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‘Domestic Abuse: A Health, Well-Being & Safeguarding Issue’
Surrey Against Domestic Abuse Partnership
Domestic Abuse
An issue for all of us
What is Domestic Abuse?
Domestic Violence Definition
“Any incident or pattern of incidents of controlling, coercive or 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. This can encompass, but is not limited to, the following types of abuse:
• psychological• physical• sexual• financial• Emotional(Home Office, March 2013)
Domestic Abuse – the Impact on Health & Well-being
Domestic Abuse & Sexual Health• Abused women are three times more likely to
experience gynaecological problems than non-abused women, with a dose-response relationship and the risk increases when experiencing both physical and sexual abuse. These include;recurrent urinary tract infectionsabnormal vaginal bleedingDyspaeruniachronic pelvic pain.
(Professor Gene Feder - Professor of Primary Care Research & Development)
Domestic Abuse & Pregnancy• More than 30% of domestic abuse cases first start
during pregnancy.
• 40-60% of women experiencing domestic abuse are abused during pregnancy.
• More than 14% of maternal deaths occur in women who have told their health professional they are in an abusive relationship.
(CEMACH Report ‘Saving Mothers’ Lives - Reviewing maternal deaths to make motherhood safer 2003-2005’, December 2007)
• Women suffering domestic abuse during pregnancy are more likely to experience, miscarriage, maternal death, premature birth, babies with low birth-weight/stillbirth/injury/death
(‘Responding to Domestic Abuse’, DH, 2005).
Domestic Abuse & Mental Distress• Between 50% and 60% of women mental health service
users have experienced DA and up to 20% will be experiencing current abuse
• DA is the most prevalent cause of depression and other mental health difficulties
• Between 35% and 73% of abused women experience depression or anxiety disorders. This is at least three times greater than the general population
• DA commonly results in self-harm and attempted suicide and a third of all female suicide attempts can be attributed to current or past experience of DA.
• The figures for minority ethnic women are even higher. For
example, 50% of women of Asian origin who have attempted suicide or self-harm are DA survivors.
• 70% of female psychiatric in-patients and 80% of those in secure settings have histories of physical and or sexual abuse
(Adapted from Women’s Aid Guidance for mental health professionals, J Barron 2005)
DA & Substance MisuseAlcohol misuse is linked to domestic abuse in a number of
ways; – Survivors may use alcohol as a mechanism for coping
with abuse
– Perpetrators may use alcohol as an excuse for being abusive or violent and physical incidents of abuse maybe more likely to occur once alcohol has been consumed.
– Alcohol misuse among domestic violence perpetrators may be up to seven times higher than in the general population
(National Alcohol Harm Reduction Strategy, 2004).
– Those experiencing domestic abuse are as much as fifteen times more likely to misuse alcohol and nine times more likely to misuse drugs than women generally
(Maryland Department of Health, 2001).
Domestic Abuse & Physical Health • Women injured by domestic violence as
opposed to other means are 13 times more likely to be injured in the breast, chest and abdomen.
• Domestic abuse/violence is one of the most common causes of injury in women.
• The long term physical affects of domestic abuse on health include chronic pain (headaches, back pain), increased minor infections, neurological symptoms (fainting & dizziness), chronic IBS, raised blood pressure and coronary artery disease.(Professor Gene Feder)
The true cost of domestic abuse…
• More than 1 in 4 women and around 1 in 6 men have experienced domestic abuse since the age of 16. (Home Office, ‘Homicide, Firearm Offences & Intimate Violence 2008/09’, January 2010)
• Women are more likely than men to experience longer periods of partner abuse, repeat victimisation and injury or emotional effects as a result of the abuse.
(Home Office, ‘Homicide, Firearm Offences & Intimate Violence 2008/09’, January 2010)
• On average 2 women per week are killed in England & Wales by their partners or ex-partners (Crime in England and Wales 2006/07 Report)
Domestic Abuse in Surrey
• In the 51 weeks to 25th March 2013 Surrey Police received 12,567 reports of a domestic incidents or crimes. That is 246 reports every week. (Surrey Police, 2013)
• In 2012-2013 the specialist domestic abuse outreach services in Surrey dealt 3,127 new service users.
