Gender-based violence - 6 tips for health and social care practitioners

This edition of Forward Focus highlights six evidence-based messages for frontline health and social care practitioners to ensure they can recognise the signs of Intimate Partner Violence, and provide support.

Intimate Partner Violence and the role of healthcare professionals

Intimate Partner Violence (IPV) encompasses any behaviour within an intimate relationship - whether current or previous - that causes physical, sexual, psychological, or financial harm.

Research has consistently found that victims of domestic violence and coercive control are more likely to disclose their experience to a healthcare practitioner than to any other service provider. Health and social care services therefore present a key opportunity to detect and respond to domestic violence.

CES Rapid Review of the evidence

CES carried out a rapid review of the evidence on intimate partner violence (IPV), which includes guidance materials from statutory and voluntary agencies, as part of our?Access Evidence?series of evidence briefs for frontline practitioners in health and social services.

The review identified 6 key messages to improve understanding of some of the risk factors in order to recognise the warning signs, and to determine what health and social care professionals can do to support someone experiencing IPV.

1. The victim may find it hard to seek help

Only 4-27% of victims of IPV seek help and many people do not disclose their experience to anyone. Reasons for this include fears of social stigma, retaliatory violence, and a fear of setting a process in motion that they have no control over. Public perceptions of IPV victims as young, heterosexual females can prevent others who do not fit this profile (male victims, older victims, victims from same sex couples, for example.) from coming forward,

2. Clinician Inquiry can inspire disclosure

Targeted questions from clinicians can encourage disclosure. Evidence shows that most women do not object to being asked about domestic violence. The?HSE Practice Guide on Domestic, Sexual and Gender Based Violence?provides guidance on asking about IPV.

3. The victim may not be thinking of leaving their abuser

Victims may have many practical reasons for staying in an abusive relationship, such as fear for their safety and that of their children, or pressure from extended family or community to remain with their partner. They may be hopeful that the situation will improve, and may not want to break up their family. People from minority communities are particularly vulnerable to social isolation.

4. Help seeking is a journey

Help seeking involves a series of judgments and actions, rather than a single event. Victims may leave and return to an abusive relationship multiple times, as abuse itself is a cyclical process where violent episodes are followed by periods of perpetrator remorse. During peaceful periods victims may often retract their statement. Many victims do eventually leave their abuser.

5. The Victim is Best Placed to Know When to Act

The research highlights the victim’s sense of risk as an important factor in determining the likelihood of re-assault. A risk assessment can help practitioners to identify signs of escalating violence and take appropriate action. It should include consideration of risk to children or dependents in the household, and the severity of previous violence. The?HSE National Domestic, Sexual and Gender-Based Violence Training Resource Manual?provides guidance to front line practitioners on conducting a risk assessment.

6. The most dangerous time is when the victim is about to leave and the 12 months following separation

There can be an intensification of abuse during the period of separation, particularly if the perpetrator feels they are losing control of the victim. In the UK, between 2009 and 2015, 76% of women who were killed by their ex-partner or ex-spouse were killed within the first year of their separation; a third were killed within a month

Useful resources

Responding to Intimate Partner Violence: Tip Sheet for Health and Social Care Professionals pdf (238.584 KB)

Domestic Violence Advocacy Service (DVAS)?and Safe Ireland have created a short film called?Help her To Tell?which illustrates how a health professional can support a person experiencing IPV to contact a dedicated domestic violence service.

Safe Ireland?provides information for professionals on recognising and responding to IPV.

Cosc | Increase Surveillance, Decrease Violence! provides information on local and national domestic violence services.

The full CES Access Evidence report on IPV is available here:

IPV_AccessEvidence.pdf (notion.so)