How can healthcare systems better support victims of domestic violence?

Use trauma informed tactics to speak with the survivor. They’ve been through hell and may just need someone to listen. Also realize that survivors may or may not want to involve law enforcement. If they are not ready to engage, offer them other means of support - therapy, refer to transitional housing, and anything else they may need. Lastly, write as open ended a doctor’s note for the survivor’s job as possible - they may need more time to recover emotionally, which can be hard to explain to your employer (or may not want to). How the medical and legal systems engage with survivors directly affects whether they come back for help again.

There are many answers to the question of how healthcare systems can better support victims of domestic violence, in terms of the services they offer. But the most important change that is needed is a strategic one: that health professionals consistently approach domestic abuse as a health issue (physical and mental) for both adults (especially, but by no means exclusively, women) and children. That acceptance is key to unlocking resources and linking with other services. Some countries and organisations are further ahead than others in making the transition. It's similar to how, in the past, Police organisations had to start treating domestic abuse more systematically as criminal behaviour rather than "just a domestic".

To train members of the healthcare team to recognize the signs of domestic violence in their coworkers and patients. This is not something routinely taught in school, and it requires a high level of sensitivity for the situation.

-Have a team of social workers & support system info readily available. -Understand that persons (i.e. it's not always women) in dv situations may not be emotionally able to leave yet. Don't judge them.

In my experience, domestic violence is present within all socioeconomic classes. Too often the healthcare system will portray a domestic violence victim as a person of color from a lower socioeconomic status. This literally colors our perception and how we interact with our patients. There need to be discreet safe havens where any affected person can be learn and strategize how best to protect him/herself.

As we know there are more than thousand cases which do not get reported because of many factors such as Fear of Society, friends lack of trust, Not enough awareness, domestically forced, no proper police cooperation and many more. Healthcare system should find all the factors and spread such awareness and facilities that such cases do not get buried easily. No person should be left treated because of gender, ethnicity, community or such barriers. We should form communities to help those in need and set an example for everyone.

One barrier to access is advocacy. We as healthcare providers need to also be our patient’s advocates. If we see something we need to say something.

Healthcare providers often grapple with the complexities of abuse, lacking knowledge on escalation, confidentiality, police involvement, recognizing repetitive injuries, providing psycho-social support, and facilitating legal aid, despite being the primary point of contact for many survivors. On the other hand, victims often feel marginalized, frightened, and cornered, primarily due to factors like identity, social norms, or other personal reasons. Overcoming these barriers to disclosure necessitates utmost sensitivity and empathy. It also calls for practical training for healthcare workers and doctors, enabling them to effectively address and support survivors of abuse

La compréhension tant par le personnel de santé que par l'opinion publique reste non uniforme sur le sujet. Quand bien même elles seraient identifiées ces violences, beaucoup de victimes ''réelles'' sont confrontées au désastre de la brisure du foyer pour lequel elles se sont battues et un faible nombre ose finalement les déclarer.

The issue of domestic violence is intricate, lacking a straightforward solution. My experience with DV victims highlighted challenges and complexities involved in reporting, due to the repercussions it entails. Despite its public nature, reporting is essential, and everyone bears a responsibility to ensure victims receive support. Healthcare facilities, with their confidential and supportive environments, play a crucial role in detecting DV. Patients trust healthcare professionals who can identify signs of abuse during routine exams or discussions about injuries, mental health, or overall well-being. These settings have established protocols to handle such situations, safeguarding privacy and connecting victims with appropriate resources.

Universal screening of all patients with careful attention to using gender neutral language to avoid intrusion of heteronormative assumptions and biases. Practitioner’s should practice transparency around reporting requirements and offer compassionate, informed and non judgmental support. Recognizing survivor’s autonomy and expertise in empowering them to make informed decisions about their own needs helps create appropriate safety plans.

Healthcare workers are educated to spot indications and symptoms of domestic violence. They can uncover possible cases of domestic abuse through normal screenings or when patients appear with certain symptoms or injuries. Healthcare providers can assist victims in disclosing abuse and facilitating appropriate interventions by asking sensitive questions in a secure and supportive atmosphere. Domestic abuse victims can get help from healthcare providers in developing safety plans to safeguard themselves and their children. This may include addressing risk-mitigation measures, offering information about accessible resources such as shelters or hotlines, and informing victims of their legal rights and options.

As usual there is a lot of answer of this question.... Transperancy Humbleness, are two major factors for best screening and interventions.

