Physical violence, real or threatened, psychological violence and the denial of physical and economic resources have an enormous impact on women's mental health. These problems take many forms, and all impact women's ability to achieve a basic quality of life for themselves and their families. Abuse is strongly associated with alcoholism and drug use in women (Facts About Domestic Violence). It can also lead to “tiredness and passivity accompanied by an extreme sense of uselessness” (Violence against women in the family, 78). These symptoms together remove all initiative and decision-making ability from the victim. This lethargy, combined with economic barriers, makes it very difficult to get out of the situation. Lack of initiative also hinders women's ability to participate in activities outside the home. High levels of stress and depression are also extremely common mental health problems for victims of family violence, often leading to suicide (Facts About Domestic Violence). In the United States, a quarter of suicide attempts by white women and half of attempts by African American women are preceded by abuse (In the Health of Women: A Global Perspective, 128). World Bank analysis found that domestic violence is a leading cause of disability and death among women; the burden of family violence is comparable to that of HIV, tuberculosis, cardiovascular disease or cancer (Domestic Violence Against Women: A Global Issue,