The National Health Service (NHS) in the UK is a government-sponsored organization that is tasked with promoting the quality of health for all UK citizens. Therefore, this organization undertakes several measures and activities which are meant to guarantee the continuous improvement of the quality of health in the public sector. One of the key issues that the NHS considers within its public health promotion programs is the quality of sexual health. The NHS, for example, recognizes the significance of promoting sexual health illnesses as a crucial component of the overall well-being of individuals within the UK. For this reason, sexual health has been interested in the broader frameworks of the public health systems, and the NHS, together with other bodies that are concerned with public health within the UK, have similarly undertaken several initiatives and policies that are aimed at promoting various aspects of sexual health (Martin et al., 2019). Looking at sexual health on its own, it is evident that this is a crucial component of public health systems. Sexual health encompasses both elements of physical health, mental health and the social health of an individual’s life. Several aspects of sexual health have been directly correlated to the comorbidities of other forms of physical and mental health, which need to be addressed by the public c health systems. This means that it is vital to address sexual health systems as part of the overall public health program to guarantee the overall good quality health of the public.
As part of the public health program, there are several components of sexual health which are similarly addressed by different components and different institutions of health in the UK. Sexual health in itself encompasses a range of physical, emotional, mental and social wellbeing status that all relate to the sexual wellbeing of the individual. For example, according to the World Health Organization (WHO), sexual health is defined as the state of physical, emotional and social wellbeing that relates to sexuality. This definition, therefore, highlights the significance of the sexual health issue as one that transcends beyond the physical elements of sexuality. Therefore, one of the key components of sexual health that will be considered in this essay is emotional abuse. Emotional abuse has the potential to lead to some severe mental health issues, affect the individual’s social relationships, or lead to intimate partner violence among other related issues. On the other hand, having a proper health based practice to address emotional abuse can lead to significant boost in helping individuals cope with this challenge, as well as providing suggestions for cultural and policy interventions that can be adopted to help address the issue of emotional abuse as a form of sexual health programs. Therefore, this essay will consider the sexual health challenges related to emotional abuse, the role of cultural and policy differences in promoting emotional abuse, and highlight some of the interventions that can be undertaken to help prevent this vice within the context of the UK public health system.
Background
To first understand the background for this study, it is vital to first examine the definitions of sexual health promotion as it has been defined in various instances through research and practice. Various large organizations have defined sexual health promotions as a multifaceted concept, which entails multiple efforts that are undertaken with the single purpose of promoting the different elements of sexuality for individuals and communities. For example, as mentioned in the introduction, the WHO defined sexual health as the state of physical, emotional, mental and social wellbeing of an individual that relates to their sexuality (WHO, 2019). The Centre for Disease Control and Prevention (CDC) defines sexual health promotion as providing individuals with accurate information and sexual health, encouraging health behavior, and preventing or addressing sexually transmitted Infections (STIs) (CDC, 2023). There are many other definitions that can be outsourced from different sources, but the key ideas underlying sexual health promotion still remain the same. It is based on a holistic approach that entails more than just the physical wellbeing of sexuality. The emotional and social aspects of the individual’s wellbeing form a crucial element of their sexual health (Hughes et al., 2019). Therefore, all the efforts that are put to enforce these components of sexual health, which may include the provision of educational programs, enacting prevention measures, and creating supportive environments, will all be considered as measures of sexual health promotions.
Based on the above definition of the sexual health promotions, it therefore follows that emotional abuse qualifies as one of the key components of sexual health. This is because emotional abuse can be directly connected to the mental and even physical wellbeing of an individual. However, the linkage between emotional abuse and sexual health is concealed into a complex interconnectivity of factors that still need to be sequentially unpacked in order to clearly understand the connection (Kumari, 2020). To begin with, emotional abuse often relates to the intentional use of words or behavior to manipulate, isolate, or control another individual. Emotional abuse, therefore, leads to emotional distress, fear, or a general loss of self-esteem for the victim (Kumari, 2020). Therefore, when comparing this to the above definition of sexual health, it has been established that the social, mental emotional wellbeing of an individual is all related to sexuality. Therefore, when emotional abuse exists between intimate partners, it falls s within the category of sexual health.
Within the UK, emotional abuse has been gradually integrated into the sexual health and wellness practices. For example, back in 2015, the UK government report titled. “Hidden in Plain Sight” was published as a form of recognizing the emotional abuse as significant public health issues within the country. This article did shed some light on the prevalence of emotional abuse and the detrimental effects of emotional abuse. However, despite this recognition, it is still vital to note that the emotional abuse as a component of sexual health has been superficially covered, and especially in comparison to the physical health aspects (Kumari, 2020). Majority of the sexual health initiatives undertaken within both the private and the public sectors, have focused on physical health aspects of sexual health, and this has led to an overall neglect ion of the emotional wellbeing and the quality of relationships within the country.
