk openly about mental health, offer empathy instead of judgment, and recognize that mental health struggles are central to the conversation about abuse.4
Engage our communities. Support local organizations and educate others about the intersection of mental health and abuse.5
A Call for Compassion, Justice, and Healing
Paul writes in 2 Corinthians 1:3-4, “Praise be to the God and Father of our Lord Jesus Christ, the Father of compassion and the God of all comfort, who comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves receive from God.” We are called to comfort the suffering, to stand up for those harmed, and to seek justice for those wronged.
Compassion does not mean excusing harm.
Justice does not mean abandoning mercy.
Healing doesn’t mean forgetting the past.
We must hold all of these together as we build a world where survivors are believed, mental health is understood, and perpetrators are held accountable.
Warmly,
In 2013, the United States reauthorized the Violence Against Women Act (VAWA), which included provisions for trauma-informed care. This law now encourages training for law enforcement and legal professionals on how to approach survivors in a trauma-informed way. It was a significant shift that helps survivors navigate the legal system without being re-traumatized by insensitive questioning or procedures. Further training is needed however in educating police officers and judges in identifying abuse dynamics in reported incidents, court cases including divorces, assaults, and juvenile charges.
Some jurisdictions around the U.S. have developed community-based trauma recovery centers that work with survivors of abuse and violence by offering trauma-focused mental health services alongside legal advocacy. By integrating both mental health and legal support, these centers help survivors heal more holistically. Some domestic violence shelters/programs provide similar support. However, policies that expand coverage for mental health services through Medicaid or other insurance programs, specifically for survivors of abuse, would offer additional needed services.
While there are examples of effective abuser treatment programs that are designed to rehabilitate abusers, in order to be effective, offenders must sincerely desire to change their thinking, not just their conduct for long-lasting change. The reality is that we can’t force someone to think differently, which often results in a catch 22 for rehabilitating abusers, whether it is sexual abuse, domestic abuse including coercive control, or abuse of power or spiritual concepts.
NAMI (National Alliance on Mental Illness) and various campaigns have taken huge steps in de-stigmatizing mental health by encouraging people to speak openly about their experiences. These movements have worked to reframe mental health struggles not as weaknesses but as part of human vulnerability and the healing process, which is crucial in the context of abuse survivors. On World Mental Health Day or otherwise, one idea is to support public awareness about the effects of trauma on survivors of abuse and the impact of abuse on mental health.
The Me Too movement was a powerful example of widespread community engagement. Survivors came forward publicly to share their stories, calling attention to how insidious abuse is and how often it goes unaddressed. Communities were mobilized to demand change at societal and legal levels. Unfortunately, in the wake of Johnny Depp’s win in his abuse defamation trial, and with the election of a notorious abuser as president and his appointment of others with credible allegations of sexual abuse, many gains in that regard have all but evaporated.
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