COVID-19 National Health Guidance
As calls to the domestic abuse helpline continue to rise during the Covid-19 isolation measures, we anticipate that survivors accessing support from healthcare professionals and attending A&E will also increase. Many health professionals will be in contact with patients they know are being subjected to abuse and will be concerned about the potential escalation in risk that isolating with a perpetrator can cause. This guidance has been produced to support health professionals to respond appropriately to these patients under these unique circumstances.
Why it matters
A study of the use of health services by survivors of domestic abuse found that:
- 18% of survivors see a doctor in the first year of abuse.
- 56% of survivors see a doctor after the second year of abuse.
- 31% of survivors have no contact with a doctor until the third year of abuse.
Health practitioners are uniquely placed to enquire about domestic abuse. They may be the first, and only, person a survivor discloses domestic abuse to.
This is particularly true in Maternity and Mental Health services:
- 30% of domestic abuse either begins or will intensify during pregnancy.
- Foetal morbidity from violence is more prevalent than gestational diabetes or pre-eclampsia.
- 50% of women who have experienced domestic abuse have a clinical mental health diagnosis, compared to only 20% of women who have not experienced domestic abuse.
However, a 2013 Home Office analysis of 54 Domestic Homicide Reviews identified multiple instances where health professionals failed to identify, follow up, or felt they didn't have the necessary skills to respond to disclosures of domestic abuse.
What we do
We bring together those providing health services in our local area into an operational group.
Through the group we start conversations about domestic abuse within and between different agencies and different sectors. We support them to share information and learning, to collaborate, and to keep communicating.
We inform, guide, and monitor the activity of the group to ensure that their work is safe, effective, and responds to the shifting needs of domestic abuse survivors and their children.
Through this work, and other components of our Coordinated Community Response, we are able to break down barriers between agencies and help to spread good practice.
The Department of Health and the Royal College of General Practitioners (RCGP) have both identified that GPs play a vital role in relation to domestic violence. Survivors of domestic violence are often isolated from friends, family and services; the GP surgery may be the one place they are able to go by themselves.
STADV offer training and support to General Practitioners in order to improve confidence in responding safely and appropriately to survivors.
Maternity and Accute Health
Our Acute Trust Coordinator is collocated at sites in Chelsea and Westminster Hospital NHS Foundation Trust. This work is essential in raising the awareness of domestic abuse within the Trust and equipping staff to respond to domestic abuse. The overall aim of this work is to ensure more survivors are identified and offered the support with their safety and wellbeing that they deserve.
Over the last five years, we have exponentially grown our Big Lottery funded maternity project. With coordination, training, and domestic abuse specialists embedded within maternity services we have seem a 30% increase in identification of abuse and a 783% increase in referrals.
“I was glad [the midwife] asked me, you suffer in silence unless you know of services. I wouldn’t have mentioned it so was glad she asked.”
Survivor of domestic abuse
We have been working with mental health service providers in west London since 2015. The work has focussed on making strategic and structural changes to healthcare trusts which has resulted in:
- The ratification of new comprehensive domestic abuse policies
- Increased awareness of the dynamics of domestic abuse amongst mental health practitioners
- Better relationships between mental health and domestic abuse services
- Increased referrals from mental health to domestic abuse services
- Better mental health representation at local domestic abuse multi-agency meetings
What we can do for you
Domestic Abuse Link network
In order to work effectively with victims/survivors of domestic abuse and to ensure their safety, professionals need to have a common understanding of the issues and have the ability to coordinate their efforts and work more efficiently.
STADV has identified that developing a network of Domestic Abuse Leads in each Trust supports this process, improving the identification and response to domestic abuse and providing a system of peer support when dealing with cases.
Practical interventions we can provide:
- Engaging and integrating services.
- Writing terms of reference.
- Developing and implementing policies, procedures, and protocols.
- Training and workforce development.
- Measuring impact.
Please contact us to find out how we can help you reduce and prevent domestic abuse through your local health services.