Sofia Athanassiou's death was no surprise to those who knew her.

Found dead on Wellington's Mt Victoria two months ago, a family member called her one of the “grey people” who drifted in and out of state care most her adult life.

A regular on the soup-kitchen circuit, the 39-year-old had a learning disability, mental health issues and frequently abused alcohol, and was well known to the city's social services, which had tried to help her.

But Sofia was also harbouring a secret. She was being abused.

She never sought help despite attempts at intervention by doctors, police, family and abuse services, who saw the bruises but could not get Sofia to name her abuser.

“She was too naive and scared to say anything,” a social services worker, who asked not to be named, said.

Various agencies spoken to say they helped her all they could. Her family said they tried repeatedly to keep her safe, but didn't know what else might have been done for someone with so many issues.

“We always knew it would end like this,” a relative said. “We don't know what kind of help would have helped Sofia.”

However, domestic violence researcher Debbie Hager says Sofia's circumstances are all too common, and is calling for a better service for women with what health professionals call “dual diagnosis”.

The Auckland University lecturer is the author of a study called “He Drove Me Mad”, which found women can be driven insane by abuse.

“There are many impacts on mental health, whether it's blows to the head, or being frightened and anxious all the time,” she says.

That can affect women's willingness to get help, or push them further into the abuse cycle.

“If you're focused on survival, how are you meant to process information in the same way as if you're safe?”

Having mental health problems or addictions can also hinder access to services such as Women's Refuge, Hager says.

In a 2006 study of 39 refuges, she found 178 women were known to have been denied access because of those issues.

She believes there's enough of a case for women with dual diagnosis to support the creation of a specialised, multi-agency housing service - like those in Australia - where women have long-term access to support programmes.

Her plea has the backing of Mental Health Foundation chief executive Judi Clements, who said a service was vital in helping society's vulnerable.

“Although there's much being done, there are still women who fall through the cracks.”

So far the call has gone unanswered. Women's Refuge, which Hager says does a good job, cannot cope with demand. It works with addiction and mental health services only on a referral basis.

Wellington Women's Refuge head Philippa McAfee said women with both mental health and addiction problems were accepted at their safe house, but if they used drugs or alcohol were not allowed to return until they were sober.

But she said there were “gaps” in the system.

“It's hard for women who are experiencing mental illness to hook up with mental health services. There are lots more people looking for support than getting it.”

Sofia was a regular at Wellington drop-in centre the Clubhouse, where director Karen Sole says most clients aren't in mental healthcare because of a lack of funds.

“If you don't suffer from a debilitating illness, you're not going to get lots of support.”

Sofia's death is unexplained pending toxicology reports.

“A lot of people tried to help her. It's difficult to help people who don't want help.”

Wellington City Mission chief executive Michelle Branney said more professional intervention was required.

“But gone are the days when we would tell people what's good for them. Now we're more inclined to let them set their own terms.”

But Branney said she agreed it was time to have a discussion about what more can be done, “because there are many other Sofias out there”.

- © Fairfax NZ News