To establish responsive healthcare systems, continuous sensitisation & training are crucial to raise awareness about various forms of abuse, equip healthcare workers & doctors with tools to identify signs of abuse, and endow them with the skills to provide support and referral services. This approach positions the healthcare system as a key player in breaking the cycle of abuse and promoting the well-being of survivors. Repetitive injuries indicate domestic violence, emphasising the importance of healthcare workers understanding the intricacies of abuse. Healthcare professionals can approach such cases with heightened empathy and facilitate their connection with essential support systems

Il est important pour les soignants, de dialoguer avec les patients et l'environnement familial des victimes afin de créer des alertes, de contribuer à un meilleur dialogue entre les membres de la famille, mais aussi de permettre une décision de groupe une fois que plusieurs critères de violence domestique ont été répertoriés afin de soulager psychologiquement la victime. D'où l'importance de l'empathie dans les soins.

Patient Advocacy in supporting victims/survivors of Domestic Violence is paramount - it is literally a lifesaving measure that falls in alignment the same way CPR and ACLS protocols are in place in an ER setting. Vulnerable populations such as migrants & the LGBTQ population sometimes do not have familial &/or loved ones support for several reasons. Sometimes there are roadblocks to a victim coming out as a survivor such as language barriers &/or financial strain that entangle a victim before they can leave the situation safely. As Healthcare providers, ensuring that our health systems are set up to provide resources such as shelter placement, mental health services, and support from Social Services is imperative and a lifesaving measure.

Once I was attending an ED shift and received a young girl who had delivered 7 days ago, she was dehydrated, was reluctant to talk to us. I requested permission to her family to be assessed by a female doctor who got the cause of her situation: She was doing the housework for whole family, and at the same time taking care of her baby. Therefore she was not feeding herself properly. We followed the protocol, gave the medical care and call up the social workers and authorities that have to be involved. We discussed the situation with the whole family. After discharging from ED she had follow up with psychologist, social service, and her condition improved. Every institution must have an action protocol for cases of domestic violence

Patient advocacy is vital because it guarantees that the rights, needs, and preferences of patients are reflected and emphasized in healthcare decision-making. Advocates play an important role in empowering patients to make educated decisions about their care, offering support, and assisting them in navigating the healthcare system. Patient advocacy also fosters accountability, openness, and higher quality of treatment by drawing attention to problem areas and advocating for positive change. In conclusion, patient advocacy is an important support system for individuals who want to have a say in their own health and well-being.

As a Healthcare advocate, you should be familiar with all the running policies, and laws of government. It requires proper training and assistance as an Advocate is the person responsible for representing all the wrongs and rights of the healthcare industry. It should be someone who addresses domestic violence, ethnic disparities, emotional connect, and gender equivalent in a way that it could be considered a viable problem, not someone who forces their thoughts and policies as it could be dangerous to any community of people.

I agree. Many persons don’t trust our current healthcare system and have difficulty maneuvering through the system. We acknowledge that racism is inherent within our healthcare system. We must examine our biases. Patient advocates need to know what biases and pre-conceived opinions they bring to these encounters.

Promoting "Cross- Cultural Psychoeducation" is essential for supporting and treating victims of domestic violence. This education empowers victims to discern between normalcy and violence within diverse cultural contexts fostering trust between care providers and victims. This trust forms the foundation for mutual understanding, nurturing and unveiling the long- standing trauma experienced unknowingly by victims. Ultimately, Cross- Cultural Psychoeducation strengthens the therapeutic relationship, enhancing treatment outcomes and contributing to the healing and recovery process.

It is important for healthcare practitioners to understand differing religious worldviews and the impact of faith and religious ideology on victims of domestic abuse. There is an intersection of domestic and spiritual abuse, mainly against women when they are advised by religious leaders to continue in abusive marriages due to archaic religious beliefs. When victims are subjected to such multiple dimensions of abuse, it makes it all the more difficult for them to open up about the violence as they fear ostracizing by their faith community and also experience guilt that they are sinning against God for wishing to leave their toxic husbands. Healthcare professionals should be trained to watch out for spiritual oppression in domestic abuse.

In my experience the hardest part is to deal with the police department and the general attorneys office. I have experienced sexual assault myself and it was hard to navigate the legal side of the assault. My detective was engaged and wanting to help me to charge the person, but I was told directly from the General Attorneys office that it was my fault for agreeing to see the person. I ended up in the ER with a neck and head concussion and vaginal ruptures. Having to go through the health examination to get evidence was painful and hearing it was my own fault for agreeing to meet with the person made me think this is why victims don’t want to report. There’s no support.

Le violant et le violenté tous mérite une thérapie ! Il y a des violences culturelle, le violant a subi un traumatisme qui le pousse à reproduire a son tour la violence! Nous pensons que c'est dans les écoles (obligatoire)qu'il faut apprendre aux enfants la mesure et le Dialogue. L'évitement et la compréhension. La violence est une carrence en culture et savoir vivre. Ia violence est tabou et le violenté pense parfois mériter le e chatiment, il faut les amener à avoir plus d'estime de soi. Il faut éduquer les Hommes à accorder de la valeur à la dignité de l'autre à lui reconna?tre le droit au bonheur et aux respect, l'autre est notre reflets du miroir.