Emotional abuse qualifies as a form of public health issue in many ways. One way through which this can be seen is by first examining the prevalence of emotional abuse. It is estimated that every one in four women and one in six men within the UK experience emotional abuse at some point in their lifetime. Looking at the numbers, this can translate to around 13 million people in England alone (Hartney et al., 2019). In addition, emotional health is also related to other long-term health consequences, such as deteriorating mental health. Emotional abuse can lead to other issues such as depression, anxiety, and eating disorders, among others., and with the increase in mental health issues within the society, the whole community is affected. Capturing the whole picture of the extent and the prevalence of emotional abuse within the UK can be challenging because of the intricate nature of the problem. However, some of the data that has been captured within the domestic abuse databases can shed some light on this topic. For example, the NSPCC Childline receives an average of 34 calls every day from children and young people who are experiencing a certain form of emotional abuse (NSPCC Learning, 2022). On the other hand, the women and also reported to have supported more than 260,000 women and children as victims of domestic abuse between 2021 and 2022 (Homme et al., 2023). Therefore, this shows that there is a high prevalence of the issue, and the majority of the people being affected are women and the young people. The number of women being affected is almost twice as much as the number of men that experience the same issues.
The Implications of Culture
Looking at the concept of emotional abuse within the UK provides an opportunity to undertake the cultural influence on emotional abuse. Cultural norms and values have the potential to influence how individuals react to different stimuli in their immediate environment, and therefore, this can lead to different manifestations of emotional abuse in different cultures, as well as changes in how this issue affects the victims. When looking at the cultural landscape within the UK, the country is made up of a large combination of cultural inclinations, within individuals from different cultural identities all having different indications towards these issues. For example, within the UK, there are cultures such as the South Asian communities, the African and Caribbean communities, the Eastern Europeans communities, and the LGBTQ+ communities, among others. Each of these have unique cultural norms, expectation and power dynamics, which affects how they perceive and react in relation to emotional abuse.
To begin with, the South Asian communities hold on to the traditional patriarchal structures, which identify males as the accepted leaders within the family structures. This has the effect of making women more subjective and dependent on their families and spouses, and inadvertently increasing their vulnerability to emotional manipulation and control. Women are easily coerced into being subjects for the husband and male’s dominant (Homme et al., 2023). In addition, there exists honor-based violence and forced marriages, which contribute to the emotional abuse that women experience, and this has the potential to cause some severe sexual health consequences. When looking at the African and the Caribbean communities, it is evident that these communities are strongly influenced by their religious beliefs on gender hierarchy, and the communal gender roles. These communities are also characterized by the inherent taboos and expectations that are held around sexuality, and this often makes it harder for individuals to have open discussion relating to issues that affect their sexualities. As a result, most of the victims that undergo emotional abuse find it extremely difficult to talk about the issues that they have encountered and even to seek any form of help. This has often led to more serious consequences of the emotional abuse that they experience. Experiencing emotional abuse without seeing any form of assistance can lead to serious deterioration of mental health and may even lead to depression. ‘
Another cultural inclination can be found within the Eastern and the European communities. This group has a group of individuals, who may experience language barriers within the UK, or face isolation, due to their immigrant status. Most of these women live in an environment that is not familiar to them and is not native. They lack a proper social connection, and are mainly engaged in blue collar labor to generate their income. Therefore, this highly complicates their ability to communicate and to seek help with issues relating to emotional abuse. Issues relating to emotional abuse are best addressed within a safe space, where an individual can get the medication to freely express their concerns and their fears. In addition, there are other cultural inclinations towards masculinity and maintaining family honor, which make it harder for women to break away from abusive relationships or even to seek help when they need to. The next community section to consider is the LGBTQ+ community, which is a community that has been affected by prejudice and discrimination on a large scale. Therefore, this can foster internalized homophobia, which is likely to push these individuals to more emotional abuse, either by their partners or by family members who discriminate against them. They also experience a unique form of difficulty in navigating the healthcare systems based on the unwelcoming environment that they may receive due to their identities.
Understanding the motivations for the perpetrators of the emotional abuse is also another key component in diffusing the situation. However, the motivations for emotional abuse are also widespread, varied and complex to understand. There is no one particular cause that influences the perpetrators’ decisions. However, some of the common emotional related elements include the desire for control and power, and maintaining dominance in a relationship. Some of the perpetrators of emotional abuse have often experienced the same at an earlier stage in their lives. On the other hand, the survivors may also be a part of the challenges, with their inability to break away from these abusive relationships. Most of them also have varied reasons for sticking with their r abusive partners. These reasons range from fear, financial dependence, cultural pressure, and the lack of an efficient support network.
