This truly is the time to keep an eye out for your neighbours, relatives, friends and colleagues

We have all seen in the news reports; the increase in calls to domestic abuse helplines and harrowingly the  increase in domestic homicides during the lockdown.

This truly is the time to keep an eye out for your neighbours, relatives, friends and colleagues

Firstly: Corona virus doesn’t trigger abuse. An abuser triggers abuse. Blaming coronavirus or blaming financial worries for abuse or murder suggests anyone could become an abuser or do the same given the circumstances and this is simply not true. The responsibility for domestic abuse starts and ends with the abuser. The abuse belongs to them.

There are many known factors that increase the risks of someone being abused:

  • Pregnancy
  • Having a baby under 12 months old
  • Lack of safe and appropriate support sources
  • Age, disability or other factors, making safety strategies difficult to implement.
  • Victim threatens to leave
  • Perpetrator threatens suicide
  • Immigration status
  • Isolation from family and friends

Domestic abuse has an enormous effect on a victim’s mental health. The emotional effects of domestic abuse can cause; depression, anxiety, panic attacks, loss of self-confidence, difficulty in sleeping and concentration difficulties. It can lead to increased use of alcohol, drugs and other substances.

Ordinarily, the window for a victim of abuse to seek help is extremely limited, but during periods of isolation with perpetrators, this window narrows further.

Signs of abuse to look out for include:

  • Someone is being deprived of basic needs such as food or medication.
  • They are not allowed out to go out, not even once a day to the shops.
  • They are not allowed to call any support services, including medical services.

If you are family, friend or a neighbour can you make your self – safely – to be that trusted friend who keeps in touch?

Are you able to encourage someone to talk to you about what they are experiencing? Could you be that friend a survivor can set up a code word/phrase to let you know that it is not safe to talk or to ask you to phone the police? Could you be that trusted person to set up a check in call so a survivor knows that someone will contact them at certain times of the week?

During the lockdown it may not be safe to ask someone about the safety of their relationship, but you can ask gentle general questions about how someone is feeling?

What you have seen may not be something that you would easily identify as abuse but you might have noticed behaviour and attitudes that make you uncomfortable. Ask how things are going at home?

If someone disclosed abuse, it is important consider what action to take. Do not just storm in.

Listen, believe and remind them that the abuse is not their fault ; What ever the circumstances violence, abuse and control can not be justified.

Explain that they are not alone ;help and support is available. This will give the person hope for the future.

Encourage them to either contact the police( reassure them that the police will come ) or a specialist domestic abuse support organisations. What ever safe means of communication you have keep them open.

Do not approach the perpetrator, this could escalate the abuse and put you and the victim/survivor at risk of harm.

Make sure you keep your self-informed.

https://www.refuge.org.uk/

-National Domestic abuse helpline 0808 2000 247 .You can speak to specialist domestic abuse services for advice and support .Helpline staff can discuss a survivor’s rights and options with a third party and are able to signpost useful services that they can pass on, such as community-based outreach services.

https://safelives.org.uk/

Silent 55 call https://www.policeconduct.gov.uk/sites/default/files/Documents/research-learning/Silent_solution_guide.pdf

If someone is in danger call 999  

 

 

Knowing the risk factors and indicators of domestic abuse, saves lives and frees people from abuse and violence; This blog is for professionals, worried friends, relatives and colleagues:

There are many known factors that increase the risks of someone being abused. Pregnancy, having a baby under 12 months old, lack of safe and appropriate support sources,age,disability or other factors,making safety strategies difficult to implement. Mental health issues, substance misuse, victim threatens to leave, perpetrator threatens suicide, immigration status and isolation from family and friends.

There are also whole ranges of indicators to warn that someone may be experiencing domestic abuse; the victim usually has an inconsistent relationship with health and support services,frequent appointments for vague symptoms and or frequently missed appointments, including antenatal clinics , non- compliance of treatment or early discharge from hospital.(Responding to domestic abuse, a resource for health professionals DoH 2017)

Injuries inconsistent with explanation of cause or the victim tries to hide or minimise the extent of injuries, multiple injuries at different stages of healing or repeated injury, all with vague or implausible explanations (particularly injuries to the breasts or abdomen). Unexplained reproductive symptoms, including pelvic pain, adverse reproductive outcomes, including multiple unintended pregnancies or terminations/miscarriages.

Person may tell you that their partner insults them in front of other people, are constantly criticicing them as a parent or/and partner, and that they are constantly worried about making their partner angry.Their partner is preventing them from taking their medication and they make excuses for their partner’s behavior.Their partner is extremely jealous or possessive and they have stopped spending time with friends and family. They are depressed or anxious, or you notice changes in their personality.