Surrey Statistics
Since 2000 there have been 58 known attempted or actual DA related killings in Surrey
• Number of murders: 26• Number of attempted murders: 29• Number of manslaughters: 3
(Surrey Police, April’13)
Links between DA & Safeguarding
In 2005, Section 120 of the Adoption and Children Act 2002 came into force, which extends the legal definition of harming
children to include harm suffered by seeing or hearing ill treatment of others, especially in the
home. This includes domestic abuse.
Impact of Domestic Abuse & Children
Womb – 1 Year Old - Premature Birth, Still Birth, Unborn baby maybe the target of an attack, Miscarriage, Low Birth Weight, Poor antenatal & postnatal care, Affected by a mother’s diet, alcohol, and drug consumption
2 – 13 years - Poor health, Difficulties sleeping & settling, Excessive screaming or crying, Frozen Awareness, Slow emotional development, They may present with challenging behaviours, They may be withdrawn, Nightmares & disrupted sleep patterns, Bedwetting & eating disorders, Physical problems such as headaches, stomach cramps, asthma or skin complaints, Suicidal feelings and self harm
Teenagers - Alcohol & drug misuse, Early sexual activity and/or pregnancy, Self Harm, Suicidal Thoughts/Attempts, Homelessness, Criminal Activity, Abusive behaviours within their own Intimate relationships, Medical issues - stress-related issues such as IBS, skin complaints, gynaecological issues etc.
Working Together
• Early help is more effective in promoting the welfare of children than reacting later. Early help means providing support as soon as a problem emerges, at any point in a child’s life.
• Professionals should, in particular, be alert to the potential need for early help for a child who:
– is disabled and has specific additional needs;
– has special educational needs;
– is a young carer;
– is showing signs of engaging in anti-social or criminal behaviour;
– is in a family circumstance presenting challenges for the child, such as substance abuse, adult mental health, domestic violence; and/or
– is showing early signs of abuse and/or neglect.
(Working Together 2013)
Munro Reports
“Domestic violence is a significant issue linked to child protection, and its prevalence may be varied in different localities. Services need to be developed to reflect this:
•There are 120,000 victims in any year who are at high risk of being killed or seriously injured as a result of domestic abuse (1)
•69% of high risk victims have children (2)”
http://www.thewhocarestrust.org.uk/data/files/Munrointerimreport.pdf
Serious Case Reviews (SCR)
• A study of 130 SCR’s published between 1 January 2008 and 12 September 2011 involving a child aged under one year found that.– domestic abuse was a factor in at least 60 of these cases– substance misuse was a factor in at least 46 of these cases– parental mental health was a factor in at least 34 of these cases.– one or more of the above was a factor in 94 cases(‘An analysis of serious case reviews concerning children under one’, NSPCC,
December 2011)
• Domestic abuse has been a factor in all three Serious Case Reviews in Surrey since September 2011
(Surrey Safeguarding Children Board, 2013)
Why we need to work together?
• Domestic abuse & violence has a long lasting and often devastating impact on the health & wellbeing of survivors, their children & families.
• Health care services, particularly primary care, can be a survivor’s first or only point of contact with professionals.
• Abused women identify doctors as the professional from whom they would most like to seek support
• Domestic abuse is a significant and sometimes fatal safeguarding issue
Why now?• Royal College of GPs has made tackling
domestic abuse a ‘clinical priority’
• Department of Health recommends that all health professionals play a role in tackling domestic abuse & violence
• IRIS Project findings
• NICE review & consultation
• Health & Well-Being Board Priorities
• WHO Guidelines on Responding to intimate partner violence and sexual violence against women
Surrey Against Domestic Abuse
Domestic abuse is a key priority for agencies, partnership Boards and Groups:
• Structure:• Community and Public Safety Board• Domestic Abuse Development Group• Local DA Fora• Specialist Task and Finish Groups• 2013-2018 Domestic Abuse Strategy for Surrey• Transforming Public Services agenda• Health & Well Being Board
Cont ....
www.surreyagainstda.info
Surrey Against Domestic Abuse
Surrey DA Services• Outreach Services• Children’s Services• Refuges• 24 hr Helpline• Counselling• Group work• Volunteering Services• Legal Advice Drop-in• Specialist Domestic Violence Courts• Sanctuary Scheme• Awareness Raising
How we work with service users
Follow up, Other agency
referral if appropriate
Offer Advice/Information/
Advocacy/Support What does the
client want to achieve?
Consider Safeguarding
Adults & Children
Risk Assessment & Safety Planning
Self or Agency Referral
Client