Cultural inclinations also contribute to gender differences relating to emotional abuse. For example, most cultural beliefs, coupled with the patriarchal nature of religious beliefs, tend to enforce the general expectation that women should be nurturing and submissive. This makes the women have a higher tendency to tolerate the emotional abuse that they receive from their male partners before they release how harmful it is. In addition, this gender imbalance in power provides the perpetrators more leverage, which they can use to manipulate their female victims. The traditional notions of masculinity also may have a negative impact on the men that are victims of emotional abuse. Masculinity can discourage the men from acknowledging they have emotional abuse problems, and thus make it hard for them to seek help. This led to under-reporting and a delayed period for seeking help. In addition, they are also silenced by the social stigmas that relate to the male vulnerability, since most cultures portray men as strong and independent, and thus makes it harder for them to represent their vulnerabilities. Therefore, these evidences highlight the key contributions of cultural practices to emotional abuse, and provide important pointers for addressing the challenge in the community.
The Impacts of Ethical and Legal Frameworks
The ethical and legal frameworks also have a huge significance relating to the sexual health within the UK, and especially relating to emotional abuse. This linkage is also multifaceted, and widely spread across multiple instances. For example, there are several legal frameworks that could be linked to addressing emotional abuse within the country. To begin with, the first one of the domestic abuse acts of 2021 (Homme et al., 2023). Through this act, coercive control was recognized as a criminal offense, and this provided a powerful tool through which the perpetrators of emotional abuse can be held liable before the court of law. This provides a basis for persecuting such perpetrators, although there are still concerns about the sufficient reporting of these cases.
In addition to this act, other related laws can also be used to provide help to victims of emotional abuse. For example, the Equality Act of 2010 prohibited discrimination and harassment of all individuals based on certain protected characteristics, which include sexuality and disability. This can therefore be used to address certain elements of emotional abuse, and especially those that are perpetrated across gender identities (Hughes et al., 2019). In addition, the legal age of consent is also key in protecting individuals against emotional abuse. The legal consent age within the UK is 16 years. This therefore, protects the younger children against any form of sexual based emotional abuse, but this cannot be used for individuals who are beyond the age of 16.
When looking at the ethical aspects of the issue, there are several concerns that make it harder to protect individuals from emotional abuse. One such ethical concern is the idea of individual liberty and protection. In the desire to protect individuals from abuse, it is likely that the advocacy agents are likely to cross their boundaries of personal decision making and autonomy. This is especially difficult for individuals who have been affected by the cultural practices that make them subdue themselves in abusive relationships for fear of a cultural backlash. Therefore, it becomes hard to convince such victims to break free from their oppressors, and this could make it very difficult to save them from such instances (Hughes et al., 2019). Therefore, with this in mind, it is evident that a lot of public awareness needs to be conducted to help the victims understand their rights and empower them with the ability to make these tough decisions. A cultural change is also likely to make it easier for such victims to break away from their oppressors without fear of reproach. Conducting a public awareness program is likely to bring about this much-needed cultural change and make the community more alert to emotional abuse.
Within the UK, there are a number of recent policy and intervention changes that have been undertaken to combat the issue of emotional abuse as a component of sexual health. The first among these is the Domestic Abuse Act of 2021, which has been referred to above. Recognizing the coercive control as a criminal offense was a huge step towards curbing the emotional abuse both domestically and on a social scene (Homme et al., 2023). The government also launched the integrated Sexual Health services, which was aimed at integrating the emotional wellbeing into the sexual health services. This platform provides training to healthcare professionals to help them become effective in identifying and addressing abuse. In addition, it also focuses on creating a safe space through which the victims can discolored their issues, and to receive a holistic support system that will help them to navigate through their problem (Hughes et al., 2019). Significance funding of community-based initiatives has also been recognized, which are crucial in developing culturally sensitive areas for emotional abuse. This is vital because cultural change is crucial to combating these issues.
While the majority of these interventions have been largely successful, it is evident that there is still room for improvement in terms of their implementation. For example, the domestic abuse act of 2021 still needs improvement with regards to the reporting mechanisms. Without willingness of the victim to report their perpetrators, such an act will remain ineffective (Homme et al., 2023). Therefore, it has to work hand in hand with the cultural change initiatives, which will lead to the development of a safe space where victims can freely seek help in times of need.
In conclusion, this essay has been instrumental in uncovering the components of emotional abuse that relate it to the public health initiatives. It has been established that emotional abuse is a key component of public health, and initiatives that are undertaken to prevent emotional abuse contribute to the overall wellbeing of the whole community. There is a certain inclination from both the cultural, ethical, and policy structures that both affect the state of emotional wellbeing of patients in the community. However, the cultural factors have a great role to play among all these. Cultural forces determine the effectiveness of the policies implemented and many other interventions. Therefore, driving a cultural change that will break the strings of patriarchy and female subjugation are some of the key ways through which emotional abuse can be overcome.
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