Domestic abuse has a considerable impact on the victims health; both physical and emotional well-being. The immediate physical effects of domestic violence include injuries such as bruises, cuts, sprains, fractures, scratches, burns, broken teeth, loss of hair, miscarriage, concussion, stillbirth and miscarriage, and complications in pregnancy.

Domestic abuse can also cause or worsen chronic health problems of various kinds. 80% of group more than 1000 women who identified themselves as survivors of domestic abuse reported low back pain, chronic headaches, arthritis. They also had higher than average incidences of depression, diabetes, asthma and digestive disease. The research shows that 81% of women who experienced domestic violence have some type of chronic health condition (Verizon foundation 2013). Other chronic health problems can include asthma, epilepsy, migraine, hypertension, and skin disorders.

Domestic abuse also has an enormous effect on a victim’s mental health. The emotional effects of domestic abuse can cause; depression, anxiety, panic attacks, loss of self-confidence, difficulty in sleeping and concentration difficulties. It can lead to increased use of alcohol, drugs and other substances.

The majority of female psychiatric patients report to have experienced domestic abuse on their lifetime.70% of women psychiatric in patients and 80% of those in secure settings have histories of physical and sexual abuse domestic abuse commonly resulting in self-harm and attempted suicide.(Phillips, 2000; Department of Health, 2002)

One- third of women attending emergency departments for self-harm were domestic abuse survivors. Abused women are 5 times more likely to attempt suicide and third of all female suicides can be attributed to current or past experience of DA.(Women’s Aid 2013).In fact everyday almost 30 women attempt suicide as a result of domestic abuse and every week 3 women take their own lives to escape the abuse.

Many of the indicators can be quite subtle and it is important that professionals remain alert to the potential signs and respond appropriately. Victims rely on professional, friends, family and colleagues to listen, persist and enquire about signs and cues. We need to follow up conversations in safe, private and confidential settings. We might think that  these are difficult conversation  but they are crucial in freeing victims from abuse and violence and ultimately saving lives.

Please see useful links for: 24h Domestic abuse helpline and Department of Health DA resource for health professionals.

…..Coming soon my next blog: ”Asking someone about the safety of their relationships ”

Related to this blog are three of my previous blogs:

“The importance of inter-professional collaboration and training in domestic abuse “

What is coercive control?”

“Domestic abuse is an epidemic- a child health issue that must be addressed by all “

 

 

 

 

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The importance of inter-professional collaboration and training in domestic abuse

NO single professional can have a full picture of a child’s needs and circumstances and, if children and families are to receive the right help at the right time, everyone who comes into contact with them has a role to play in identifying concerns, sharing information and taking prompt action.

(Working Together to Safeguard Children 2018)

WHO has stated that inter-professional collaboration is an essential component in satisfactory service delivery. In the UK, poor inter-professional collaboration has been identified as a contributing factor in high-profile cases with poor outcomes. Pollard et all   (2005)

 We know that for years, almost every safeguarding; review, report and enquiry have listed the following as the main reasons as why true effective inter professional/partnership working has not taken place, often leading to devastating consequences:

  • Lack of understanding of each other’s professionals’ roles responsibilities and duties.
  • Lack of opportunities to access inter-professional training.
  • Lack of knowledge and understanding of what services are available locally. lack
  • Poor communication which has led to misunderstandings and frustrations, professionals communicate in their “agencies language” have not developed a common language.

Over the years I have chaired many partnership boards, multiagency groups and forums. I have learnt to speak; health, education, police, social care and voluntary community sector. On multiple occasions I had taken on the role of an interpreter when agencies have used jargon and abbreviations which could have potentially lead to lack of clarity of what was being said.

We have current robust evidence, and testimony from victims and survivors of domestic abuse, that barriers listed above – and I am sure that there are many more – are unfortunately still very much an everyday reality aided by cuts in agencies budgets.

In December 2016 The Home Office published the key findings from their analysis of domestic homicide reviews (DHR), what they found was: (acknowledging that recommendations made to each agency would have been affected by the exact circumstances surrounding the DHR).

Community Safety Partnerships (CSP) and health bodies were identified as having the highest proportion of recommendations (both around a quarter of all recommendations) across the four years analysed.

 In 2013, agencies receiving the largest proportion of recommendations were in the health sector, in both 2014 and 2015 this was the CPS and in 2016 the highest proportion of recommendations were for the police.  Across all four years, training was consistently the highest proportion of recommendations.

Working Together- statutory guidance 2018 states that, in order for organisations, agencies and practitioners to collaborate effectively, it is vital that everyone working with children and families, including those who work with parents/carers, understands the role they should play and the role of other practitioners. …

Transforming the response to domestic abuse consultation responses and draft bill published in January 2019 asked: What more the government could do to encourage and support effective multiagency working? The most popular responses were training, sharing effective practice, and incentives through funding.

