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Evid Based Nurs 17:63-64 doi:10.1136/eb-2014-101868
  • Editorial

Disclosure of domestic violence and abuse: how prepared are you?

  1. Alison Twycross
  1. Faculty of Health and Social Care, London South Bank University, London, UK
  1. Correspondence to: Dr Alison Twycross, Faculty of Health and Social Care, London South Bank University; London SE1 0AA, UK; a.twycross{at}lsbu.ac.uk

As I write this editorial I have just completed this month's ‘shortlisting’ of articles for the journal. One of the papers chosen discusses the issue of abuse during pregnancy.1 In February the National Institute for Health and Care Excellence (NICE) published guidelines entitled: Domestic violence and abuse: how health services, social care and the organisations they work with can respond effectively.2 There was also a report in March 2014 that suggests the police response to domestic abuse is not always as good as it could be. This made me think about the issue of domestic abuse more widely. In the UK the cross-government definition of domestic violence and abuse is Any incident or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between those aged 16 or over who are, or have been, intimate partners or family members regardless of gender or sexuality. The abuse can encompass, but is not limited to: psychological, physical, sexual, financial and emotional. (From: https://www.gov.uk/domestic-violence-and-abuse)

Some facts

  • One in four women will experience domestic violence and abuse in their lifetime.

  • Thirty per cent of this abuse starts in pregnancy, and existing abuse may get worse during pregnancy or after giving birth.

  • Two women a week are killed by a current or former male partner.

  • One in six men will experience domestic violence and abuse in their life.

  • One man dies every 3 weeks as a result of domestic violence and abuse.

  • Domestic violence occurs in heterosexual and homosexual relationships.

What should you do as a healthcare professional?

A significant percentage of us will experience domestic abuse in their lifetimes. This means that inevitably you will have colleagues and patients who have been or are in this situation. (You may even have been abused or are being abused yourself.) Given this how prepared do you feel to cope with disclosures about domestic abuse? Would you recognise the signs? Where would you advise people to go for help? A list of questions you can ask to help discover if someone is experiencing domestic abuse are provided in box 1. If someone has answered yes to one or more of these questions they may be experiencing domestic abuse.

Box 1 Questions you can ask to help discover if someone is experiencing domestic abuse

  • 1. Are you afraid of your partner?

  • 2. Do you feel isolated, bullied or belittled?

  • 3. Does your partner cut you off from friends or family?

  • 4. Does your partner verbally abuse you?

  • 5. Does your partner physically hurt you?

  • 6. Do you feel as if you are walking on eggshells?

  • 7. Do you change your behaviour to avoid triggering an incident?

  • 8. Does your partner threaten you or your children?

  • 9. Does your partner control the money?

  • 10. Does your partner force you to have sex or make unreasonable demands?

  • 11. Does your partner accuse you of being unfaithful?

  • 12. Does your partner say you are useless and could not cope without them?

  • 13. Does your partner have sudden changes of mood that dominate the house?

  • 14. Is your partner charming 1 min and abusive the next?

  • 15. Are you afraid of making your own decisions? (From http://www.reducingtherisk.org.uk/cms/content/home)

Two of the recommendations in the NICE guidelines are particularly pertinent to frontline staff and relate to creating an environment for disclosing domestic violence and abuse as well as ensuring that staff ask people about domestic violence and abuse. Important elements of the recommendations are to ensure:

  • Information is displayed in waiting areas about the support on offer for those affected by domestic violence and abuse.

  • Information on where to get support is available in a range of formats and locally used languages.

  • People accessing this support are given maximum privacy.

  • Staff are trained to recognise the indicators of domestic violence and abuse and have access to information about local services, policies and procedures.

Does your area of work comply with these recommendations? Have you had training in this area? Are you aware of the local services/support available?

Where to get help for domestic abuse

If someone discloses domestic violence or abuse to you, you should

  • Provide them with information about local support services.

  • Give them privacy if they want to contact these services.

  • Advise them they do not have to wait for an emergency situation to seek help but that if an emergency situation does arise to call 999.

  • Tell them they can always speak to their doctor or another healthcare professional.

  • Let them have details of national helplines—for example, the 24 h National Domestic Violence Helpline (0808 2000 247).

Footnotes

  • Competing interests None.

References

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