Although partnership working around domestic abuse has moved forward it has not resulted in significantly improved outcomes for victims and much more needs to be done.  

A study by Department of Schools and Families 2007(cited in Barlow and Scott 2010), to identify how inter professional working develops in safeguarding found that:

  • Strong personal, local relationships are a key feature.
  • Good practice was characterised by staff’s commitment, from strategic management level to front line practitioners to adopt a genuine inter professional approach.
  • An induction process that imbeds inter- professional working to staff from all relevant agencies and the adoption of common assessment models, language and models of working all improved inter-professional working practices.
  • Enhanced by opportunities for the staff to attended and access   formal and informal multi agency networks including training opportunities.
  • High level of professional support for staff
  • Regular updates on services available in local area.
  • Effective information sharing with all relevant agencies, obtaining consent from the family at the outset.
  • The importance of shared values and in particular of taking a Child and Family (client / person centred) approach.

We know that if we work effectively with all relevant partner organisations, we improve the way we support victims and make perpetrators accountable. One of the main barriers to effective multiagency working is the lack of or different levels of understanding of the many complex issues around domestic abuse and its impact. Professionals often focus on other areas such as; addiction, mental health, disability or parenting, rather than trying to get to the underlying issue. Peckover, Golding and Cooling (2013 ) rightly state that professionals don’t always agree that domestic abuse should remain the primary focus for professional intervention.

Victims of domestic abuse come in contact with many services. To ensure that our interventions are more effective; professionals need to view the whole picture. To achieve this requires collaboration; In order to collaborate we need to be competent, compassionate and committed.

 

 

What is coercive control ?

 “Controlling behaviour is a range of acts designed to make a person subordinate and/or dependent by isolating them from sources of support, exploiting their resources and capacities for personal gain, depriving them of the means needed for independence, resistance and escape, and regulating their everyday behaviour. Coercive behaviour is an act or a pattern of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, punish, or frighten a person.” (Transforming the Response to Domestic Abuse Consultation Response and Draft Bill, January 2019)

In the media we too often hear the words: “Domestic abuse incident” or “the incident occurred after the relationship had broken down, when someone has been murdered or seriously injured. Domestic Abuse is not a single incident but a pattern of behaviour that extends beyond physical force, beyond the home and often beyond the duration of the relationship.

The types of coercive control being used will differ from victim to victim. Perpetrators will often use a combination of tactics and/or take advantage of any perceived weaknesses or insecurities in order to maximise the victim’s distress.To assert power and control over their victim and the whole family, including children they will:

 Intimidate and isolate the victim from family, friends and any source of support. Control or observe/track the victim’s daily activities; making them account for their time, restricting access to money and restricting their movements. Intercepting and checking phones calls, messages, emails and social media. Prevent the victim from taking medication and/ or accessing health care. They will humiliate and embarrass the victim and deny their access to personal hygiene (sanitary products), eating, sleeping and going to the toilet.

I heard an interview with a lawyer on the radio last month who works with women who have been victims and survivors of coercive control. She talked about a client of hers who was made to eat all her meals from a dog bowl. Another client was only allowed to use the toilet when the perpetrator gave their permission.

The perpetrator will constantly criticise the victim, as a parent and partner. Threatening to take the children, kill the victim, children, themselves, the whole family.

They behave inconsistently and have little or no concern for the welfare of the family, although on the surface often appear to portray the very opposite. They use the non-abusing parent’s inability (owing to abuse they are suffering) to parent against them so that they may be afraid to ask for help as they may fear their children will be taken away from them.

In his book Coercive Control (Oxford University Press 2007), Professor Evan Stark explains how the perpetrator closes down the victim’s opportunities to escape, to communicate or to have access to transport. He talks about the violence used in coercive control being designed to punish, hurt or control the victim: Its effects being cumulative rather than incident-specific, frequently resulting in serious injury or death.

Domestic abuse will impact on every part of the victim’s life. They may feel helpless, frightened hopeless, trapped and isolated, have feelings of guilt over a “failed” relationship. The perpetrator will make them feel responsible for the abuse, show remorse and make promises that they will change .They will minimise the abuse; blame it on stress, alcohol, drugs.

The perpetrators are “master manipulators”, they will try to manipulate family, friends, colleagues, neighbours and any professional that may be involved with the victim / family.

Supporting a victim who has been coercively controlled is most complex and challenging area of work for practitioners in safeguarding, caring and support services. It can be very frightening and upsetting even for the most experienced practitioners. What victims tell us is that they want to be listened, believed, supported and measures to be taken to assure their safety….